Posters

Selective laser trabeculoplasty as first line treatment for primary open-angle glaucoma and ocular hypertension

Poster Details

First Author: M. Ratwatte UK

Co Author(s): J. Than   R. Bourne                 

Abstract Details

Purpose:

The purpose of this retrospective observational study is to analyse the efficacy of Selective Laser Trabeculoplasty (SLT) as a first line treatment for primary open angle glaucoma and ocular hypertension. Medical treatment in the form of eye drops (e.g. prostaglandin analogues, beta-blockers, carbonic anhydrase inhibitors) is considered traditional first line therapy, although evidence increasingly shows SLT to be an effective therapy in controlling intra-ocular pressure (IOP). This study attempted to establish whether the Eye Department at Hinchingbrooke Hospital was achieving a mean IOP drop after primary SLT treatment comparable to previously published literature.

Setting:

Eye Department at Hinchingbrooke Hospital, Huntingdon; a regional district general hospital in the UK serving a population size of approximately 160,000 people.

Methods:

Medisoft Ophthalmology software (Medisoft Ltd., Leeds, UK) was used to audit the records of 64 patients (103 eyes) who had undergone SLT at Hinchingbrooke Hospital between July 2013 and November 2014 as primary treatment for primary open angle glaucoma or ocular hypertension. Age, gender, primary diagnosis, SLT procedure details, visual acuity pre-SLT, IOP at 2 weeks, IOP at 2 month follow up and IOP at 6 month follow up were recorded. Cox proportional hazard regression analysis was used to identify potential risk factors for failure of SLT treatment, defined as IOP exceeding 16 or 21 in separate analyses.

Results:

Mean IOP across all 103 eyes prior to first SLT treatment was 19.9mmHg. Mean IOP at 2 week follow up was 15.6 mmHg (21.6% reduction). Mean IOP at 2 month follow up was 16.2 mmHg (18.6% reduction). Mean IOP at 6 month follow up was 14.5 mmHg (27.1% reduction). SLT was shown to be effective in reducing IOP and maintaining this reduction through 6 months post-procedure. Lens status, pre-treatment IOP and IOP at 2 week follow up post-treatment were found to be statistically significant factors in predicting treatment success.

Conclusions:

There are several advantages to SLT treatment over eye drops, including fewer issues with patient compliance. A 27.1% reduction in mean IOP over 6 months is comparable to that of other studies but measured at the 1 year follow up period. This confirms the effectiveness of SLT as a first line treatment in patients with primary open angle glaucoma and ocular hypertension.

Financial Disclosure:

None