Effect of Age on Reduction in Intraocular Pressure and Number of Medications after Selective Laser T

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Effect of Age on Reduction in Intraocular
Pressure and Number of Medications after
Selective Laser Trabeculoplasty in Patients with
Glaucoma

• Lookjan Riansuwan, M.D. Vinod B. Voleti, B.S.
  Elaine M. Miglino Lama A. Al-Aswad, M.D.
  Lawrence F. Jindra,,, M.D.
• Columbia University, Floral Park Ophthalmology,
  
• Winthrop University Hospital

Lookjan Riansuwan declares no financial interest
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Introduction

• Selective Laser Trabeculoplasty (SLT) has been
  used successfully to treat patients with primary
  open-angle glaucoma, but there are factors which
  influence the level of SLT response.
• Knowing the outcome predictors of SLT is very
  useful when selecting patients who will most
  benefit from the procedure.
• Several factors such as baseline intraocular
  pressure (IOP), amount of trabecular meshwork
  pigmentation, age, and sex, have been studied as
  outcome predictors of SLT treatment.

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Objective

• To examine the relationship between age and the
  effectiveness of SLT (relative mean reduction of
  IOP and decrease in mean number of medications
  (meds) used), in patients with glaucoma.

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Methods

• Retrospective consecutive chart review was
  performed on 1566 eyes which underwent SLT
  between January 2002 and April 2006.
• Data were divided into phakic and pseudophakic
  groups.
• Correlation and regression analyses were used
  to examine the relationships between age and
  relative mean reduction of IOP and between age
  and mean decrease in number of meds used after
  SLT.

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Data Set

• Eyes which were aphakic, required repeat SLT,
  and which were lost to follow up were excluded.
• The remaining 1241 eyes were divided into
  phakic (937 eyes) and pseudophakic (304 eyes)
  groups, comparing age and reduction in IOP.
• The 565 eyes which received secondary SLT
  (treated with meds before SLT) were divided into
  phakic (383 eyes) and pseudophakic (182 eyes)
  groups, comparing age and decrease in meds after
  SLT.

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Results Age and IOP Reduction

• Phakic group
• There was a 30 relative mean reduction of IOP
  from 18.2?4.2 pre-SLT to 12.7?3.6 mmHg post-SLT.
• A weak negative correlation was noted between
  age and relative mean decrease in IOP (r
  -0.075) and was significant with p-value lt 0.05.

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Results Age and IOP Reduction

• Pseudophakic group
• There was a 27 relative mean reduction of IOP
  from 18.5?4.9 pre-SLT to 13.4?4.1 mmHg post-SLT.
• A weak positive correlation was noted between
  age and relative mean decrease in IOP (r 0.062)
  but was not significant.

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Results Age and Meds Reduction

• Phakic group
• There was a 73 decrease in mean number of meds
  used from 2.1?1.2 pre-SLT to 0.7?1.2 meds
  post-SLT.
• Correlation between age and decrease in meds
  was not significant.

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Results Age and Meds Reduction

• Pseudophakic group
• There was a 56 decrease in mean number of meds
  used from 2.6?1.2 pre-SLT to 1.2?1.4 meds
  post-SLT.
• Correlation between age and decrease in meds
  was not significant.

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Conclusion

• In this series
• The IOP lowering effect of SLT significantly
  decreased with age in phakic eyes while it showed
  a not significant trend to increase with age in
  pseudophakic eyes.
• There was no significant correlation between age
  and reduction of meds after SLT in either the
  phakic or pseudophakic groups.