title: Treatment Outcomes and Prognostic Factors of Selective Laser Trabeculoplasty for Open-angle Glaucoma Receiving Maximal-tolerable Medical Therapy.
abstract: To evaluate the efficacy of selective laser trabeculoplasty (SLT) for patients with open-angle glaucoma receiving maximal-tolerable medical therapy.
  
  
  
  Consecutive patients with open-angle glaucoma who were followed up for at least 1 year after SLT were retrospectively evaluated. The effectiveness was assessed using Kaplan-Meier survival analysis with 2 criteria for failure: (1) intraocular pressure (IOP) equal to or more than baseline; and (2) <20% reduction from baseline, on 2 consecutive visits. Those 2 failure criteria also included loss of light perception, reoperation of SLT, and glaucoma surgery. Influence of baseline factors on success were assessed using mixed-effects Cox proportional hazard models.
  
  
  
  Seventy-five eyes [39 primary open-angle glaucoma, 23 exfoliation glaucoma, and 13 secondary open-angle glaucoma (SOAG)] of 59 patients (21 females) aged 65.5±15.9 (mean±SD) were included. Preoperative mean IOP was 23.3±6.5 mm Hg with 3.4±1.3 IOP lowering medications. The overall success ratio at the end of study period was 45.3% by criterion 1 and 14.2% by criterion 2. The success ratio by criterion 1 and 2 was 61.1% and 21.7% in primary open-angle glaucoma, 29.3% and 14.5% in exfoliation glaucoma, and 15.4% and 7.7% in SOAG, respectively. Higher preoperative IOP and diagnosis of SOAG were significantly associated with treatment failure (P<0.01 and 0.04, respectively).
  
  
  
  One-year efficacy of SLT in controlling IOP was very limited in patients with maximal-tolerable medical therapy. Types of glaucoma and preoperative IOP were significant prognostic factors for treatment success.
authors.affiliation: The Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Miki
authors.forename: Rumi
authors.initials: R
authors.lastname: Kawashima
authors.forename: Shinichi
authors.initials: S
authors.lastname: Usui
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsushita
authors.forename: Kohji
authors.initials: K
authors.lastname: Nishida
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents