The Effect Of Selective Laser Trabeculoplasty On Intraocular Pressure In Patients With Dexamethasone Intravitreal Implant-Induced Elevated Intraocular Pressure

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 degrees 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, p0.01), and 34.9% at six months (15.6 +/- 2.1 mmHg, p0.01). 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, p0.01), and six months (0.77 +/- 0.95, p0.01) after SLT. Conclusion. SLT is an effective and safe procedure to control OHT following DEX-implant intravitreal injection.