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The data were analyzed for means and standard deviation. The windows for data collection at 1, 4, and 6 months were ☑ month and 12 months were ☒ months. Goldmann IOP measurements were collected at baseline, 1, 4, 6, and 12 months after each SLT treatment. Demographics, laser treatment parameters, and number of glaucoma medications at SLT1 and SLT2 were collected. Patients who had successful (S1) and modest (M1) response upon 1 st SLT (SLT1) treatment were further analyzed to determine 2 nd SLT (SLT2) responses (S2 or M2). Non-responders, defined as those whose post-treatment 12-month mean IOP remained the same or increased compared to baseline after SLT1, were excluded. Patients with a history of SLT other than to 360 degree of angle, ALT, or incisional glaucoma surgery were excluded. All included subjects had angle grades of 3 or 4 and were given non-contiguous spot treatment.
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Inclusion and exclusion criteria were defined as follows: For inclusion only those treated with 360 degree SLT at each of the two treatment sessions were included. Successful response (S) was defined as a post-treatment mean IOP reduction over 12 months ≥20% from baseline, while modest response (M) was defined as a 12-month mean IOP reduction 0% from baseline. Post-treatment 12-month mean IOP was calculated as the mean of all recorded visits over 12 months.
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Therefore, baseline IOP for SLT2 was defined as the last measured IOP prior to treatment. The timing for each patient to undergo SLT2 was at the discretion of the treating ophthalmologist, which precluded the calculation of the mean pressure from two prior visits. For SLT1, baseline IOP was defined as the mean pressure from the previous two visits prior to SLT. The decision to repeat SLT was made by individual clinicians when further IOP reduction was needed.ĭefinitions of baseline IOP, post-treatment 12-month mean IOP, non-responders, successful response, and modest response were defined as follows. There were no defined IOP thresholds or initial response thresholds for repeat treatment. The decision to perform SLT was based on the clinician's assessment of the need to lower IOP in each particular glaucoma patient. Patients with open angle glaucoma who underwent two treatments of SLT for IOP reduction between 20 were eligible for the study. To evaluate the possibility that repeat SLT may have an additional effect regardless of initial response, we evaluated the efficacy of repeat SLT in eyes that exhibited a successful response (≥20% IOP reduction) compared to a modest response (<20% IOP reduction) to initial SLT.Ī retrospective review of the electronic records at a large multi-physician academic ophthalmology practice was conducted after institutional review board approval.
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10 Less is known about the effectiveness of repeat SLT in eyes with sub-optimal response to first SLT. Repeat SLT has been shown to be effective after initially successful SLT (≥20% IOP reduction from baseline). 8, 9 These differences between the platforms may render SLT more safely repeatable owing to lesser collateral tissue damage. 6, 7 Despite uncertainty regarding mechanism of action, SLT offers some potential benefits over ALT, including decreased damage to trabecular meshwork. 2, 3, 4, 5 Although multiple theories exist, the exact mechanism by which laser trabeculoplasty (ALT or SLT) lowers IOP remains unknown. 1 Trials comparing SLT to argon laser trabeculoplasty (ALT) have shown that both laser platforms produce comparable intraocular pressure (IOP) reductions. The treatment uses a 532-nm frequency-doubled q-switched neodymium: Ttrium-aluminum-garnet laser to selectively target pigmented trabecular meshwork cells. Selective laser trabeculoplasty (SLT) is a popular initial and adjunctive treatment for open angle glaucoma.