Comparison of intraocular pressure reduction of initial and adjunct selective laser trabeculoplasty for primary open angle glaucoma in Nigerians

Abstract

Objective: The objective was to compare the intraocular pressure (IOP) lowering effect of selective laser trabeculoplasty (SLT) as initial and adjunct therapy in primary open angle glaucoma (POAG).

Subjects and Methods: Retrospective chart review of POAG patients who had SLT either as initial or adjunct therapy over a period of 1‑year. Each patient had SLT done in 360° of the anterior chamber angle. IOP measurement with the Goldmann applanation tonometer was done at baseline, 60 min post procedure, days 1, 7, 30, 90, and 180.

Results: Mean baseline IOP was 15.4 ± 3.5 mmHg and 17.5 ± 5.5 mmHg for initial and adjunct, respectively (P = 0.153); not significant. Mean IOP at 90 days was 10.5 ± 1.8 mmHg and 16.2 ± 6.3 mmHg for initial and adjunct, respectively (P = 0.013); statistically significant. Records at 180 days revealed mean IOP of 14.1 ± 3.9 mmHg and 15.7 ± 7.7 mmHg (P = 0.465) for initial and adjunct, respectively; not significant. The maximal mean IOP reduction in both groups was at 7 days. 70% of patients in the initial had IOP reduction of >20% compared to 63.5% of adjuncts throughout the study period. Initial sustained mean reduction of ≥3 mmHg from day 1 to 90, while the adjunct was till day 30.

Conclusion: Initial SLT showed a sustained reduction in IOP, compared to adjunct with marginally lower measurements.

Keywords: Adjunct, initial, primary open angle glaucoma, selective laser trabeculoplasty