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. 2020 Oct 13:2020:3439182.
doi: 10.1155/2020/3439182. eCollection 2020.

The Effect of Selective Laser Trabeculoplasty on Intraocular Pressure in Patients with Dexamethasone Intravitreal Implant-Induced Elevated Intraocular Pressure

Amin Bennedjai  1 , Vincent Theillac  1 , Jad Akesbi  1 , Raphaël Adam  1 , Thibaut Rodallec  1 , Chafik Keilani  1 , Esther Blumen-Ohana  1 , Antoine Labbé  2 , Jean-Philippe Nordmann  1
Affiliations

The Effect of Selective Laser Trabeculoplasty on Intraocular Pressure in Patients with Dexamethasone Intravitreal Implant-Induced Elevated Intraocular Pressure

Amin Bennedjai et al. J Ophthalmol. .

Abstract

Introduction: To assess the safety and efficacy of selective laser trabeculoplasty (SLT) for ocular hypertension (OHT) induced by a dexamethasone (DEX) intravitreal implant.

Materials and methods: We performed a retrospective study of patients who underwent an SLT procedure for ocular hypertension induced by injection of a DEX intravitreal implant. Patients had, at least, one injection of the DEX-implant for symptomatic macular edema. SLT was delivered to 360° of the trabecular meshwork in two sessions. The primary outcome was a decrease in IOP, evaluated at one, three, and six months after the SLT procedure.

Results: Twenty-six eyes of 22 patients were included. The mean intraocular pressure (IOP) measured after DEX-implant injection was 25.4 ± 5.4 mmHg, and the mean increase in IOP was 35.8 ± 14.6%. The mean follow-up after SLT was 18.3 ± 7.7 months. After SLT, the mean IOP dropped by 30.9% at one month (16.9 ± 4.5 mmHg, p=0.01), 33.6% at three months (16.0 ± 2.7 mmHg, p < 0.01), and 34.9% at six months (15.6 ± 2.1 mmHg, p < 0.01). Each patient had a minimum follow-up of 6 months after SLT. Eight eyes (31%) received a second DEX-implant injection after the SLT procedure without experiencing an increase in the IOP above 21 mmHg or >20%. No glaucoma surgery was required during the follow-up. The mean number of medications (1.65 ± 1.36) was significantly reduced at one (1.19 ± 1.20, p=0.04), three (0.96 ± 1.03, p < 0.01), and six months (0.77 ± 0.95, p < 0.01) after SLT.

Conclusion: SLT is an effective and safe procedure to control OHT following DEX-implant intravitreal injection.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Intraocular pressure lowering after the SLT procedure with a follow-up of 6 months.
Figure 2
Figure 2
Evolution of mean intraocular pressure (IOP) before and after a DEX-implant injection in eyes that underwent selective laser trabeculoplasty versus contralateral eyes at one, three, and six months after treatment.
Figure 3
Figure 3
Kaplan–Meier survival curves plotting the cumulative probabilities that the IOP remains below 25 mmHg, 21 mmHg, and 18 mmHg, respectively, following the SLT procedure.
See this image and copyright information in PMC

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