Journal of Current Glaucoma Practice

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VOLUME 15 , ISSUE 3 ( September-December, 2021 ) > List of Articles

ORIGINAL RESEARCH

Repeat Selective Laser Trabeculoplasty for Glaucoma Patients: A Systematic Review and Meta-analysis

Hyunsoo J Jang, Brian Yu, William Hodge, Monali S Malvankar-Mehta

Keywords : Glaucoma, Intraocular pressure, Laser, Meta-analysis, Repeat selective laser trabeculoplasty, Selective laser trabeculoplasty, Systematic review, Trabeculoplasty

Citation Information : Jang HJ, Yu B, Hodge W, Malvankar-Mehta MS. Repeat Selective Laser Trabeculoplasty for Glaucoma Patients: A Systematic Review and Meta-analysis. J Curr Glaucoma Pract 2021; 15 (3):117-124.

DOI: 10.5005/jp-journals-10078-1302

License: CC BY-NC 4.0

Published Online: 27-01-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim and objective: To evaluate repeat selective laser trabeculoplasty (SLT) for treating primary open-angle glaucoma (POAG). Materials and methods: PubMed, CINAHL, and EMBASE were systematically searched along with grey literature. All English articles that measured intraocular pressure (IOP) before and after repeat SLT on adult patients with POAG were included. Studies were not filtered by location or publication date. Covidence was used to screen imported articles. Risk of bias assessment and data extraction was performed after screening. Meta-analysis was performed using STATA 16.0. Fixed-effect or random-effects models were developed depending on the presence of heterogeneity. Results: Database and grey literature search identified 512 unique studies. After duplicate removal and screening, 12 articles were included and data from included studies were synthesized. Nine articles were included in the meta-analysis. Three studies were prospective observational studies, and nine studies were retrospective chart reviews. Due to the presence of heterogeneity, a random-effects model has been utilized that suggested significant IOP reduction (IOPR) by repeat SLT at 24 months follow-up. Conclusion: Based on our results, repeat SLT could be an effective procedure in reducing IOP for patients with glaucoma for up to 24 months. Efficacy of third, fourth, or further SLT remains to be verified. More data from long-term, high-quality randomized-controlled trials (RCTs) are required to make conclusions. Clinical significance: Repeat SLT may be an effective treatment for lowering IOP with minimal complications or safety issues. This may allow the use of SLT as a primary treatment for POGA, allowing the discontinuation of medications or eye drops and lead to additional benefits.


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  1. Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet 2019;393(10180):1505–1516. DOI: 10.1016/S0140-6736(18)32213-X.
  2. Noecker RJ. How SLT works. Glaucoma Today 2005. 30–31. http://glaucomatoday.com/pdfs/0305_01.pdf (accessed October 25, 2019).
  3. 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.
  4. Latina MA, Sibayan SA, Shin DH, et al. Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty). Ophthalmology 1998;105(11):2082–2090. DOI: 10.1016/s0161-6420(98)91129-0.
  5. Katz LJ, Lee D, Zheng C. Selective Laser Trabeculoplasty as Primary Glaucoma Therapy. Glaucoma Res Found 2018. https://www.glaucoma.org/treatment/selective-laser-trabeculoplasty-as-primary-glaucoma-therapy.php (accessed September 11, 2019).
  6. Reardon G, Kotak S, Schwartz GF. Objective assessment of compliance and persistence among patients treated for glaucoma and ocular hypertension: a systematic review. Patient Prefer Adherence 2011;5:441–463. DOI: 10.2147/PPA.S23780.
  7. Robciuc A, Witos J, Ruokonen SK, et al. Pure glaucoma drugs are toxic to immortalized human corneal epithelial cells, but they do not destabilize lipid membranes. Cornea 2017;36(10):1249–1255. DOI: 10.1097/ICO.0000000000001322.
  8. Melamed S, Simon GJBen, Levkovitch-Verbin H. Selective laser trabeculoplasty as primary treatment for open-angle glaucoma. Arch Ophthalmol 2003;121(7):957–960. DOI: 10.1001/archopht.121.7.957.
  9. Lee R, Hutnik CML. Projected cost comparison of selective laser trabeculoplasty versus glaucoma medication in the Ontario health insurance plan. Can J Ophthalmol 2006;41(4):449–456. DOI: 10.1016/S0008-4182(06)80006-2.
  10. Juzych MS. 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.
  11. Avery N, Soon G, Simon A. Repeatability of primary selective laser trabeculoplasty in patients with primary open-angle glaucoma. Int Ophthalmol 2013(5):501–506. DOI: 10.1007/s10792-013-9729-3.
  12. Durr GM, Harasymowycz P. The effect of repeat 360-degree selective laser trabeculoplasty on intraocular pressure control in open-angle glaucoma. J Fr Ophtalmol 2016;39(3):261–264. DOI: 10.1016/j.jfo.2015.10.008.
  13. Francis BA, Loewen N, Hong B, et al. Repeatability of selective laser trabeculoplasty for open-angle glaucoma. BMC Ophthalmol 2016;16(1):128. DOI: 10.1186/s12886-016-0299-9.
  14. Hong BK, Winer JC, Martone JF, et al. Repeat selective laser trabeculoplasty. J Glaucoma 2009;18(3):180–183. DOI: 10.1097/IJG.0b013e31817eee0b.
  15. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998;52(6):377–384. DOI: 10.1136/jech.52. 6.377.
  16. Zhang WY, Po ALW, Dua HS, et al. Meta-analysis of randomised controlled trials comparing latanoprost with timolol in the treatment of patients with open angle glaucoma or ocular hypertension. Br J Ophthalmol 2001;85(8):983–990. DOI: 10.1136/bjo.85. 8.983.
  17. Realini T, Curtis H. Repeat selective laser trabeculoplasty in Afro-Caribbean eyes with primary open-angle glaucoma. Investigative Ophthalmology & Visual Science, Vol. 57, 2016 ARVO Annu. Meet., Seattle, Washington: The Association for Research in Vision and Ophthalmology; 2016. https://iovs.arvojournals.org/article.aspx?articleid=2562518.
  18. Lai J, Bournias TE. Repeatability of selective laser trabeculoplasty (SLT). Investigative Ophthalmology & Visual Science, Vol 46, J. Lai; T.E. Bournias. 2005 ARVO Annu. Meet., Fort Lauderdale, Florida: The Association for Research in Vision and Ophthalmology; 2005, p. 119.
  19. Khouri AS, Berezina T, Maltzman BA, et al. Efficacy of second and third repeat selective laser trabeculoplasty. AAO 2010. Chicago, Illinois: American Academy of Ophthalmology, 2010.
  20. Polat J, Grantham L, Mitchell K, et al. Repeatability of selective laser trabeculoplasty. Br J Ophthalmol 2016;100:1437–1441.
  21. Baser EF, Akbulut D. Significant peripheral anterior synechiae after repeat selective laser trabeculoplasty. Can J Ophthalmol 2015;50(3):e36–e38. DOI: 10.1016/j.jcjo.2015.02.006.
  22. Khouri AS, Lari HB, Berezina TL, et al. Original article long term efficacy of repeat selective laser trabeculoplasty. J Ophthalmic Vis Res 2014;9:444–448.
  23. Khouri AS, Lin J, Berezina TL, et al. Repeat selective laser trabeculoplasty can be effective in eyes with initial modest response. Middle East Afr J Ophthalmol 2014;21:205–209.
  24. Peragallo JH, Malen M, Lai PC. Effectiveness of repeat selective laser trabeculoplasty on primary open angle glaucoma (POAG) patients. 2010 ARVO Annu Meet. Fort Lauderdale, Florida: The Association for Research in Vision and Ophthalmology; 2010. p. 4427.
  25. Copparam S, Kuley B, Zheng CX, et al. Outcomes of repeat selective laser trabeculoplasty for open-angle glaucoma. 2019 ARVO Annu Meet. Vancouver, British Columbia; 2019.
  26. Garg A, Vickerstaff V, Nathwani N, et al. Efficacy of repeat selective laser trabeculoplasty in medication-naive open-angle glaucoma and ocular hypertension during the LiGHT trial. Ophthalmology [Internet] 2020;127:467–476. Available from: https://doi.org/10.1016/j.ophtha.2019.10.023.
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