title: Intraocular pressure-lowering medications and long-term outcomes of selective laser trabeculoplasty.
abstract: BACKGROUND
  To investigate the effects of current intraocular pressure-lowering medications on the efficacy of selective laser trabeculoplasty.
  
  
  METHODS
  Retrospective chart review of records from an urban glaucoma clinic in Sydney, Australia.
  
  
  METHODS
  Patients who received their first selective laser trabeculoplasty between 2002 and 2005 were studied (grouped from 0 to 3 according to the number of pre-selective laser trabeculoplasty medications, and followed for 5 years). Those with previous argon laser therapy, trabeculectomy or angle-closure were excluded.
  
  
  METHODS
  Selective laser trabeculoplasty (Ellex) used to deliver 180 or 360 degree of treatment, under the same protocol.
  
  
  METHODS
  Responders were defined by ≥20% reduction from baseline intraocular pressure. Data were censored when pressure-lowering intervention was required. The mean intraocular pressure, survivor, response rate, number and type of medications were compared.
  
  
  RESULTS
  There were 206 patients with ocular hypertension, primary, pseudo-exfoliation, or pigmentary glaucoma who used none (n = 20), one (n = 33), two (n = 61) or three or more (n = 92) pre-selective laser trabeculoplasty topical anti-glaucoma medications. The mean baseline intraocular pressures for each group was 23.7, 22.2, 20.7 and 20.4 mmHg, respectively (P = 0.061). Post-treatment mean intraocular pressure was 17.9, 17.7, 15.5, and 15.7 mmHg; percentage reduction was similar between groups (23.6-25.6%, P = 0.20). Kaplan-Meier survival analysis showed comparable survival rates across groups (P = 0.445). At 60 months, 11.1, 17.1, 30.5 and 11.5% of responders remained in each group. Higher proportions of patients in groups 2 and 3 required further laser or surgery.
  
  
  CONCLUSIONS
  The number of pre-selective laser trabeculoplasty medications did not affect the intraocular pressure-lowering effectiveness of selective laser trabeculoplasty; however, groups on more medications required more pressure-lowering interventions.
authors.affiliation: Department of Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia.
authors.forename: David M
authors.initials: DM
authors.lastname: Woo
authors.affiliation: Sydney Medical School, Center for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia.|Eye Associates, Sydney, New South Wales, Australia.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Healey
authors.affiliation: Eye Associates, Sydney, New South Wales, Australia.|Australian School of Advanced Medicine, School of Ophthalmology and Visual Science, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Stuart L
authors.initials: SL
authors.lastname: Graham
authors.affiliation: Department of Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia.|Discipline of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia.|Eye Associates, Sydney, New South Wales, Australia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D017889:Exfoliation Syndrome / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy / Q000601:surgery; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: glaucoma; intraocular pressure; selective laser trabeculoplasty