SLT and Adjunctive Medical Therapy

Abstract

Topical medications do not adversely, nor favorably, affect SLT success. SLT efficacy is positively associated with the degree of IOP elevation before SLT treatment. Pigmentation of the anterior chamber angle, class of antiglaucoma medications, diabetes, sex, corneal thickness, pseudophakia, diagnosis, washout of eye drops, and previous argon laser trabeculoplasty treatment are not associated with SLT treatment efficacy.

Treatment Outcomes and Prognostic Factors of Selective Laser Trabeculoplasty for Open-angle Glaucoma Receiving Maximal-tolerable Medical Therapy

“…4,8,11 Difference in treatment outcomes between those studies and the current study may be partly explained by exclusion of advanced cases 4 or use of paired analysis of before versus after treatment instead of cumulative survival analysis 8,11 in previous studies. Some studies also potentially show better outcomes due to restrictions in study protocols such as washout of medications and enrollment criteria limited to patients without any prior glaucoma treatment.…”

“…However, only a few of those factors such as preoperative IOP and preoperative medication were significantly correlated with the success of SLT. 11,12 And the results were not consistent among studies. This suggests the need for further studies to establish the prognostic factors for success after SLT.…”

“…However, the direction of correlation is inconsistent: higher IOP was associated with treatment success in most of previous studies, whereas higher IOP was associated with failure in this study. 11,12,21,22 Only 1 previous study from Japan demonstrated correlation between lower IOP and success of SLT. 23 One possible reason for inconsistency in effects of preoperative IOP among studies is racial difference.…”

“…In some studies, reported success ratio of SLT was relatively favorable (59.7% to 89%). 4,[8][9][10][11] Other studies, however, reported far worse outcomes. 12,13 This large variability in the success ratio suggests that the efficacy of SLT may be greatly influenced by various factors, and underlines the importance of identifying the predictors for success of SLT to determine the optimal indication for the treatment.…”

Wirksamkeit der selektiven Lasertrabekuloplastik bei Patienten mit unzureichender Augendrucksenkung unter maximaler Therapie

“…Es wurde nachgewiesen, dass die SLT eine effektive Therapie in Ergänzung zu topischer antiglaukomatöser Therapie ist [23]. Es wird allerdings postuliert, dass Prostaglandinprä-parate einen negativen Einfluss auf die Wirksamkeit der SLT haben könnten, da für SLT und Prostaglandine (PG) ein ähnlicher Mechanismus in der drucksenkenden Wirkung vermutet wird [11].…”