The effect of selective laser trabeculoplasty on intraocular pressure in patients with intravitreal steroid-induced elevated intraocular pressure

Benjamin Rubin, Anthony Taglienti, Robert F. Rothman, Craig H. Marcus, Janet B. Serle

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

PURPOSE: To assess effectiveness of selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in patients with steroid-induced elevated IOP. METHODS: Retrospective review of 7 patients (7 eyes) with IOP elevation after intravitreal triamcinolone acetonide (4.0mg/0.1 mL) injections for macular edema (6 patients) or central retinal vein occlusion (1 patient). Three patients had preexisting open angle glaucoma; 2 patients had preexisting ocular hypertension. Time between intraocular corticosteroid injection and subsequent increased IOP ranged from 5 to 29 weeks. After unsuccessful maximum tolerated medical therapy, patients underwent unilateral SLT between April 2003 and June 2005. IOP was measured 4 weeks prelaser; on the day of laser; within 3 weeks, and at 1, 3, and 6 months postlaser. Two-sample t test was used for analysis. RESULTS: The pre-SLT and post-SLT IOP measurements were the major outcome measures used to define the relative success of the SLT procedure. Seven patients were taking 4.0±0.8 ocular hypotensive medications before SLT. Preoperative IOP (mm Hg±SD) 8.4±7.3 decreased postoperative to 25.6±7.1 within 3 weeks (P<0.003), 25.9±8.8 at 1 month (P<0.007), 23.9±10.6 at 3 months (P<0.006), and 15.7±2.2 at 6 months (P<0.001). Four patients underwent a second SLT procedure. Two patients failed after the 3-month visit. IOP in fellow eyes of all patients was unchanged (P>0.080). CONCLUSIONS: SLT lowered (P<0.007) IOP in 5 eyes of 7 patients with steroid-induced increased IOP from 3 weeks to 6 months postoperative. Two patients required additional surgical procedures. Repeat SLT treatments may be necessary. SLT is a temporizing procedure to consider in patients with steroid-induced elevated IOP.

Original languageEnglish
Pages (from-to)287-292
Number of pages6
JournalJournal of Glaucoma
Volume17
Issue number4
DOIs
StatePublished - Jun 2008

Keywords

  • Elevated IOP
  • Glaucoma
  • Intraocular pressure
  • Selective laser trabeculoplasty
  • Triamcinolone acetonide

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