The Effects of Selective Laser Trabeculoplasty in Patients With Angle Recession Glaucoma: A Case Series.

Purpose: To evaluate the effectiveness of selective laser trabeculoplasty (SLT) in reducing intraocular pressure (IOP) and medication use in treated and untreated eyes of angle recession glaucoma (ARG) patients within a year post procedure.

Methods: A retrospective chart review was conducted on nine ARG patients treated with SLT at George Washington University between January 1, 2008, and January 1, 2022. Patients were excluded if they had no ARG diagnosis, did not undergo SLT, lacked follow-up within one year after SLT, or had undergone laser or glaucoma surgery in the treated or untreated eye within 12 months before SLT. Primary outcomes were IOP reduction and SLT success, defined as a ≥20% reduction in IOP without additional IOP-lowering procedures or medications. Follow-up assessments were conducted at six weeks, six months, and 12 months. Statistical analysis included paired t-tests and ANOVA.

Results: A total of nine eyes from nine ARG patients were included, with a mean age of 62.33 years. SLT treatment success was observed in five out of nine (55.5%) treated eyes at various time points. In untreated contralateral eyes, success was noted in three out of nine patients (33.3%). The mean IOP for SLT-treated eyes at baseline, six-week, six-month, and 12-month visits was 20 ± 6.22 mmHg, 17.39 ± 5.11 mmHg (P > 0.05), 18.69 ± 4.99 mmHg (P > 0.05), and 16.83 ± 3.87 mmHg (P > 0.05), respectively. For the same time points, the mean IOP for untreated eyes was 15 ± 3.28 mmHg (P > 0.05), 14 ± 3.20 mmHg (P > 0.05), 14.38 ± 4.24 mmHg (P > 0.05), and 14.83 ± 3.82 mmHg (P > 0.05), respectively. The average number of medications used for the ipsilateral eye at the baseline, six-week, six-month, and 12-month visits was 3.11 ± 1.27, 3.11 ± 1.05, 3.25 ± 1.04, and 3.50 ± 0.55, with no significant changes over time (P > 0.05). Meanwhile, for the contralateral eye, the average medication use at those same points was 1.00 ± 1.32, 1.00 ± 1.32, 1.13 ± 1.36, and 0.67 ± 0.82, also showing no significant changes (P > 0.05).

Conclusion: SLT was safe and effective in reducing IOP in a subset of treated ARG eyes, with better outcomes observed in those with higher baseline IOP. While individual responses varied, SLT could be considered a viable treatment option for delaying invasive surgery in ARG patients. Larger studies are needed to confirm long-term efficacy and identify predictors of success.