Intraocular pressure profile following selective laser trabeculoplasty in pigmentary and primary open-angle glaucoma.

Purpose: To compare the intraocular pressure (IOP) profile and the incidence of IOP spikes following selective laser trabeculoplasty (SLT) between pigmentary glaucoma (PG) and primary open-angle glaucoma (POAG).
Materials and Methods: Retrospective comparative study of 65 PG eyes of 51 patients matched with 65 POAG eyes of 65 patients who received SLT. Matching was done based on age, gender, glaucoma severity, pre-laser IOP, and number of medications. Post-SLT IOP spike was defined as IOP elevation ≥5mmHg, 30-45 min after the laser.
Results: In PG and POAG groups, the average age was 62.33 ± 9.18 and 62.58 ± 9.19 years (p = 0.95). The glaucoma severity (p = 0.708), baseline IOP (PG = 21.61 ± 1.34mmHg vs. POAG = 21.13 ± 5.09mmHg, p = 0.943), and number of topical glaucoma medications(PG = 2.34 ± 1.34 vs. POAG = 2.1 ± 1.41, p = 0.342) were comparable. More PG patients were on oral acetazolamide (PG = 26.15% vs. POAG = 1.5%, p < 0.001). Average logMAR visual acuity was significantly higher in the POAG group (0.207 ± 0.3 vs. 0.192 ± 0.37, p = 0.012). Eyes with PG received lower laser energy (POAG = 63.65 ± 22.03 mJ vs. PG = 43.71 ± 25.68 mJ, p < 0.001). IOP spikes were recorded in 5 PG eyes (7.6%) and none in the POAG group (p = 0.058). Failure rates were similar (PG = 50.7% and POAG = 43.1%, p = 0.205). In multivariable analysis, only pre-laser IOP (coefficient = 2.154 [CI: 0.765-3.543], p = 0.003) was a significant predictor of IOP change percentage after 12 months.
Conclusions: SLT was comparably effective in both PG and POAG. IOP spikes were observed only in the PG group, though the total laser energy was lower in this group compared with POAG.
Competing Interests: Declaration of conflicting interestsThe author(s) declare they have no relevant financial disclosure. The following is the full list of disclosures for each author: NNK (Kolomeyer) received research support from AbbVie/Allergan, Guardion Health Services Inc, Equinox, Nicox, Olleyes, Santen, Glaukos, Diopsys, and Aerie, and consulting fees from AbbVie/Allergan (myself, spouse), Regeneron (spouse), Alimera (spouse), Genentech (spouse); AGS (Shukla) has received research support from AbbVie, Inc, and consulting fees from AbbVie, Inc., and also participates on a Data Safety Monitoring Board or Advisory Board for AbbVie, Inc; RR (Reza) received research support from Olleyes, Equinox, and Allergan; DL (Lee) has received research support from Allergan, Equinox, Glaukos, Mati, Nicox, Olleyes, and Santan, lecture fees from Glaukos, and consulting fees from Quidel Eye Health; JSM (Myers): Research grants: AbbVie, Elios, Equinox, Glaukos, Guardian, Laboratories Thea, Nicox, Olleyes, Santen; Consulting: AbbVie, Avisi, Embark Neuro, Glaukos, Olleyes; MRM (Moster): Abbvie: Consultant/Advisor, LectureFees/SpeakersBureau, GrantSupport, ArcScan: Advisory Board Aerie Pharmaceuticals: Consultant/Advisor, LectureFees/Speakers Bureau, Grant Support, Alcon Laboratories Inc.: Consultant/Advisor, Lecture Fees/Speakers Bureau, Grant Support, Allergan: Consultant/Advisor, LectureFees/SpeakersBureau, Grant Support Bausch + Lomb: Lecture Fees/Speakers Bureau, Grant Support, Glaukos: Grant Support, Inn Focus: Grant Support, MedEdicus: LectureFees/SpeakersBureau, New World Medical, Inc.: Grant Support, Novartis, Alcon Pharmaceuticals: Lecture Fees/Speakers Bureau, Regeneron: Advisor, Santen, Inc.: Consultant/Advisor, Grant Support, Thea Inc.: Grant Support, Advisor. W. L. Gore & Associates, Inc.: Advisor ; SH, SS, NM, AM, ED, CS, and MJP declare they have no financial disclosures.