Selective laser trabeculoplasty is effective in controlling steroid-induced OHT after 0.19 µg Fluocinolone acetonide implant, a long-term outcome of 15 eyes

To evaluate the long-term effectiveness and safety of selective laser trabeculoplasty (SLT) for controlling intraocular pressure (IOP) in patients with steroid-induced ocular hypertension (OHT) treated with fluocinolone acetonide (FAc) intravitreal implants.

This was a single-center retrospective case series of patients with steroid-induced OHT. Eligibility required prior to exposure to ≥ 3 sustained-release dexamethasone intravitreal implants per eye. SLT was performed in all eyes either before (group 1, n = 6), after (group 2, n = 6), or both before and after (group 3, n = 3) the FAc implantation. IOP was analysed with linear mixed-effects models (random intercept for eye). The mean IOP and within-eye variability (SD-IOP) were summarized for the pre-SLT and post-SLT periods.

Fifteen eyes from thirteen patients treated for macular edema were followed for 32 ± 17.7 months after SLT. The mean IOP decreased by 14.2 mmHg across the cohort (p < 0,001). In group 1, which was treated with SLT before FAc implantation, the mean IOP decreased from 16.5 ± 4.8 mmHg to 13.7 ± 2.1 mmHg (p < 0.001) with significantly reduced IOP variability (-2.1 mmHg, p < 0.001). No eye required filtering surgery. Steroid-induced OHT resolved in all eyes within ≤ 4 months after the last dexamethasone implant and ≤ 36 months after the FAc implant.

SLT is a safe, effective, and repeatable intervention for preventing or controlling IOP elevation in OHT responders’ eyes receiving FAc implants. Performing SLT prior to FAc injection may offer better IOP control and reduce variability in such patients.