Effects of Selective Laser Trabeculoplasty on 24-Hour Intraocular Pressure in Patients with Well-Controlled in the Clinic but Progressing Primary Open Angle Glaucoma.

Purpose: To evaluate the effects of selective laser trabeculoplasty (SLT) on 24-hour intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG) with well-controlled IOP but who exhibit glaucoma progression. Methods: This retrospective study included all POAG patients with disease progression despite a well-controlled IOP in the clinic (≤14 mmHg) after antiglaucoma eye drops administration (mean number of medications = 3.93 ± 0.96). All patients underwent 24-hour IOP measurement before and after SLT. Using the iCare HOME tonometer, IOP was self-measured at several intervals for over 10 days at home in a sitting position. The analysis calculated the 24-hour IOP data after dividing it into eight time periods, while the average IOP values were calculated over each 3-hour period. The average, maximum, minimum, and fluctuation (maximum-minimum) were compared before and after SLT. Results: In 16 eyes of the 13 enrolled patients, the mean 24-hour IOP was significantly reduced after SLT (11.3 (10.2-13.4) (median (interquartile range) mmHg before vs 10.5 (9.4-11.8) mmHg after, p=0.029). Significant IOP reductions were observed between 3 to 6 AM and 6 to 9 PM after SLT (p=0.004 and p=0.043, respectively). Although there was a significant reduction in the maximum 24-hour IOP (p=0.039), the minimum IOP did not significantly change after SLT (p=0.083). There were also no changes after SLT in the 24-hour, diurnal and nocturnal IOP fluctuations. Conclusion: SLT significantly reduced nocturnal and maximum IOP in POAG patients whose IOP was already well-controlled in the clinic.