ESCRS - PO1059 - Efficacy Of Selective Laser Trabeculoplasty In Phakic And Pseudophakic Eyes In One-Year Follow-Up Retrospective Study.

Efficacy Of Selective Laser Trabeculoplasty In Phakic And Pseudophakic Eyes In One-Year Follow-Up Retrospective Study.

Published 2024 - 42nd Congress of the ESCRS

Reference: PO1059 | Type: Poster | DOI: 10.82333/hxv1-0m41

Authors: Sonja Jandroković 1 , Lorena Karla Šklebar* 1 , Sania Vidas Pauk 2 , Dina Lešin Gaćina 2 , Iva Bešlić 2 , Martin Oroz 1 , Martina Tomić 3

1Department of ophthalmology,University Hospital Centre Zagreb,Zagreb,Croatia;University of Zagreb School of medicine,Zagreb,Croatia, 2Department of ophthalmology,University Hospital Centre Zagreb,Zagreb,Croatia, 3Department of ophthalmology,Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases,Zagreb,Croatia

Purpose

To evaluate the role of pretreatment cataract surgery on the selective laser trabeculoplasty (SLT) outcome in glaucoma patients not sufficiently controlled or intolerant to medical therapy.

Setting

Department of ophthalmology, University Hospital Centre Zagreb, Croatia

Methods

152 eyes (112 phakic, 40 pseudophakic) with different glaucoma types treated by SLT for insufficient IOP control were included in this one-year follow-up retrospective cohort study. Patients received SLT in a standard protocol. Data were recorded on the 0th day (before SLT), one hour, the 1st month, the 3rd month, the 6th month, and one year after SLT. SLT success was defined as an IOP reduction of ≥ 20% after one year without needing further medication, laser, or surgery. Factors associated with success/failure were analyzed using Statistica software version 14.01.

Results

Before SLT, the mean of IOP in phakic eyes was 20.57±4.07 mmHg, and in pseudophakic was 20.78±3.68 mmHg. One year after SLT, the mean IOP in 69 phakic eyes who ended the study decreased insignificantly to 16.98±3.81 mmHg (p=0.178). In contrast, in 20 pseudophakic eyes who completed the study, the mean IOP significantly decreased to 15.50±3.57 mmHg (p=0.002). At one-year post-SLT, the IOP reduction of ≥ 20% was observed in 53.6% of phakic and 70% of pseudophakic eyes. The median and percentage of IOP reduction in the phakic group were 4.5 mmHg and 23.1 %, and in the pseudophakic group 8.0 mmHg and 33.3%. The IOP increase at one-year post-SLT was observed in 11 (15.9%) phakic and 2 (10%) pseudophakic eyes who ended the study. 

Conclusions

Patients with pretreatment cataract surgery and pseudophakic eyes achieved better results of SLT as an add-on treatment for insufficiently controlled glaucoma or intolerant to medical therapy. This indicates that cataract surgery followed by SLT could be an efficient therapy combination for phacic patients with sufficiently controlled IOP on medical therapy, with aim of discontinuing all medical therapy.  Further research should be conducted to investigate whether all patients with initial or barely immature cataracts and uncontrolled glaucoma should first undergo cataract surgery and then SLT.