Journal of Current Glaucoma Practice

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VOLUME 17 , ISSUE 4 ( October-December, 2023 ) > List of Articles

ORIGINAL RESEARCH

Effect of Selective Laser Trabeculoplasty on the Fellow Eye

Matthew Hirabayashi, Elizabeth Mellencamp, Sabrina Duong, Jayce Simoncic, Carlton Homan, Joshua King, Jella An

Keywords : Fellow eye, Retrospective chart review, Selective laser trabeculoplasty

Citation Information : Hirabayashi M, Mellencamp E, Duong S, Simoncic J, Homan C, King J, An J. Effect of Selective Laser Trabeculoplasty on the Fellow Eye. J Curr Glaucoma Pract 2023; 17 (4):175-177.

DOI: 10.5005/jp-journals-10078-1420

License: CC BY-NC 4.0

Published Online: 17-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: Determine if selective laser trabeculoplasty (SLT) affects the fellow eye's intraocular pressure (IOP). Materials and methods: A retrospective review of 76 pairs of eyes from 76 adult glaucoma patients who underwent SLT in one eye with at least 2 months between treatments were evaluated for IOP and medication reduction in the untreated fellow eye. Success was defined as ≥20% IOP reduction or ≥1 medication reduction without any additional IOP lowering procedures or medication. The primary outcome measures were success, IOP, and medication reduction in the untreated fellow eye at 6 months. Results: At 6 months after SLT treatment, 48.7% (38/76) treated eyes and 36.8% (28/76) untreated fellow eyes met success criteria. IOP reduction in the treated eye was 2.6 ± 5.8 (14.1%; p < 0.002) and 0.8 ± 4.3 (5.1%, p = 0.122) in the fellow eye. The fellow eye was significantly more likely to meet success criteria if the treated eye was successful [odds ratio (OR): 6.00, 95% confidence interval (CI) (2.11–17.06), p < 0.002]. Conclusion: After a unilateral treatment with SLT, over one-third of the fellow eyes experienced either ≥20% IOP reduction or medication reduction. Additionally, fellow eyes were six times as likely to meet success criteria if this was observed in the treated eye. These findings may support the proposed biochemical mechanism for the therapeutic action of SLT. Clinical significance: The implication for clinicians is that SLT treatment in one eye may allow the fellow eye to benefit and provide a prediction on the fellow eye's response without subjecting both eyes to the rare but present complications of SLT.


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  1. Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 2014;121(11):2081–2090. DOI: 10.1016/j.ophtha.2014.05.013
  2. Wise JB, Witter SL. Argon laser therapy for open-angle glaucoma. A pilot study. Arch Ophthalmol 1979;97(2):319–322. DOI: 10.1001/archopht.1979.01020010165017
  3. Ahmed I. Sidebar: micropulse laser trabeculoplasty. Glaucoma Today.
  4. Aquino MC, Barton K, Tan AM, et al. Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory study. Clin Exp Ophthalmol 2015;43(1):40–46. DOI: 10.1111/ceo.12360
  5. Ahmed I. Excellent safety profile of micropulse laser trabeculoplasty (MLT) for glaucoma. Glaucoma Today 2014;1–2.
  6. Barkana Y, Belkin M. Selective laser trabeculoplasty. Surv Ophthalmol 2007;52(6):634–654. DOI: 10.1016/j.survophthal.2007.08.014
  7. Beidoe G, Mousa SA. Current primary open-angle glaucoma treatments and future directions. Clin Ophthalmol 2012;6:1699–1707. DOI: 10.2147/OPTH.S32933
  8. Prum BE Jr, Rosenberg LF, Gedde SJ, et al. Primary open-angle glaucoma preferred practice pattern® guidelines. Ophthalmology 2016;123(1):P41–P111. DOI: 10.1016/j.ophtha.2015.10.053
  9. Hirabayashi M, Ponnusamy V, An J. Predictive factors for outcomes of selective laser trabeculoplasty. Sci Rep 2020;10(1):9428. DOI: 10.1038/s41598-020-66473-0
  10. Gulati V, Fan S, Gardner BJ, et al. Mechanism of action of selective laser trabeculoplasty and predictors of response. Invest Ophthalmol Vis Sci 2017;58(3):1462–1468. DOI: 10.1167/iovs.16-20710
  11. Alon S. Selective laser trabeculoplasty: a clinical review. J Curr Glaucoma Pract 2013;7(2):58–65. DOI: 10.5005/jp-journals-10008-1139
  12. 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
  13. Kirzhner M, Shildkrot Y, Hughes BA. Crossover effect of selective laser trabeculoplasty. Investig Ophthalmol Vis Sci 2009;50(13):155.
  14. Onakoya AO, Olowoyeye AO, Onyekwelu OMA, et al. Intraocular pressure changes post selective laser trabeculoplasty in the contralateral untreated eyes of Nigerian patients with primary open angle glaucoma. Niger Q J Hosp Med 2015;25(2):133–138.
  15. 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
  16. Realini T. Is there a crossover effect with selective laser trabeculoplasty? Eye World. Published online September 2009.
  17. 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
  18. Yarangümeli A, Köz OG, Kural G. The effect of trabeculectomy on the intraocular pressure of the unoperated fellow eye. J Glaucoma 2003;12(2):108–113. DOI: 10.1097/00061198-200304000-00004
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