Comparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months

Comparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months

Matthew T Hirabayashi,1 Trevor L Rosenlof,1,2 Jella A An1,21University of Missouri Columbia School of Medicine, Columbia, MO, USA; 2Mason Eye Institute, Department of Ophthalmology, University of Missouri, Columbia, MO, USAPurpose: To identify and compare factors predictive of successful outcome for...

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Autores principales: Hirabayashi MT, Rosenlof TL, An JA
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2019
Materias:
glaucoma
intraocular pressure
ocular hypertension
MLT
SLT
POAG
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/39071bb64acd45b491cfd690bbe9b41b
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spelling oai:doaj.org-article:39071bb64acd45b491cfd690bbe9b41b2021-12-02T04:16:40ZComparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months1177-5483https://doaj.org/article/39071bb64acd45b491cfd690bbe9b41b2019-06-01T00:00:00Zhttps://www.dovepress.com/comparison-of-successful-outcome-predictors-for-micropulsereg-laser-tr-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Matthew T Hirabayashi,1 Trevor L Rosenlof,1,2 Jella A An1,21University of Missouri Columbia School of Medicine, Columbia, MO, USA; 2Mason Eye Institute, Department of Ophthalmology, University of Missouri, Columbia, MO, USAPurpose: To identify and compare factors predictive of successful outcome for MicroPulse® laser trabeculoplasty (MLT) and selective laser trabeculoplasty (SLT).Methods: 50 MLT-treated eyes and 50 SLT-treated eyes of open-angle glaucoma patients were reviewed for baseline characteristics, pre- and postoperative IOP and medications, and adverse events including postoperative IOP elevation >5 mmHg (IOP spikes) through 6 months of follow-up. Success was defined as ≥20% IOP reduction or ≥1 medication reduction without additional IOP lowering procedures at 6 months follow-up.Results: MLT and SLT had similar success rates (44% vs 40%, P=0.983). Older age predicted success for SLT (P=0.013) but not MLT (P=0.154). Both MLT and SLT led to greater IOP lowering in patients with baseline IOP >18 mmHg, but only for SLT did baseline IOP have a significant association with success (P=0.035 vs P=0.983). Number of laser shots was associated with success in MLT (P=0.031) but not in SLT (P=0.970). Glaucoma severity and pigmentation of the trabecular meshwork (PTM) were not associated with rate of success for either group. The rate of IOP spikes was significantly (P=0.022) higher in the SLT group (10%) compared to none in the MLT group. No other complications or visually significant adverse events occurred in either group.Conclusion: Although MLT and SLT resulted in similar success rates, older age and higher baseline IOP predicted success for SLT while MLT was equally efficacious regardless of these factors. Glaucoma severity and PTM were not associated with success of either laser procedures. 10% of SLT patients experienced IOP spike post procedure, whereas none in the MLT group did. MLT may be a safer alternative to SLT that is effective in lowering IOP and need for medications for a wider variety of patients with open angle glaucoma.Keywords: glaucoma, intraocular pressure, ocular hypertension, MLT, SLT, POAGHirabayashi MTRosenlof TLAn JADove Medical Pressarticleglaucomaintraocular pressureocular hypertensionMLTSLTPOAGOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1001-1009 (2019)
institution DOAJ
collection DOAJ
language EN
topic glaucoma
intraocular pressure
ocular hypertension
MLT
SLT
POAG
Ophthalmology
RE1-994
spellingShingle glaucoma
intraocular pressure
ocular hypertension
MLT
SLT
POAG
Ophthalmology
RE1-994
Hirabayashi MT
Rosenlof TL
An JA
Comparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months
description Matthew T Hirabayashi,1 Trevor L Rosenlof,1,2 Jella A An1,21University of Missouri Columbia School of Medicine, Columbia, MO, USA; 2Mason Eye Institute, Department of Ophthalmology, University of Missouri, Columbia, MO, USAPurpose: To identify and compare factors predictive of successful outcome for MicroPulse® laser trabeculoplasty (MLT) and selective laser trabeculoplasty (SLT).Methods: 50 MLT-treated eyes and 50 SLT-treated eyes of open-angle glaucoma patients were reviewed for baseline characteristics, pre- and postoperative IOP and medications, and adverse events including postoperative IOP elevation >5 mmHg (IOP spikes) through 6 months of follow-up. Success was defined as ≥20% IOP reduction or ≥1 medication reduction without additional IOP lowering procedures at 6 months follow-up.Results: MLT and SLT had similar success rates (44% vs 40%, P=0.983). Older age predicted success for SLT (P=0.013) but not MLT (P=0.154). Both MLT and SLT led to greater IOP lowering in patients with baseline IOP >18 mmHg, but only for SLT did baseline IOP have a significant association with success (P=0.035 vs P=0.983). Number of laser shots was associated with success in MLT (P=0.031) but not in SLT (P=0.970). Glaucoma severity and pigmentation of the trabecular meshwork (PTM) were not associated with rate of success for either group. The rate of IOP spikes was significantly (P=0.022) higher in the SLT group (10%) compared to none in the MLT group. No other complications or visually significant adverse events occurred in either group.Conclusion: Although MLT and SLT resulted in similar success rates, older age and higher baseline IOP predicted success for SLT while MLT was equally efficacious regardless of these factors. Glaucoma severity and PTM were not associated with success of either laser procedures. 10% of SLT patients experienced IOP spike post procedure, whereas none in the MLT group did. MLT may be a safer alternative to SLT that is effective in lowering IOP and need for medications for a wider variety of patients with open angle glaucoma.Keywords: glaucoma, intraocular pressure, ocular hypertension, MLT, SLT, POAG
format article
author Hirabayashi MT
Rosenlof TL
An JA
author_facet Hirabayashi MT
Rosenlof TL
An JA
author_sort Hirabayashi MT
title Comparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months
title_short Comparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months
title_full Comparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months
title_fullStr Comparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months
title_full_unstemmed Comparison of successful outcome predictors for MicroPulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months
title_sort comparison of successful outcome predictors for micropulse® laser trabeculoplasty and selective laser trabeculoplasty at 6 months
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/39071bb64acd45b491cfd690bbe9b41b
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AT rosenloftl comparisonofsuccessfuloutcomepredictorsformicropulsereglasertrabeculoplastyandselectivelasertrabeculoplastyat6months
AT anja comparisonofsuccessfuloutcomepredictorsformicropulsereglasertrabeculoplastyandselectivelasertrabeculoplastyat6months
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