Journal of Current Glaucoma Practice

Register      Login

VOLUME 16 , ISSUE 1 ( January-April, 2022 ) > List of Articles

ORIGINAL RESEARCH

Consensual Ophthalmotonic Reaction Following Selective Laser Trabeculoplasty

Nariman Nassiri, Frank Mei, Hassan Tokko, John Zeiter, Sarah Syeda, Chaesik Kim, Ronald Swendris, Anju Goyal, Elise In\'T Veld, Alma Mas-Ramirez, Sonia W Rana, Mark S Juzych, Bret A Hughes

Keywords : Consensual ophthalmotonic reaction, Glaucoma treatment, Intraocular pressure, Retrospective study, Selective laser trabeculoplasty

Citation Information : Nassiri N, Mei F, Tokko H, Zeiter J, Syeda S, Kim C, Swendris R, Goyal A, Veld EI, Mas-Ramirez A, Rana SW, Juzych MS, Hughes BA. Consensual Ophthalmotonic Reaction Following Selective Laser Trabeculoplasty. J Curr Glaucoma Pract 2022; 16 (1):36-40.

DOI: 10.5005/jp-journals-10078-1361

License: CC BY-NC 4.0

Published Online: 03-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: “Consensual ophthalmotonic reaction” refers to changes in intraocular pressure (IOP) in one eye, which is accompanied by a corresponding change in IOP in the contralateral eye. This study evaluates whether monocular administration of selective laser trabeculoplasty (SLT) leads to a consensual ophthalmotonic reaction and how long this effect lasts. Materials and methods: A retrospective chart review was performed on patients receiving SLT at Kresge Eye Institute in Detroit, MI, from January 2015 to August 2016. Patients were excluded if they had previous history of glaucoma incisional and/or laser procedures; required additional laser trabeculoplasty; had glaucoma medication changes during the follow-up period; experienced no decrease in IOP during the follow-up period; or had a diagnosis of angle closure on gonioscopy. Various demographic, clinical, and surgical data were collected. IOP measurements were collected at baseline and postoperatively at 1–3 months, 4–9 months, and 12–15 months. Results: At all follow-up periods, the IOP of the treated eye was decreased from baseline IOP (p ≤ 0.05, paired t-test). For the fellow eye, there was a statistically significantly decrease from baseline up to the 4–9 months follow-up period (p ≤ 0.05, paired t-test). Linear regression analysis of the percent reduction in IOP from baseline in the SLT-treated eye with the fellow eye shows a mild correlation at all-time points: R2 = 0.284 (p < 0.001) at 1–3 months; R2 = 0.348 (p < 0.001) at 4–9 months; R2 = 0.118 (p = 0.054) at 12–15 months. Conclusion: This study showed that monocular administration of SLT results in a consensual ophthalmotonic reaction. The consensual ophthalmotonic reaction appears to last for up to 4–9 months. Clinical significance: Therefore, although SLT does lead to a consensual ophthalmotonic reaction, monocular administration of SLT is not a reliable method of long-term IOP control for the contralateral non-SLT-treated eye.


PDF Share
  1. Weekers L. Modifications experimentales de l'ophtalmotonus. Reaction ophtalmotonique consensuelle. Arch Ophtalmol (Paris) 1924;41: 641–658. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.879.7259&rep=rep1&type=pdf
  2. Gibbens MV. The consensual ophthalmotonic reaction. Br J Ophthalmol 1988;72(10):746–749. DOI: 10.1136/bjo.72.10.746
  3. Piltz J, Gross R, Shin DH, et al. Contralateral effect of topical beta-adrenergic antagonists in initial one-eyed trials in the ocular hypertension treatment study. Am J Ophthalmol 2000;130(4):441–453. DOI: 10.1016/s0002-9394(00)00527-4
  4. Saari KM, Ali-Melkkila T, Vuori ML, et al. Absorption of ocular timolol: drug concentrations and beta-receptor binding activity in the aqueous humour of the treated and contralateral eye. Acta Ophthalmol (Copenh) 1993;71(5):671–676. DOI: 10.1111/j.1755-3768.1993.tb04659.x
  5. Newman H, Kurtz S, David R. Intraocular pressure changes in the contralateral eye after topical treatment: does an “ophthalmotonic consensual reaction” exist? Isr Med Assoc J 2010;12(9):568–571. https://www.ima.org.il/FilesUploadPublic/IMAJ/0/40/20185.pdf
  6. Rouland JF, Morel-Mandrino P, Elena PP, et al. Timolol 0.1% gel (Nyogel 0.1%) once daily versus conventional timolol 0.5% solution twice daily: a comparison of efficacy and safety. Ophthalmologica 2002;216(6):449–454. DOI: 10.1159/000067548[published Online First: Epub Date]|.
  7. Van Buskirk EM. Pathophysiology of laser trabeculoplasty. Surv Ophthalmol 1989;33(4):264–272. DOI: 10.1016/0039-6257(82)90152-7
  8. Kagan DB, Gorfinkel NS, Hutnik CM. Mechanisms of selective laser trabeculoplasty: a review. Clin Exp Ophthalmol 2014;42(7):675–681. DOI: 10.1111/ceo.12281[published Online First: Epub Date]|.
  9. Latina MA, Park C. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions. Exp Eye Res 1995;60(4):359–371. DOI: 10.1016/s0014-4835(05)80093-4
  10. Rachmiel R, Trope GE, Chipman ML, et al. Laser trabeculoplasty trends with the introduction of new medical treatments and selective laser trabeculoplasty. J Glaucoma 2006;15(4):306–309. DOI: 10.1097/01.ijg.0000212233.11287.b3[published Online First: Epub Date]|.
  11. Francis BA, Ianchulev T, Schofield JK, et al. Selective laser trabeculoplasty as a replacement for medical therapy in open-angle glaucoma. Am J Ophthalmol 2005;140(3):524–525. DOI: 10.1016/j.ajo.2005.02.047[published Online First: Epub Date]|.
  12. Vysniauskiene I, Shaarawy T, Flammer J, et al. Intraocular pressure changes in the contralateral eye after trabeculectomy with mitomycin C. Br J Ophthalmol 2005;89(7):809–811. DOI: 10.1136/bjo.2004.050294[published Online First: Epub Date]|.
  13. Stocker FW. On changes in intraocular pressure after application of the tonometer; in the same eye and in the other eye. Am J Ophthalmol 1958;45(2):192–196. DOI: 10.1016/0002-9394(58)90643-3
  14. Latina MA, Sibayan SA, Shin DH, et al. Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology 1998;105(11):2082–2090. DOI: 10.1016/S0161-6420(98)91129-0
  15. Rhodes KM, Weinstein R, Saltzmann RM, et al. Intraocular pressure reduction in the untreated fellow eye after selective laser trabeculoplasty. Curr Med Res Opin 2009;25(3):787–796. DOI: 10.1185/03007990902728316[published Online First: Epub Date]|.
  16. McIlraith I, Strasfeld M, Colev G, et al. Selective laser trabeculoplasty as initial and adjunctive treatment for open-angle glaucoma. J Glaucoma 2006;15(2):124–130. DOI: 10.1097/00061198-200604000-00009
  17. Juzych MS, Chopra V, Banitt MR, et al. Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology 2004;111(10):1853–1859. DOI: 10.1016/j.ophtha.2004.04.030[published Online First: Epub Date]|.
  18. Latina MA, de Leon JM. Selective laser trabeculoplasty. Ophthalmol Clin North Am 2005;18(3):409–419, vi. DOI: 10.1016/j.ohc.2005.05.005[published Online First: Epub Date]|.
  19. Bruen R, Lesk MR, Harasymowycz P. Baseline factors predictive of SLT response: a prospective study. J Ophthalmol 2012;2012:642869. DOI: 10.1155/2012/642869[published Online First: Epub Date]|.
  20. Latina MA, de Leon JM. The effect of topical glaucoma medication on the efficacy of SLT. Glaucoma Today 2004:31–33. https://glaucomatoday.com/articles/2004-nov-dec/1104_01.html
  21. Kara N, Altan C, Satana B, et al. Comparison of selective laser trabeculoplasty success in patients treated with either prostaglandin or timolol/dorzolamide fixed combination. J Ocul Pharmacol Ther 2011;27(4):339–342. DOI: 10.1089/jop.2011.0015[published Online First: Epub Date]|.
  22. Novack GD, David R, Lee PF, et al. Effect of changing medication regimens in glaucoma patients. Ophthalmologica 1988;196(1):23–28. DOI: 10.1159/000309870[published Online First: Epub Date]|.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.