Intraocular Pressure-Lowering Effect of Omidenepag Isopropyl as a Predictor of the Efficacy of Laser Trabeculoplasty.

PRCIS: A strong intraocular pressure reduction with omidenepag isopropyl predicts greater efficacy of patterned laser trabeculoplasty in primary open angle glaucoma, while prior omidenepag use does not diminish laser treatment outcomes.

OBJECTIVES

To determine whether the intraocular pressure (IOP)-lowering response to omidenepag isopropyl (OMDI) predicts the efficacy of patterned laser trabeculoplasty (PLT) in primary open angle glaucoma (POAG) patients and to assess any interaction between OMDI and PLT when used in combination.

METHODS

This retrospective propensity score-matched study included 63 eyes treated with OMDI followed by PLT and 63 matched eyes treated with PLT alone, matched by baseline IOP and age. IOP reduction with OMDI was assessed before PLT, and the IOP-lowering outcomes of PLT were evaluated 1 month after the procedure. Statistical analyses were performed to identify predictors of PLT response within each group and to compare PLT efficacy between the groups.

RESULTS

Baseline characteristics were comparable between the groups. The IOP reduction rate after PLT did not differ significantly between the OMDI+PLT and PLT-only groups. In the OMDI+PLT group, PLT responders had greater IOP reductions from OMDI than nonresponders (31.52±13.03% vs. 15.62±17.43%; P <0.001). Linear regression identified the IOP-lowering rate from the OMDI as the sole significant predictor of PLT response in the OMDI+PLT group ( B =0.792, P <0.001). In the PLT-only group, only baseline IOP predicted the PLT response.

CONCLUSIONS

A greater IOP-lowering response to OMDI predicts a larger IOP reduction with PLT, supporting the use of OMDI responsiveness as a potential indicator of PLT efficacy in POAG. OMDI administration did not alter the IOP-lowering effects of PLT.