Repeat SLT safely lowers IOP after initial laser therapy fails

J Glaucoma. 2009;18(3):180-183.

Performing selective laser trabeculoplasty a second time after an initially successful laser treatment lost efficacy appears to be an effective way of continuing to lower pressure, a study found.

The retrospective chart review looked at 44 eyes of 35 patients, 18 years and older, with primary open-angle, pseudoexfoliation or pigmentary glaucoma. Patients in the study had uncontrolled glaucoma with maximum tolerated medical therapy. They underwent initial 360° SLT, which was successful for 6 months or more, with a gradual loss in effectiveness.

All patients in the study underwent a second SLT procedure.

Success was defined as 20% or more peak IOP reduction. Within that definition, success rates for first and second SLT treatment were not statistically significantly different. Patients also showed no significant difference when receiving a second SLT treatment either 6 to 12 months after initial SLT treatment or 12 months or more after the initial treatment.

"Reduction in IOP after [first SLT surgery] and [second SLT surgery] was significantly less with repeat treatment at 1 to 3 months, with average decreases of –5 mm Hg and –2.9 mm Hg, respectively (P = .01), but there were no statistically significant differences between treatments at the other equivalent time points," the study authors said.