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SLT followed by phaco in open angle glaucoma patients safe, cost effective
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PHOENIX – Selective laser trabeculoplasty followed by clear cornea phacoemulsification cataract extraction may be a safer and more cost effective approach in open angle glaucoma patients than other glaucoma and cataract patients, a poster study presented here at Academy 2012 found.
Moreover, “it is our finding that selective laser trabeculoplasty followed by cataract extraction is most effective in patients with an IOP greater than 18 mm Hg to 20 mm Hg,” the study authors, led by Dominick Opitz, OD, FAAO, said.
Data on 28 glaucomatous eyes were included in the study. Patients underwent selective laser trabeculoplasty (SLT), then 3 to 5 months later had cataract extraction (CE). IOP data was collected for each of the eyes included in the study once at baseline, twice after SLT and 1 year after CE. The two measurements taken after SLT were averaged together for a more accurate representation of IOP after SLT.
For the overall population, the mean IOP at baseline for all eyes (group 1) was 17.5 mm Hg. After SLT, the study authors observed a 10.28% drop in mean IOP (P = .002) and an additional 12.17% drop after CE (P = .001), resulting in a final mean IOP of 13.8 mm Hg.
For eyes with a baseline IOP of less than 18 mm Hg (group 2; n = 17), the mean baseline IOP was 15.1 mm Hg. Mean IOP dropped 5.09% after SLT in group 2 and an additional 7.94% after CE, resulting in a 12.63% (1.9 mm Hg) total drop in mean IOP from baseline (P = .007).
For eyes with a baseline IOP of greater than 18 mm Hg (group 3; n = 11), the mean baseline IOP was observed at 21.2 mm Hg. SLT reduced this mean IOP by 16.10% from baseline (P = .002), and mean IOP fell an additional 17.39% after CE (P < .001), leveling the mean IOP out at 14.6 mm Hg. The total mean IOP reduction in group 3 from baseline after surgeries was 30.69% or 6.5 mm Hg (P < .001).