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Predictors of Success in Selective Laser Trabeculoplasty for Chinese Open-angle Glaucoma

Lee, Jacky W.Y. FRCS Ed*; Liu, Catherine C.L. PhD; Chan, Jonathan C.H. FRCS Ed; Lai, Jimmy S.M. MD*

doi: 10.1097/IJG.0000000000000049
Original Studies

Aim: To investigate the determinants of success of selective laser trabeculoplasty (SLT) in Chinese open-angle glaucoma patients.

Methods: This prospective cohort study sequentially recruited Chinese subjects with unilateral or bilateral primary open-angle glaucoma (POAG) or normal tension glaucoma (NTG). All subjects received a single session of 360-degree SLT treatment. Success was defined as IOP reduction ≥20%. The following were analyzed in univariate and multivariate regression analyses for association with SLT success: type of glaucoma, age, sex, lens status, presenting IOP, pre-SLT IOP, day 1 IOP, 1-week IOP, number and type of anti-glaucoma medications, number of SLT shots and energy, retinal nerve fiber layer (RNFL) thickness, Visual Field Index, endothelial cell count, central corneal thickness, Snellen visual acuity, and spherical equivalent.

Results: In 111 eyes of 65 subjects, there were 51 POAG eyes and 60 NTG eyes. The overall success was 53.15% with a mean IOP reduction of 19.81±15.93%. In univariate analysis, a thinner RNFL [coefficient=−0.027; odds ratio (OR)=0.95; P=0.017] was associated with success. In multivariate analysis, a lower day 1 IOP (coefficient=−0.29; OR=0.75; P=0.049) and using topical carbonic anhydrase inhibitors (CAI) (coefficient=2.92; OR=18.63; P=0.0020) were associated with success. In both univariate and multivariate analyses, a higher pre-SLT IOP significantly predicted success (coefficient=0.20/0.46; OR=1.23/1.58; P=0.0017/0.0011) and using 3 anti-glaucoma medications (coefficient=−1.08/−3.74; OR=0.3/0.024; P=0.037/P=0.0081) was associated with SLT failure.

Conclusion: The positive predictors of SLT success included: higher pre-SLT IOP, use of topical CAI, thinner RNFL, and lower day 1 IOP. Using 3 anti-glaucoma medications was associated with failure.

*The Department of Ophthalmology, The University of Hong Kong

Department of Applied Mathematics, The Hong Kong Polytechnic University

The Department of Ophthalmology, Queen Mary Hospital, Hong Kong SAR, People’s Republic of China

Ethics approval was obtained from the Hospital Authority ethics committee.

Written informed consents were obtained before start of study.

Disclosure: The authors declare no conflict of interest.

Reprints: Jacky W.Y. Lee, FRCS Ed, Room 301, Level 3 Block B, Cyberport 4, 100 Cyberport Road, Hong Kong, People’s Republic of China (e-mail: jackywylee@gmail.com).

Received June 8, 2013

Accepted March 4, 2014

© 2014 by Lippincott Williams & Wilkins.