| Description: |
OBJECTIVE: In this study we examined whether short-term use of topical NSAID or steroid therapy affected the efficacy of selective laser trabeculoplasty (SLT). DESIGN: Double-masked, randomized, placebo-controlled, dual-center, multi-surgeon trial Subjects and controls: Patients over 18 years with IOP >18 mm Hg for whom the clinician decided SLT would be appropriately indicated therapy were randomized to one of three groups in a ratio of 1:1:1 as follows: ketorolac 0.5%, prednisolone 1%, or saline tears. METHODS: After SLT was performed, patients randomized into each group were instructed to use an unmarked drop 4 times per day starting the day of the SLT and continuing for 4 additional days. Kruskal Wallis test and Wilcoxon Rank Sum test were used for continuous variables when comparing two or three treatment groups, respectively. Fisher’s Exact test was used for categorical variables. MAIN OUTCOME MEASURES: The primary outcome of this study was intraocular pressure (IOP) at 12 weeks. Secondary outcome measures included IOP at 1 and 6 weeks, patient-reported pain, and detectable anterior chamber inflammation. RESULTS: 96 eyes of 85 patients fit inclusion criteria and were enrolled between the two sites. The NSAID, steroid, and placebo groups were similar in baseline demographics and baseline IOP (mean 23.3± 3.9 mm Hg, p=0.57). There was no statistically significant difference in IOP decrease among groups at week 6. Both the NSAID and steroid groups had a statistically significantly greater decrease in IOP at week 12 compared to placebo (−6.2±3.1, −5.2±2.7 and −3±4.3 mmHg, respectively; ANOVA p-value 0.02; t-test p=0.002 for NSAID vs. placebo; p=0.02 for steroid vs. placebo). CONCLUSIONS: Significantly better IOP reduction at 12 weeks was measured in eyes treated with steroid or NSAID drops following SLT. Short-term postoperative use of NSAID or steroid drops may improve IOP reduction after SLT. Longer-term follow-up studies are indicated. |