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. 2015 Aug;160(2):275-282.e4.
doi: 10.1016/j.ajo.2015.04.031. Epub 2015 Apr 30.

Subsequent Receipt of Interventions for Glaucoma Among a Nationwide Sample of Patients Who Underwent Laser Peripheral Iridotomy

Surbhi Bansal  1 , S Asha Balakrishnan  1 , Taylor Blachley  1 , Jennifer S Weizer  1 , Paul P Lee  2 , Joshua D Stein  3
Affiliations

Subsequent Receipt of Interventions for Glaucoma Among a Nationwide Sample of Patients Who Underwent Laser Peripheral Iridotomy

Surbhi Bansal et al. Am J Ophthalmol. 2015 Aug.

Abstract

Purpose: To evaluate use of medical, laser, or incisional surgical interventions for glaucoma after laser peripheral iridotomy (LPI).

Design: Retrospective longitudinal cohort study.

Methods: All enrollees aged ≥21 years in a US managed-care network who underwent bilateral LPIs in 2001-2011 were identified. The mean numbers of pre- and post-LPI glaucoma medication classes prescribed and the proportion of enrollees requiring cataract or glaucoma surgery within 2 years after the LPIs were determined. Multivariable logistic regression assessed factors associated with enrollees' prescription of ≥1 glaucoma medication class after bilateral LPIs.

Results: Of the 1660 patients undergoing bilateral LPIs, 1280 (77.1%) had no pre- or post-LPI prescriptions for any glaucoma medication class. Of the remaining patients, 251 (66.1%) required more glaucoma medication classes after than before the procedures, whereas 44 (11.6%) used fewer after the procedures; 85 (22.4%) were prescribed the same number before and after the LPIs. A total of 167 patients (10.1%) underwent cataract surgery and 79 (4.8%) received glaucoma surgery over the 2-year follow-up. Black patients had a 130% increased odds for glaucoma medication-class prescriptions after bilateral LPIs, compared with white patients (P = .02). The odds of post-LPI glaucoma medication use increased by 21% for every additional 5 years of age (P < .0001).

Conclusion: Most patients undergoing bilateral LPIs received no pre- or post-LPI glaucoma medication-class prescriptions and had no cataract or additional glaucoma surgery within 2 years after LPIs. Clinicians should alert black or older patients and those already taking glaucoma medications before the procedure of their higher odds of requiring medications afterward.

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Conflict of interest statement

The authors have no proprietary interest in any material discussed in this manuscript.

Figures

Figure 1
Figure 1
Sample Selection of Enrollees in a Large Managed Care Plan who Underwent Bilateral Laser Peripheral Iridotomy During 2001–2011 LPI=Laser peripheral iridotomy; LTP=Laser trabeculoplasty
See this image and copyright information in PMC

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