J Korean Ophthalmol Soc > Volume 58(7); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(7):828-835.
DOI: https://doi.org/10.3341/jkos.2017.58.7.828    Published online July 15, 2017.
The Effectiveness of Selective Laser Trabeculoplasty in Patients with Medically Uncontrolled Open-angle Glaucoma.
Hye Won Park, Seung Soo Han, Jong Woon Park
1The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
2Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Korea. unij143@naver.com
3Department of Ophthalmology, Suncheon Medical Center, Suncheon, Korea.
약물로 조절되지 않는 개방각녹내장에서 선택적레이저섬유주성형술의 효용성
박혜원1,2⋅한승수1,2,3⋅박종운2
연세대학교 의과대학 안과학교실 시기능개발 연구소1, 국민건강보험 일산병원 안과2, 전라남도 순천의료원 안과3
Correspondence:  Jong Woon Park,
Email: unij143@naver.com
Received: 12 January 2017   • Revised: 24 April 2017   • Accepted: 16 June 2017
Abstract
PURPOSE
To determine the effect of intraocular pressure (IOP) reduction of selective laser trabeculoplasty (SLT) on medically uncontrolled open-angle glaucoma (OAG) and the factors associated with the treatment result. METHODS: Forty-seven eyes of 47 OAG patients were enrolled for 180° SLT or 360° SLT, all under maximal tolerated medical therapy and with IOP above their target pressure. All patients were followed-up for at least 1 year after the procedure. Treatment success was defined as IOP reduction ≥20% from baseline at 12 months after SLT treatment without additional anti-glaucomatous intervention. RESULTS: The treatment success rate was 65.96%. Baseline IOP was 23.84 ± 4.52 mmHg in the success group and 21.44 ± 2.97 mmHg in the failure group (p = 0.035). Significant mean IOP reduction was observed at 6, 9, and 12 month follow-ups (p = 0.001 at 6 months; 0.041 at 9 months, and <0.001 at 12 months). The success rate did not vary significantly by sex (p = 0.362), age (p = 0.081), history of cataract surgery (p = 0.470), number of medications (p = 0.857), duration of medication (p = 0.613), or angular degree of SLT treatment (180° vs. 360°) (p = 0.137). There was a positive correlation between mean baseline IOP and mean reduction of IOP from baseline in the success group (p < 0.001, r = 0.861), while there was no such correlation in the failure group (p = 0.272, r = −2.921). CONCLUSIONS: SLT was an effective treatment for IOP reduction until 12 months in medically uncontrolled OAG patients. A greater amount of IOP reduction is expected in patients with higher baseline IOP in the success group.
Key Words: Intraocular pressure (IOP);Maximal tolerated medical therapy (MTMT);Selective laser trabeculoplasty (SLT);Uncontrolled glaucoma


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