The Effect of Selective Laser Trabeculoplasty on Intraocular Pressure in Patients With Intravitreal Steroid-induced Elevated Intraocular Pressure

Abstract

SLT lowered (P<0.007) IOP in 5 eyes of 7 patients with steroid-induced increased IOP from 3 weeks to 6 months postoperative. Two patients required additional surgical procedures. Repeat SLT treatments may be necessary. SLT is a temporizing procedure to consider in patients with steroid-induced elevated IOP.

Steroid eye drop treatment (difluprednate ophthalmic emulsion) is effective in reducing refractory diabetic macular edema

“…The rate of improvement did not differ between the two groups. Intraocular pressure increased above 25 mmHg in 18% of eyes in the STTA group and 36% of eyes in the eye drop group, but was controllable with instillation of ocular hypotensive agents(eye drop group) or SLT (STTA group) [14]. Infection or cataract progression was not observed in any eyes.…”

Steroid-Induced Iatrogenic Glaucoma

“…Rubin et al [138] In another study, SLT was performed on 4 patients under 47 years with elevated IOP after a sub-Tenon injection of triamcinolone acetonide which could not be maintained within normal limits by antiglaucoma medications. In 3 eyes, the mean IOP before the SLT was 28.7 mm Hg and the postoperative mean IOP was 15.3 mm Hg at 6 months without antiglaucoma medications.…”

“…An implant with a smaller plate size, such as the Ahmed implant, is probably less likely to cause chronic hypotony in patients with uveitis and steroid implants [106] . In patients with IVTA and high IOP, Ahmed valve implantation has proven to be effective [39,138] .…”

Selective Laser Trabeculoplasty

“…SLT has been shown to effectively reduce intraocular pressure in patients with intravitreal and subtenon triamcinolone acetonide-induced intraocular pressure elevation (Baser & Seymenoglu, 2009;Pizzimenti, Nickerson, Pizzimenti, & Kasten-Aker, 2006;Rubin, Taglienti, Rothman, Marcus, & Serle, 2008;Yuki et al, 2010). However the role of SLT in post-steroid hypertension is still controversial due to the fact that it is non clear whether the lowering effect is more attributable to SLT or to the physiological drug wash out.…”