Factors Predicting Successful Selective Laser Trabeculoplasty to Prevent Glaucoma Progression to Surgery

Abstract

Purpose: To investigate the factors predicting successful selective laser trabeculoplasty (SLT) to prevent glaucoma progression to surgery in patients whose intraocular pressure (IOP) is not controlled with medications.Methods: This retrospective chart review included 102 eyes of 92 glaucoma patients who underwent SLT between 2018 and 2020. Success was defined as the prevention of glaucoma surgery for at least 1 year with an IOP less than 21 mmHg or no progression of retinal nerve fiber layer thinning. Kaplan-Meier survival analysis and the Cox proportional hazard model were used for the analysis.Results: A low pretreatment IOP, good visual acuity, and a smaller visual field defect were significantly correlated with success. When the other eye underwent glaucoma surgery or its SLT treatment failed, the success rate of SLT was lower. As the pretreatment IOP increased by 1 mmHg, the SLT failure rate increased by 1,376 times and when the SLT for the other eye failed, it increased by 19,577 times. When the mean deviation of the visual field increased by 1 decibel (dB), the SLT failure rate decreased by 0.928 times (<i>p</i> < 0.05).Conclusions: SLT is more effective in early glaucoma patients with an IOP lower than 25 mmHg, smaller visual field defect, and good visual acuity to prevent glaucoma progression to surgery.