Effect of Prior Cataract Surgery on the Clinical Outcome of Selective Laser Trabeculoplasty

Hyun Ju Park; Jong Woon Park

doi:10.3341/jkos.2015.56.6.911

Journal List > J Korean Ophthalmol Soc > v.56(6) > 1010305

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Park and Park: Effect of Prior Cataract Surgery on the Clinical Outcome of Selective Laser Trabeculoplasty

Original Article

J Korean Ophthalmol Soc 2015;56(6):911-916.

Published online: 7 September 2015

DOI: https://doi.org/10.3341/jkos.2015.56.6.911

Effect of Prior Cataract Surgery on the Clinical Outcome of Selective Laser Trabeculoplasty

Hyun Ju Park, MD^1,², Jong Woon Park, MD²

¹Department of Ophthalmology, Yonsei University College of Medicine¹, Seoul, Korea

²Department of Ophthalmology, National Health Insurance Service Ilsan Hospital², Goyang, Korea

Address reprint requests to Jong Woon Park, MD Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, #100 Ilsan-ro, Ilsandong-gu, Goyang 410-719, Korea, Tel: 82-31-900-0590, Fax: 82-31-900-0049 E-mail: unij413@naver.com

Received 5 July 201422 December 2014 Accepted 20 April 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the efficacy of selective laser trabeculoplasty (SLT) in phakic and pseudophakic eyes in primary open-an-gle glaucoma.

Methods

Charts of 55 phakic eyes and 24 pseudophakic eyes that underwent 360-degree SLT were retrospectively reviewed. Intraocular pressure (IOP) was measured before SLT and 1 week, 1, 3, 6, 9, 12, 18 and 24 months after SLT. Treatment success was defined as IOP reduction ≥ 20% without additional medications, laser or glaucoma surgery. Mean IOP change, mean percentage of IOP reduction and success rates of phakic and pseudophakic eyes were compared.

Results

Mean percentage of IOP reduction after SLT at 1 week and 1, 3, 6, 9, 12, 18, and 24 months were 18.8%, 23.9%, 24.6%, 23.3%, 24.0%, 22.1%, 20.8%, and 17.9%, respectively, in the phakic group and 15.7%, 22.3%, 23.7%, 25.3%, 25.6%, 25.2%, 21.9%, and 19.3%, respectively, in the pseudophakic group. Success rates were 57.6 ± 11.9% in the phakic group and 61.3 ± 10.4% in the pseudophakic group. No statistically significant differences in IOP change, percentage of IOP reduction, and success rates were observed between the groups at each time point after SLT (p > 0.05).

Conclusions

Application of 360-degree SLT appears an efficient treatment option for the management of phakic and pseudophakic open-angle glaucoma. Evaluating the success of SLT 1 month postoperatively may be premature.

Keywords: Cataract surgery, Intraocular pressure reduction, Primary open angle glaucoma, Selective laser trabeculoplasty

References

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Figure 1.

Mean IOP after selective laser trabeculoplasty for phakic and pseudophakic eyes. The numbers on graph indicates p-value at each time point. IOP ＝ indicates intraocular pressure.

Figure 2.

Mean percentage decrease in IOP from baseline for pseudophakic and phakic eyes. The numbers on graph indicates p-value at each time point. IOP ＝ indicates intraocular pressure.

Figure 3.

Success rate (≥ 20% intraocular pressure decrease) for phakic and pseudophakic eyes. The numbers on graph indicates p-value at each time point.

Figure 4.

In the Kaplan-Meier chart for phakic and pseudophakic eyes using the definition of success, the course of the curves was dispersed. There were not statistically significant differences between the survival curves in the follow-up period (log-rank test, p＝0.933).

Table 1.

Patient demographics at baseline

Characteristics	Phakic	Pseudophakic	p-value
Age (year)	65.0 ± 12.2	66.9 ± 11.6	0.52^*
Female	22 (40.0)	7 (29.2)	0.51^†
Right eye	30 (54.5)	11 (45.8)	0.64^†
No. of medications
1	6 (10.9)	2 (8.3)	0.72^†
2	15 (27.3)	4 (16.7)	0.40^†
3	21 (39.8)	9 (37.5)	0.91^†
4	15 (27.3)	11 (45.8)	0.11^†
Type of medications
Prostaglandin analogue	53 (96.4)	23 (95.8)	0.99^†
β-blocker	28 (50.9)	17 (70.8)	0.10^†
Carbonic anhydrase inhibitor	49 (89.1)	20 (83.3)	0.48^†
α-2 adrenergic agonist	23 (51.1)	13 (54.2)	0.81^†

Values are presented as mean ± SD or n (%) unless otherwise indicated.

^* The p-value was calculated by Student t-test

^† The p-value was calculated by Chi-square test.

Table 2.

Change from baseline intraocular pressure (mm Hg) after selective laser trabeculoplasty

Time	Phakic	Pseudophakic	p-value^*
1 week	4.42 ± 5.59	4.62 ± 5.07	0.88
1 month	5.78 ± 4.77	4.40 ± 5.55	0.30
3 months	5.85 ± 4.52	6.32 ± 6.33	0.74
6 months	5.49 ± 5.32	5.69 ± 8.07	0.91
9 months	5.57 ± 6.25	7.00 ± 6.86	0.48
12 months	4.75 ± 4.70	7.00 ± 5.72	0.19
18 months	4.41 ± 3.12	5.00 ± 4.08	0.70
24 months	3.56 ± 4.36	4.75 ± 7.50	0.72

Values are presented as mean ± SD.

^* The p-value was calculated by Student t-test.

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