Intraocular Pressure Control in Primary Open Angle Glaucoma Following Selective Laser Trabeculoplasty at 1 year in an African Black Population

Glaucoma

Abstract

Background: Primary open angle glaucoma (POAG) is the commonest type of glaucoma, with its highest prevalence in Africans thus  the need for early and effective intervention.1 Early Selective laser trabeculoplasty(SLT) treatment in POAG patients is advocated. This  is due to the high incidence of ocular surface disease which worsens with topical medication use in glaucoma patients and low  acceptance of drainage surgery. SLT offers the benefits of safety, low side effects, compliance, cost savings, efficacy and simplicity of technique.2 Few studies however, have evaluated the efficacy of intraocular pressure(IOP) control following SLT in African blacks, thus  the need for this study.

Patients and Methods: Retrospective review of patients with uncontrolled POAG who underwent SLT at The Eye Specialist Hospital  Enugu, Nigeria from December 2011 to December 2012. Information on bio-data, diagnosis, use of antiglaucoma medications and  modality of treatment were retrieved. Newly diagnosed cases of POAG and patients who had adjunctive SLT for uncontrolled IOP were  included. Patients who had prior glaucoma surgery were excluded. Patients underwent 360 degrees laser applications at an energy  level of 0.7-1.3 mJ performed by a single ophthalmologist. Gutt Brimonidine 0.2% was administered prior to treatment while Gutt Diclofenac 8hourly applications were given postoperatively for 5 days. Patients on Latanoprost stopped medication 28 days prior to SLT. Each patient had SLT in one eye either as primary or adjunctive treatment. Pre SLT IOP and IOP in treated eyes were measured at  2weeks, 6weeks, 3months, 9months and 12months post SLT using the Goldmann applanation tonometer. Data was analysed using  SPSS version 22 with level of significance set at p<0.05.