The Effect of Selective Laser Trabeculoplasty on Intraocular Pressure in Patients with Dexamethasone Intravitreal Implant-Induced Elevated Intraocular Pressure

Abstract EN

Introduction.

To assess the safety and efficacy of selective laser trabeculoplasty (SLT) for ocular hypertension (OHT) induced by a dexamethasone (DEX) intravitreal implant.

Materials and Methods.

We performed a retrospective study of patients who underwent an SLT procedure for ocular hypertension induced by injection of a DEX intravitreal implant.

Patients had, at least, one injection of the DEX-implant for symptomatic macular edema.

SLT was delivered to 360° of the trabecular meshwork in two sessions.

The primary outcome was a decrease in IOP, evaluated at one, three, and six months after the SLT procedure.

Results.

Twenty-six eyes of 22 patients were included.

The mean intraocular pressure (IOP) measured after DEX-implant injection was 25.4 ± 5.4 mmHg, and the mean increase in IOP was 35.8 ± 14.6%.

The mean follow-up after SLT was 18.3 ± 7.7 months.

After SLT, the mean IOP dropped by 30.9% at one month (16.9 ± 4.5 mmHg, p=0.01), 33.6% at three months (16.0 ± 2.7 mmHg, p<0.01), and 34.9% at six months (15.6 ± 2.1 mmHg, p<0.01).

Each patient had a minimum follow-up of 6 months after SLT.

Eight eyes (31%) received a second DEX-implant injection after the SLT procedure without experiencing an increase in the IOP above 21 mmHg or >20%.

No glaucoma surgery was required during the follow-up.

The mean number of medications (1.65 ± 1.36) was significantly reduced at one (1.19 ± 1.20, p=0.04), three (0.96 ± 1.03, p<0.01), and six months (0.77 ± 0.95, p<0.01) after SLT.

Conclusion.

SLT is an effective and safe procedure to control OHT following DEX-implant intravitreal injection.