Comparing the use of steroid vs artifitial tears following selective laser trabeculoplasty

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Abstract

Purpose

To compare between using potent steroid, mild steroid or just artificial tears following selective laser trabeculoplasty (SLT), and its effect on outcome

Methods

Retrospective file review of all patients underwent SLT in our institute for a year, the data divided into 3 groups: group 1 received Prednisolone acetate 1% ophthalmic suspension ± their glaucoma medications, in the immediate post laser period, group 2 had Fluorometholone eye drops, and group 3 had artificial tears. The rate of complication & outcome was compared between the groups.

Results

215 eyes of 129 patients underwent SLT, from October 2012-October 2013. During the post-laser period, Prednisolone acetate 1% was used in 134 eyes, for 8.79±3.6days (3-14 days), Fluorometholone for 41 eyes for 6.85±2.1 (3-14 days) & 40 patients had neither. Most of the eyes had 360* treatment, half of the patients had DM & 40% had hypertension Pre-SLT intraocular pressure(IOP) in group 1 was 19±6mmHg on 2.4 glaucoma medications, in group 2 19.4±5.4mmHg on 2.4 medications & in group 3 was 21±6.2mmHg on 2.5 medications. The first group treated with 78.6±13.2 shots of 0.56mj per shot, group 2 with 81.1±16.6 shots of 0.59mj, and group 3 with 75.9±15.2 of 0.59mj. The resulted decrease of IOP in the first group was 2.4±5.3mmHg (12.7%), in group 2 was 3.4±4.8mmHg (17.7%) & in the last group was 5.5±6.1mmHg (26.1%). One patient had persistent anterior chamber reaction for more than 2 week, in both eyes, in the first group( that was treated with prednisolone). In the other groups, no eye showed any degree or AC reaction.

Conclusion

The use of steroid had an adverse effect on the result of SLT, while the use of artificial tears post-SLT did not result in increased rate of complication.

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