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SLT monotherapy a viable option for underserved Caribbean glaucoma patients
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 Anthony D. Realini |
NEW YORK — In an epidemiologic study conducted in St. Lucia among a population with a high glaucoma prevalence, selective laser trabeculoplasty was found to lower IOP by an amount that would reasonably be expected to alter the clinical course of the disease, a speaker said here.
"SLT has the potential to bend the blindness curve in this population," Anthony D. Realini, MD, said at the American Glaucoma Society annual meeting.
The study included 61 patients with glaucoma from a population of 100% African descent with a nearly 9% incidence of glaucoma among people older than 30 years.
Dr. Realini reported that SLT significantly decreased IOP in this medically underserved population for whom medications are not affordable and surgical opportunities are limited.
"Of the 46 out of 61 patients who were controlled at 12 months — definition of control: 10% or more IOP reduction — 90% had a 20% or greater IOP reduction 12 months after SLT on no medications," he said.
Patients were older than 40 years and had non-advanced glaucoma controlled on one medication. Preoperatively, all patients were washed out of IOP-lowering therapy for 30 days. On the day of laser therapy, baseline IOP was measured twice at a 1-hour interval, and bilateral 360° SLT was done in one sitting. Assessments were done 1 hour, 1 week, and 1, 3, 6, 9 and 12 months after treatment. All IOP measurements were taken by the same examiner using the same tonometer at the same time of day.
The rationale for trabeculoplasty in this population is that the procedure is essentially "fire and forget," Dr. Realini said. There is no need for postoperative care or daily medical therapy, and SLT is portable, incrementally inexpensive and may be repeatable, he said.
- Disclosure: Dr. Realini has no relevant financial disclosures.