A retrospective case-series to assess the effectiveness of selective laser trabeculoplasty in the management of open angle glaucoma in black patients

• Main Author: Fernandes, G A
• Format: Others
• Language: en
• Published: 2016
• Online Access: http://hdl.handle.net/10539/21218

A research report submitted to the Faculty of Health Sciences , University of the Witwatersrand, Johannesburg in partial fulfillment of the requirements for the degree of Master of Medicine in Ophthalmology === Aims This study aims to evaluate the efficacy of SLT as a treatment option in black patients with open angle glaucoma and to distinguish which patients are most likely to respond to SLT. Methods The study is a retrospective case-series of black patients collected at St. John’s Eye Hospital in Johannesburg. Data from 46 eyes were collected from the files of patients who had had SLT at least six months previously. The data collected included demographic factors, ocular characteristics and intraocular pressure (IOP) before and at each visit after selective laser trabeculoplasty (SLT). The data were analysed statistically firstly by comparing the pre-SLT IOP with the average post-SLT IOP, and secondly by Kaplan-Meir analysis of the duration of IOP control post-SLT. Results The mean age of participants was 58,3 years. The mean follow up time was 8 months (range1 week to 33 months). The mean pre-SLT IOP was 20,7mmHg and the mean post–SLT IOP was 17,8mmHg. The change in IOP was statistically significant (p<0,001). The mean reduction in IOP was a 12% reduction from baseline. The mean duration of IOP control by Kaplan-Meier analysis was 13 months. The only demographic or ocular factor associated with a greater reduction in IOP was trabecular meshwork pigmentation. Patients with higher pigmentation had a median IOP reduction of 23,0% and those with low pigmentation a median reduction of 3,5%. Conclusion SLT resulted in a statistically significant but modest reduction in IOP in black glaucoma patients. The average reduction in IOP was 12% from baseline. High trabecular meshwork pigmentation was associated with a statistically significantly greater reduction in IOP. === MT2016