Long-term Results of Selective Laser Trabeculoplasty versus Latanoprost or Dorzolamide/Timolol Fixed Combination

Jong Hoon Lim; Don Gyung Kim; Seok Ho Cho; Young Jae Hong

doi:10.3341/jkos.2016.57.9.1415

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Lim, Kim, Cho, and Hong: Long-term Results of Selective Laser Trabeculoplasty versus Latanoprost or Dorzolamide/Timolol Fixed Combination

Original Article

J Korean Ophthalmol Soc 2016;57(9):1415-1421.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.9.1415

Long-term Results of Selective Laser Trabeculoplasty versus Latanoprost or Dorzolamide/Timolol Fixed Combination

Jong Hoon Lim, MD, Don Gyung Kim, MD, Seok Ho Cho, MD, Young Jae Hong, MD, PhD

Nune Eye Hospital, Seoul, Korea

Address reprint requests to Young Jae Hong, MD, PhD Nune Eye Hospital, #404 Seolleung-ro, Gangnam-gu, Seoul 06198, Korea Tel: 82-2-2086-7789, Fax: 82-2-2086-7710 E-mail: youngjhong@gmail.com

Received 28 January 2016 Revised 18 May 2016 Accepted 19 August 2016

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 patients treated with either latanoprost or dorzolamide/timolol fixed combination (DTFC) for primary open-angle glaucoma.

Methods

This retrospective study included 92 consecutive patients who underwent a 180-degree SLT for the first time. The subjects divided into two groups:patients who received latanoprost (n = 63) or DTFC (n = 29) before and after SLT. The main outcome measure was intraocular pressure (IOP) decrease over five years after SLT. The mean IOP change, mean percentage of IOP reduction, and success rates were compared between the patients treated with latanoprost and the patients treated with DTFC. Success was defined as an IOP decrease ≥ 3 mm Hg or IOP reduction ≥ 20% without additional medications, laser surgery, or glaucoma surgery.

Results

At the postoperative one-year follow-up, the mean IOP was 15.7 ± 2.2 mm Hg in the latanoprost group and, 16.2 ± 2.4 mm Hg in the DTFC group. At the postoperative five-year follow-up, the mean IOP was 15.1 ± 2.5 mm Hg in the latanoprost group and, 14.6 ± 1.7 mm Hg in the DTFC group. There were no statistically significant differences in IOP change, percentage IOP reduction, or success rate between the groups at each time point after the SLT (p > 0.05).

Conclusions

Selective laser trabeculoplasty showed a reasonable efficacy in lowering the IOP over a five-year follow-up period. There were no significant differences in IOP lowering effect or success rate between the patients treated with latanoprost or DTFC.

Keywords: Dorzolamide/Timolol fixed combination, Intraocular pressure, Latanoprost, Selective laser trabeculoplasty

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Figure 1.

The intraocular pressure (IOP) profile before and after the selective laser trabeculoplasty. The numbers on the graph indicated the p-value at each time point. The p-value was calculated via the Student's t-test. LP = latanoprost; DTFC = dorzolamide/timolol fixed combination.

Figure 2.

The mean change in pressure from the pre-treatment intraocular pressure (PreIOP) for latanoprost (LP) and dorzolamide/timolol fixed combination (DTFC). The numbers on the graph indicated the p-value at each time point. The p-value was calculated via the Student's t-test.

Figure 3.

The Kaplan-Meier chart for latanoprost (LP) and dorzolamide-timolol fixed combination (DTFC) using the definition of success. There were not statistically significant differences between the survival curves in the follow-up period (Logrank test, p ＝ 0.235).

Table 1.

Comparison of the baseline characteristics of the latanoprost and dorzolamide/timolol fixed combination groups

Characteristics	Latanoprost (n = 63)	DTFC (n = 29)	p-value
Age (years)	53.5 ± 12.6	46.9 ± 16.0	0.056^*
Gender (male/female)	27/36	15/14	0.428^†
Right/Left eye	30/33	16/13	0.501^†
Family history of glaucoma (yes/no)	12/51	3/26	0.294^†
Diabetes mellitus (yes/no)	5/58	1/28	0.418^†
Hypertension (yes/no)	20/43	4/25	0.068^†
Lens status (phakic/pseudophakic)	8/55	5/24	0.561^†
Preoperative medication period (months)	15.8 ± 16.8	19.1 ± 20.6	0.420^*
MD (dB)	−9.06 ± 7.77	−9.08 ± 5.38	0.988^*
PSD (dB)	8.13 ± 5.17	8.14 ± 4.44	0.991^*
Vertical C/D ratio	0.76 ± 0.12	0.73 ± 0.14	0.361^*
Average RNFL thickness (μ m)	67.95 ± 16.85	70.17 ± 19.01	0.574^*
CCT (μ m)	553.5 ± 37.6	566.8 ± 40.2	0.130^*
Spherical equivalent (D)	−1.75 ± 3.50	−2.13 ± 2.87	0.618^*
Baseline IOP (mm Hg)	20.2 ± 3.7	20.3 ± 4.5	0.921^*
PreIOP (mm Hg)	17.4 ± 2.5	18.2 ± 2.8	0.182^*
Laser parameters
Number of spots	56.79 ± 3.76	56.95 ± 3.78	0.878^*
Total energy during SLT (mJ)	42.82 ± 3.90	42.43 ± 4.45	0.745^*

Values are presented as mean ± SD unless otherwise indicated.

DTFC = dorzolamide/timolol fixed combination; MD = mean deviation; PSD = pattern standard deviation; C/D ratio = cup/disc ratio

RNFL = retinal nerve fiber layer; CCT = central corneal thickness; IOP = intraocular pressure; PreIOP = pre-treatment IOP; SLT = selective laser trabeculoplasty.

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

^† The p-value wascalculated by Chi-square test.

Table 2.

Mean intraocular pressure at pre-treatment and at various time points up to 5 years

	Latanoprost		p-value^*	DTFC		p-value^*
	Numbers of eyes	Mean IOP (mm Hg)	p-value^*	Numbers of eyes	Mean IOP (mm Hg)	p-value^*
PreIOP	63	17.4 ± 2.5		29	18.2 ± 2.8
1 month	63	14.9 ± 1.8	<0.001	29	15.5 ± 2.2	<0.001
3 months	63	14.9 ± 1.7	<0.001	29	15.2 ± 2.4	<0.001
6 months	63	15.1 ± 1.9	<0.001	29	15.9 ± 2.5	<0.001
1 year	63	15.7 ± 2.2	<0.001	29	16.2 ± 2.4	<0.001
2 years	45	14.8 ± 2.1	<0.001	18	15.3 ± 2.0	<0.001
3 years	32	14.5 ± 2.3	<0.001	16	15.8 ± 2.3	<0.001
4 years	24	14.9 ± 2.0	<0.001	10	15.8 ± 2.1	0.001
5 years	19	15.1 ± 2.5	<0.001	5	14.6 ± 1.7	0.049

Values are presented as mean ± SD unless otherwise indicated.

DTFC = dorzolamide/timolol fixed combination; IOP = intraocular pressure; PreIOP = pre-treatment IOP.

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

Table 3.

Change from the pre-treatment intraocular pressure after the selective laser trabeculoplasty

Time	Latanoprost (mm Hg)	DTFC (mm Hg)	p-value^*
1 month	2.5 ± 1.7	2.7 ± 2.2	0.571
3 months	2.5 ± 1.6	3.0 ± 1.9	0.288
6 months	2.3 ± 1.8	2.3 ± 2.3	0.934
1 year	1.7 ± 1.8	2.0 ± 1.8	0.488
2 years	2.2 ± 1.6	3.3 ± 2.9	0.070
3 years	2.6 ± 1.4	3.0 ± 2.4	0.504
4 years	2.4 ± 1.3	3.6 ± 2.5	0.076
5 years	2.3 ± 1.8	3.8 ± 3.0	0.165

Values are presented as mean ± SD unless otherwise indicated.

DTFC = dorzolamide/timolol fixed combination.

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

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