Effectiveness of Selective Laser Trabeculoplasty Applied to 360° vs. 180° of the Angle

Abraham Nirappel; Emma Klug; Rebecca Ye; Nathan Hall; Marika Chachanidze; Ta C Chang; David Solá-Del Valle

doi:10.1155/2021/8860601

Effectiveness of Selective Laser Trabeculoplasty Applied to 360° vs. 180° of the Angle

J Ophthalmol. 2021 Feb 16:2021:8860601. doi: 10.1155/2021/8860601. eCollection 2021.

Authors

Abraham Nirappel¹, Emma Klug², Rebecca Ye², Nathan Hall², Marika Chachanidze², Ta C Chang³, David Solá-Del Valle²

Affiliations

¹ Case Western Reserve University School of Medicine, Cleveland, OH, USA.
² Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
³ Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.

Abstract

Purpose: To compare the effectiveness and safety of 360° and 180° of Selective Laser Trabeculoplasty (SLT) for the treatment of elevated intraocular pressure (IOP).

Methods: Retrospective cohort study. The main outcome measure was the Kaplan-Meier analysis comparing the cumulative probabilities of survival between the 360° and 180° SLT groups in terms of IOP reduction. Success was defined as ≥20% IOP reduction from baseline with an IOP between 5-18 mmHg and ≤1 glaucoma medication added postoperatively. Additional outcome measures included changes in average IOP, number of glaucoma medications, and the incidence of postoperative IOP spikes. Measurements were obtained at 6 weeks, 1 year, and 2 years postoperatively.

Results: Two hundred and fifty-eight eyes of 258 patients were included in the 360° group, and 196 eyes of 196 patients were included in the 180° group. The mean IOP reductions at 2 years were 2.21 ± 2.02 mmHg and 2.43 ± 1.81 mmHg (p=0.33) in the 180° and 360° groups, respectively. There were no significant differences in the incidence of postoperative IOP spikes between the two groups. There was a significant difference in the survival curves of the two groups (p=0.035). The Cox proportional-hazard model indicated that 360° of SLT application was a significant predictor of long-term success (p=0.030).

Conclusions: 360° of SLT application seems to provide for greater long-term IOP control than 180° of application without putting patients at an elevated risk for postoperative IOP spikes.