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Prostaglandin Analog Improves Results of Selective Laser Trabeculoplasty: Presented at ARVO

By Michael Casasnovas

FT. LAUDERDALE, F.L. -- May 3, 2006 -- After selective laser trabeculoplasty (SLT), the use of topical prostaglandin analogs significantly reduces intraocular pressure for patients with glaucoma, said researchers here at the Association for Research on Vision and Ophthalmology (ARVO) annual meeting.

"We found a significant reduction in the intraocular pressure, and percent intraocular pressure, in eyes receiving PGF-2a agonists 1 month after trabeculoplasty, compared to those patients who did not receive these agents," said Warren Scherer, MD, PhD, ophthalmologist, Montgomery Eye Center, Naples, Florida.'

The researchers reviewed reports on 113 eyes of patients with open-angle glaucoma who received selective laser trabeculoplasty. The patients were stratified into groups of those who were administered PGF-2a, and if so, was it alone or in combination with other treatments.

Researchers created a baseline for intraocular pressure from an average of measurements taken from 2 separate visits before the selective laser trabeculoplasty. This baseline did not differ between prostaglandin analog and nonprostaglandin analog users.

Patients received 1 drop of 1% pilocarpine in the operative eye 20 minutes before the laser procedure. Researchers used a Lumenis Selecta Laser II to perform the selective laser trabeculoplasty. After surgery, patients continued their regular glaucoma medications and used 1% prednisolone acetate 4 times a day for 3 days following the procedure.

"The effects of PGF-2a analogs on the trabecular meshwork structure and function following a procedure that alters the normal physiological state of the trabecular meshwork as does selective laser trabeculoplasty, are not known. This study assessed the effects of PGF-2a analogs on postoperative intraocular pressure and treatment success following selective laser trabeculoplasty," Dr. Scherer said.

A significant percentage of eyes receiving PGF-2a agonists 1 month after SLT achieved a 3 mm Hg or greater decrease in intraocular pressure, when compared with those patients who did not receive these agents. That was significant at the P <.02 level, he reported. A greater percentage of eyes receiving PGF-2a agonists achieved a 20% or greater decrease in intraocular pressure 1 month after selective laser trabeculoplasty compared with eyes that did not receive these agents (P <.05).

"Laser trabeculoplasty enhances metalloproteinase activity in the trabecular meshwork. The resulting modification of the trabecular meshwork extracellular matrix may contribute to the effectiveness of this procedure," said Dr. Scherer.


[Presentation title: Effect of Topical Prostaglandin Analog Use on Outcome Following Selective Laser Trabeculoplasty. Abstract 399]

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