Comparative analysis of one year outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in Primary Open Angle Glaucoma patients in Nigeria

Abstract

Background: There are several challenges associated with trabeculectomy and medical management in Nigeria. This makes laser trabeculoplasty a viable option in glaucoma management. This study compares Selective Laser Trabeculoplasty (SLT) with Argon Laser Trabeculoplasty (ALT) in Nigerians with open angle glaucoma.

Methods: This was a retrospective study performed on 26 eyes of 26 patients who had ALT and were recruited consecutively at the glaucoma clinic of the University College Hospital (UCH), and 25 eyes of 25 patients who had SLT recruited from the Guinness Eye Centre, Lagos University Teaching Hospital, Lagos (LUTH). The main outcome measure was intraocular pressure (IOP) at one month, three months, six months and one year. Success was defined as IOP reduction of 3mmHg or more without additional intervention (glaucoma surgery) from the pretreatment IOP.

Results: The mean age of the patients who had ALT was 58.0±7.1 years (range of 40.0-70.0 years) while the mean age of patients who had SLT was 53.52 ± 14.65 years (Range 22 – 74 years). There was no statistically significant difference in IOP between the two groups at the different time periods. Based on our criterion for success, 84.5% of the patients had successful outcome at six months in the ALT group while 70.5% were successful in the SLT group (P=0.6). At one year, there was no statistically significant difference between the two groups on log rank test/Mantel Cox (Chi square 3.36, df=1, P=0.07.)

Conclusion: This study highlights the efficacy and safety of both lasers in Nigerians and adds to knowledge that the adjunctive IOP reducing effect of both lasers is comparable in the short term in this indigenous African population.