Clinical ophthalmology (Auckland, N.Z.) · 2026
Outcomes of Selective Laser Trabeculoplasty for Sustained Elevation of Intraocular Pressure Following Intravitreal Anti-VEGF Injections.
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Jung Kyungseok, Adelman Ron A, Liu Ji
Аннотация
PURPOSE: To evaluate the efficacy and predictors of success of selective laser trabeculoplasty (SLT) for sustained elevation of intraocular pressure (SE-IOP) associated with anti-vascular endothelial growth factor (VEGF) therapy.
DESIGN: Retrospective observational case series.
METHODS: A retrospective chart review was performed for patients who received SLT following one or more anti-VEGF injections at an academic center between January 2013 and June 2022. Exclusionary criteria included history of non-open-angle glaucoma, incisional glaucoma surgery, or SLT more than 24 months after anti-VEGF injections.
MAIN OUTCOME MEASURES: Outcomes included mean IOP and medication use up to 24 months following SLT. Failure was defined as less than 20% IOP reduction, increase in medication use, or need for additional laser or surgical interventions.
RESULTS: Thirty-three eyes of 31 patients were identified. Baseline IOP was 25.1 ± 6.1 mmHg on 2.7 ± 1.3 medications. SLT significantly reduced mean IOP but not medication use at all recorded time frames. At 24 months, mean IOP was 17.5 ± 8.2 mmHg (P = 0.009) on 3.1 ± 0.9 medications (P = 0.313). Success rates were 48.5% at 6 months, 32.3% at 12 months, and 23.6% at 24 months. The frequency of anti-VEGF injections (HR: 1.318; 95% CI: 1.072 to 1.623; P = 0.008) was the only significant predictor of SLT success in the multivariate analysis.
CONCLUSION: SLT may be an effective adjunctive therapy for SE-IOP associated with anti-VEGF injections. The frequency of anti-VEGF injections prior to SLT may be a key predictor of treatment success.
DESIGN: Retrospective observational case series.
METHODS: A retrospective chart review was performed for patients who received SLT following one or more anti-VEGF injections at an academic center between January 2013 and June 2022. Exclusionary criteria included history of non-open-angle glaucoma, incisional glaucoma surgery, or SLT more than 24 months after anti-VEGF injections.
MAIN OUTCOME MEASURES: Outcomes included mean IOP and medication use up to 24 months following SLT. Failure was defined as less than 20% IOP reduction, increase in medication use, or need for additional laser or surgical interventions.
RESULTS: Thirty-three eyes of 31 patients were identified. Baseline IOP was 25.1 ± 6.1 mmHg on 2.7 ± 1.3 medications. SLT significantly reduced mean IOP but not medication use at all recorded time frames. At 24 months, mean IOP was 17.5 ± 8.2 mmHg (P = 0.009) on 3.1 ± 0.9 medications (P = 0.313). Success rates were 48.5% at 6 months, 32.3% at 12 months, and 23.6% at 24 months. The frequency of anti-VEGF injections (HR: 1.318; 95% CI: 1.072 to 1.623; P = 0.008) was the only significant predictor of SLT success in the multivariate analysis.
CONCLUSION: SLT may be an effective adjunctive therapy for SE-IOP associated with anti-VEGF injections. The frequency of anti-VEGF injections prior to SLT may be a key predictor of treatment success.