Long‐term follow‐up of laser trabeculoplasty in multi‐treated glaucoma patients

Abstract

AbstractPurposeTo evaluate the long‐term effect of laser trabeculoplasty (LTP) in patients randomized to multi‐treatment in the Glaucoma Intensive Treatment Study (GITS).MethodsPatients with untreated newly diagnosed open‐angle glaucoma were treated with three intraocular pressure (IOP)‐lowering substances for 1 week and then 360° argon or selective LTP was performed. IOP was measured just before LTP and repeatedly during the 60‐month study period. Our previous report on 12 months follow‐up data revealed no effect of LTP in eyes having an IOP <15 mmHg before the laser treatment.ResultsBefore LTP, the mean IOP ± standard deviation in all 152 study‐eyes of 122 multi‐treated patients was 14.0 ± 3.5 mmHg. Three eyes of three deceased patients were lost to follow‐up during the 60 months. After exclusion of eyes that received increased therapy during follow‐up, the IOP was significantly reduced at all visits up to 48 months in eyes with pre‐LTP IOP ≥15 mmHg; 2.6 ± 3.1 mmHg at 1 month and 1.7 ± 2.8 mmHg at 48 months, n = 56 and 48, respectively. No significant IOP reduction was seen in eyes with pre‐LTP IOP <15 mmHg. Seven eyes, i.e., <13%, with pre‐LTP IOP ≥15 mmHg at baseline had required increased IOP‐lowering therapy at 48 months.ConclusionLTP performed in multi‐treated patients may provide a useful IOP reduction that is maintained over several years. This was true on a group level when the initial IOP was ≥15 mmHg, but if the pre‐laser IOP was lower than that, chances of LTP success were small.