Factors Associated With Favorable Laser Trabeculoplasty Response: IRIS Registry Analysis

Factors Associated With Laser Trabeculoplasty Response Duration: Analysis of a Large Clinical Database (IRIS Registry)

“…The main reasons of exclusion were: no pre-LTP IOP recorded (34.6%), no baseline visual acuity (24.6%), no laterality specified (16.6%), and no sufficient IOP measurements for baseline (12.0%). There were 117,477 eyes categorized as “response-unknown” (excluded from present analysis) and 166,332 categorized as “nonresponders” (excluded form present analysis) and 97,148 (36.9%) were categorized as “responders.” 18 From the responder cohort, we included only the first treated eye (if both eyes were treated on different dates) or a randomly selected eye (if both eyes treated on the same date), as well as all unilaterally treated eyes, which resulted in the 79,332 patients/eyes included in the present analysis.…”

“…In contrast, our survival analysis included only patients who had initially responded with adequate IOP reduction, such that the “nonresponders” that were excluded from our study would have been counted as “failures” by prior studies. 18 Furthermore, since the goal of our study was to assess the longevity of the LTP treatment effect, rather than the ability of LTP to stave off the addition of medications (which can occur despite a 20% or more IOP reduction from LTP), the addition of IOP-lowering medications after LTP treatment was a censoring rather than a failure event. This strategy perhaps better reflects the therapeutic effect of LTP in the context of medication confounders, although it limits the prognostic value of LTP in delaying additional IOP-lowering medication and/or procedures.…”

“…Multiple publications in high-impact journals using the IRIS Registry and similar registries has established this mode of research as relevant and impactful. 15 – 18 , 30 Nevertheless, clinicians should recognized the limitations of such registries, as information, selection and confounding biases are possible. 31 …”

“…(1) Current Procedural Terminology (CPT) code for LTP (65855); (2) All entries between January 1, 2013 and August 31, 2019; (3) Eyes with a glaucoma or glaucoma suspect diagnosis (Supplemental Table 1, Supplemental Digital Content 1, http://links.lww.com/IJG/A575 ) 18 not excluded below.…”

“…An analysis of factors associated with responders versus nonresponderes was reported previously. 18 Only responders were included in the present analysis.…”