Researchers discover predictor of laser treatment success in patients
with glaucoma
Pre-treatment eye pressure is best gauge of laser effectiveness

Date:
August 5, 2020
Source:
University of Missouri-Columbia
Summary:
More than 70 million people worldwide suffer from
glaucoma. Treatment options have traditionally included eye drops
to reduce the fluid the eye produces or surgery to unclog the eye's
drainage. But a new study provides insight into which patients
might benefit most from a noninvasive treatment called selective
laser trabeculoplasty (SLT), which relieves pressure by using a
laser to alter the eye tissue, resulting in better fluid drainage.



FULL STORY ==========================================================================
More than 70 million people worldwide suffer from glaucoma, a condition
that causes a build-up of fluid and pressure inside the eye and can
eventually lead to blindness. Treatment options have traditionally
included eye drops to reduce the fluid the eye produces or surgery
to unclog the eye's drainage. But a new study from the University of
Missouri School of Medicine and MU Health Care provides insight into
which patients might benefit most from a noninvasive treatment called
selective laser trabeculoplasty (SLT), which relieves pressure by using
a laser to alter the eye tissue, resulting in better fluid drainage.


========================================================================== "There's been a lack of evidence about how well SLT works, how safe it is
and the ideal candidate," said senior author Jella An, MD, an assistant professor of ophthalmology and a fellowship-trained glaucoma specialist
at MU Health Care's Mason Eye Institute. "Because so little is known
about SLT, there is a lot of apprehension among specialists about using
it as a first-line treatment for glaucoma. Our research findings have
helped me redefine the ideal patient for this procedure." An's research
team reviewed 252 SLT procedures on 198 adult patients with open- angle glaucoma to determine what percentage of these surgeries achieved a 20%
or greater reduction in intraocular pressure (IOP). Two months after
surgery, 33.6% of patients met success criteria. At the six-month mark,
38.5% achieved the threshold. The researchers discovered patients with
a higher baseline IOP had larger reductions in pressure.

"We discovered significant improvement in patients with more severe cases, which convinced me that patients with the highest pressure will benefit
the most from this laser therapy," An said.

Age, type and severity of glaucoma did not significantly predict a
successful outcome. In addition, less than 5% of patients studied
experienced the most common adverse event of an IOP spike after the
procedure.

"This study really increased my comfort level to offer SLT as a primary therapy," An said. "Prior to this research, I would prescribe these
patients multiple medications, creating the possibility of side effects
and poor adherence, which could lead to disease progression. Now
I offer this laser first if they are a good candidate because of
its safety profile. If it doesn't work, we can always move forward
with other options." In addition to An, the study's lead author was
MU School of Medicine ophthalmology resident Matthew Hirabayashi,
MD. Vikram Ponnusamy, MD, a recent graduate of MU School of Medicine,
also contributed to the findings.


========================================================================== Story Source: Materials provided by University_of_Missouri-Columbia. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Matthew Hirabayashi, Vikram Ponnusamy, Jella An. Predictive
Factors for
Outcomes of Selective Laser Trabeculoplasty. Scientific Reports,
2020; 10 (1) DOI: 10.1038/s41598-020-66473-0 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200805110110.htm

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