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High IOP before ALT predictive of ALT failure

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ORLANDO, Fla. — Glaucoma patients with intraocular pressures greater than 22 mm Hg before undergoing argon laser trabeculoplasty may have a higher risk of ALT failure, according to a poster presented here. Patients with this and other risk factors may warrant earlier intervention with ALT or other glaucoma filtering surgeries, the poster authors suggested.

Manvi Prakash, MD, and colleagues reviewed the records of 458 consecutive patients with primary open-angle glaucoma who underwent ALT. Mean follow-up was 26.9 months. Patients included in the study had uncontrolled IOP despite medical treatment with maximum tolerated IOP-lowering medications.

Of nine risk factors evaluated, the following were statistically significantly associated with ALT failure: an IOP before ALT of greater than 22 mm Hg (P <.0001), systemic hypertension (P =.0006), age over 60 years (P =.0035), and IOP greater than 17 mm Hg 1 hour following ALT.

The poster was presented here at the joint meeting of the American Academy of Ophthalmology and Pan-American Association of Ophthalmology.