Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Selective Laser Trabeculoplasty after Failed Trabeculectomy in Open Angle Glaucoma

Brian A. Francis, Vikas Chopra, Brandon Traudt, Julie Enright, Dieter Hertzog, Laurie Dustin and Bryan K. Hong

Objective: To determine the efficacy of selective laser trabeculoplasty (SLT) for uncontrolled open angle glaucoma (OAG) on maximal tolerated medical therapy and with a history of previously failed trabeculectomy.
Methods: This was a prospective, non-randomized, interventional case series. Participants included 22 eyes of 20 consecutive glaucoma patients with a previously failed trabeculectomy and medically uncontrolled intraocular pressure, unable or unwilling to undergo further incisional surgery. A single SLT treatment was performed over 270° to 360°, and participants were followed for a minimum of 12 months. Success was defined in two separate analyses as 1) absolute IOP reduction ≥ 3 mm Hg and 2) percentage IOP reduction of 20% or 15% without additional laser or surgical intervention.
Results: The mean IOP dropped from 20.8 mm Hg to 16.3 mm Hg 12 months after SLT. The mean reduction in IOP was 19.5% or 4.5 mm Hg (95% confidence interval, 1.06-7.92, p<0.001). The cumulative success rate at 12 months (3 mmHg IOP reduction) was 16%. There was no statistically significant change in the number of medications (2.2 ± 0.8 to 2.0 ± 1.1).
Conclusions: In the short- and intermediate-term, SLT had mild to moderate success in achieving lower IOP in individuals with medically uncontrolled OAG with previously failed trabeculectomy.