The Effect of Selective Laser Trabeculoplasty on Intraocular Pressure in Patients With Intravitreal Steroid-induced Elevated Intraocular Pressure

    loading  Checking for direct PDF access through Ovid

Abstract

Purpose

To assess effectiveness of selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in patients with steroid-induced elevated IOP.

Methods

Retrospective review of 7 patients (7 eyes) with IOP elevation after intravitreal triamcinolone acetonide (4.0 mg/0.1 mL) injections for macular edema (6 patients) or central retinal vein occlusion (1 patient). Three patients had preexisting open angle glaucoma; 2 patients had preexisting ocular hypertension. Time between intraocular corticosteroid injection and subsequent increased IOP ranged from 5 to 29 weeks. After unsuccessful maximum tolerated medical therapy, patients underwent unilateral SLT between April 2003 and June 2005. IOP was measured 4 weeks prelaser; on the day of laser; within 3 weeks, and at 1, 3, and 6 months postlaser. Two-sample t test was used for analysis.

Results

The pre-SLT and post-SLT IOP measurements were the major outcome measures used to define the relative success of the SLT procedure. Seven patients were taking 4.0±0.8 ocular hypotensive medications before SLT. Preoperative IOP (mm Hg±SD) 38.4±7.3 decreased postoperative to 25.6±7.1 within 3 weeks (P<0.003), 25.9±8.8 at 1 month (P<0.007), 23.9±10.6 at 3 months (P<0.006), and 15.7±2.2 at 6 months (P<0.001). Four patients underwent a second SLT procedure. Two patients failed after the 3-month visit. IOP in fellow eyes of all patients was unchanged (P>0.080).

Conclusions

SLT lowered (P<0.007) IOP in 5 eyes of 7 patients with steroid-induced increased IOP from 3 weeks to 6 months postoperative. Two patients required additional surgical procedures. Repeat SLT treatments may be necessary. SLT is a temporizing procedure to consider in patients with steroid-induced elevated IOP.

Related Topics

    loading  Loading Related Articles