Clinical Outcomes of Micropulse Laser Trabeculoplasty Compared to Selective Laser Trabeculoplasty at One Year in Open-Angle Glaucoma
Authors Sun CQ, Chen TA, Deiner MS, Ou Y
Received 3 October 2020
Accepted for publication 12 November 2020
Published 22 January 2021 Volume 2021:15 Pages 243—251
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Catherine Q Sun, Tiffany A Chen, Michael S Deiner, Yvonne Ou
Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
Correspondence: Catherine Q Sun
UCSF F.I. Proctor Foundation, 490 Illinois Street, Floor 2, San Francisco, CA 94143, USA
Background: There is limited long-term data comparing selective laser trabeculoplasty (SLT) to the newer micropulse laser trabeculoplasty (MLT) using a laser emitting at 532 nm. In this study, we determine the effectiveness and safety of MLT compared to SLT.
Design: Retrospective comparative cohort study.
Participants: A total of 85 consecutive eyes received SLT and 43 consecutive eyes received MLT.
Methods: Patients with open-angle glaucoma receiving their first treatment of laser trabeculoplasty were included. Exclusion criteria are prior laser trabeculoplasty, laser cyclophotocoagulation or glaucoma surgery, and follow-up of less than 1 year.
Main Outcome Measures: The primary outcome was success at 1 year, defined as a reduction in intraocular eye pressure (IOP) by ≥ 20% from baseline or met prespecified target IOP with no additional glaucoma medication or subsequent glaucoma intervention.
Results: Baseline IOP was 18.0 mmHg (95% CI=16.4– 19.5) in the MLT group on an average of 1.8 (95% CI=1.4– 2.2) glaucoma medications compared to 18.2 mmHg (95% CI=17.2– 19.3) for the SLT group on an average of 2.0 (95% CI=1.6– 2.3) medications. At 1-hour post-laser, the SLT group had more transient IOP spikes (MLT 5% vs SLT 16%, P=0.10). There was a trend toward increased success in the SLT group compared to MLT at 1 year (relative risk=1.4, 95% CI=0.8– 2.5, P=0.30).
Conclusion and Relevance: Eyes had similar success after MLT compared to SLT at 1 year. Laser trabeculoplasty with either method could be offered as treatment with consideration of MLT in those eyes where IOP spikes should be avoided.
Keywords: micropulse laser trabeculoplasty, selective laser trabeculoplasty, open-angle glaucoma
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