ARVO
ARVO
May 12, 2016
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Study labels laser trabeculoplasty as adjunctive, not alternative, glaucoma treatment

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SEATTLE – A retrospective analysis has found that 3 months after laser trabeculoplasty, 60% of open-angle glaucoma patients were prescribed at least one topical glaucoma medication.

Hitesh Chandwani, PhD, and colleagues reported here at the Association for Research in Vision and Ophthalmology meeting that they evaluated 2,376 patients with glaucoma from an insurance database who underwent laser trabeculoplasty (LT) and 2,783 patients treated with medication only. Mean age for both cohorts was about 67 years, and about the same number of men and women were included.

Three months after LT, 60% of laser-treated patients were prescribed at least one topical glaucoma medication, according to the study. At 1 year, nearly 20% were using at least two medications, and at 4 years 37% were using at least two.

“Only 22.9% of LT-treated patients were receiving no additional topical glaucoma medications at year 1, and this number decreased to 16.1% by 4 years post-LT,” the study said.

The researchers noted that the addition of medications was higher for the medication-only group compared to the surgery group.

They concluded that the study findings support LT as an adjunctive therapy rather than an alternative to topical medications for treating glaucoma.

“Laser trabeculoplasty is used as an alternative to medications due to noncompliance,” Chandwani told Primary Care Optometry News. “However, LT patients seem to go back on medications quickly. Yes, it brings it down to maybe one drug over the course of 4 years, but it really doesn’t help with a noncompliant patient.”

The answer may be sustained-release medications such as bimatoprost, Chandwani said, or devices that can be used to manage IOP.

“They are invasive but have the potential to provide efficacy and keep control of the treatment in the doctor’s hands,” he said. – by Nancy Hemphill, ELS, FAAO

Reference:

Coleman AL, et al. Subsequent medical management of open-angle glaucoma patients treated with laser trabeculoplasty. Presented at: Association for Research in Vision and Ophthalmology meeting; May 1-5, 2016; Seattle.

Disclosure: Chandwani is employed by Allergan.