Clinical Outcomes of Micropulse Laser Trabeculoplasty Compared to Selective Laser Trabeculoplasty at One Year in Open-Angle Glaucoma

Figures & data

Table 1 Baseline Patient and Ocular Characteristics

Characteristics (by Patient)	MLT (N=32 Patients)	SLT (N=59 Patients)	P-value
Age (years), mean (95% CI)	68 (63–72)	74 (71–77)	0.02
Female, N (%)	18 (56%)	30 (51%)	0.63
Deceased, N (%)	1 (3%)	3 (5%)	1.0
Ethnicity, N (%)			0.95
White	15 (47%)	29 (49%)
Asian	7 (22%)	15 (25.5%)
Hispanic	4 (12.5%)	6 (10%)
Black	4 (12.5%)	4 (7%)
Other	1 (3%)	2 (3.5%)
Unknown	1 (3%)	3 (5%)
Characteristics (by Eye)	MLT (N=43 Eyes)	SLT (N=85 Eyes)
Eye, N (%)			0.15
OD	26 (60%)	40 (47%)
OS	17 (40%)	45 (53%)
Diagnosis, N (%)			0.96
Primary-open angle glaucoma	32 (74%)	61 (72%)
Normal tension glaucoma	9 (21%)	20 (24%)
Pigmentary glaucoma	1 (2.5%)	2 (2%)
Pseudoexfoliation glaucoma	1 (2.5%)	2 (2%)
Best corrected visual acuity (logMAR), mean (95% CI)	0.20 (0.12–0.28)	0.24 (0.15–0.32)	0.59
Intraocular pressure (mmHg), mean (95% CI)	18.0 (16.4–19.5)	18.2 (17.2–19.3)	0.76
Glaucoma Medications, mean (95% CI)	1.8 (1.4–2.2)	2.0 (1.6–2.3)	0.49
0, N (%)	7 (16%)	20 (23.5%)
1	16 (37%)	20 (23.5%)
2	5 (12%)	5 (6%)
3	10 (23%)	24 (28%)
4	5 (12%)	16 (19%)
Central corneal thickness (μm), mean (95% CI)	562 (546–578)	545 (536–554)	0.046
Target IOP, N (%)			0.78
≤12	12 (28%)	27 (32%)
≤16	16 (37.2%)	36 (42%)
≤18	5 (11.6%)	9 (11%)
≤21	5 (11.6%)	5 (6%)
Unknown	5 (11.6%)	8 (9%)

Abbreviations: MLT, micropulse laser trabeculoplasty; SLT, selective laser trabeculoplasty; N, number; OD, right eye; OS, left eye; SD, standard deviation; CI, confidence interval; IOP, intraocular pressure; logMAR, logarithm of the minimum angle of resolution.

Table 2 Clinical Outcomes at One Year

Characteristics	MLT (N=43 Eyes)	SLT (N=85 Eyes)	P-value
Best corrected visual acuity at 1 year (logMAR), mean (95% CI)	0.21 (0.13–0.30)	0.24 (0.16–0.32)	0.73
IOP at 1 year (mmHg), mean (95% CI)	16.7 (15.5–17.9)	15.7 (14.8–16.5)	0.16
Glaucoma medications at 1 year, mean (95% CI)	1.9 (1.5–2.3)	1.7 (1.4–2.0)	0.45
0, N (%)	3 (7%)	20 (23.5%)
1	17 (40%)	23 (27%)
2	10 (23%)	15 (17.5%)
3	7 (16%)	16 (19%)
4 or more	6 (14%)	11 (13%)
Reasons patients failed, N (%)
IOP (<20% reduction or did not meet target IOP)	33 (77%)	54 (64%)	0.13
Additional glaucoma medications	12 (28%)	13 (15%)	0.09
Repeat laser trabeculoplasty	2 (5%)	4 (5%)	1.0
Need for glaucoma surgery	5 (12%)	5 (5%)	0.32
Time to repeat laser trabeculoplasty (days), mean (SD)	487 (16)	466 (78)	0.73
Time to glaucoma surgery (days), mean (SD)	208 (101)	233 (129)	0.74
Underwent standalone cataract surgery, N (%)	0 (0%)	2 (2%)	0.55

Abbreviations: MLT, micropulse laser trabeculoplasty; SLT, selective laser trabeculoplasty; SD, standard deviation; CI, confidence interval; N, number; logMAR, logarithm of the minimum angle of resolution; IOP, intraocular pressure.

Figure 1 Mean intraocular pressure (top graph) and number of glaucoma medications (bottom graph) between the micropulse laser trabeculoplasty (MLT) and selective laser trabeculoplasty (SLT) groups at follow-up intervals up to 2 years. No statistically significant difference was noted between MLT and SLT-treated eyes except for intraocular pressure at 1 month follow-up. Error bars represent standard error of the mean.

Abbreviation: N, number of eyes.

Table 3 Multivariable Regression Model Predicting Success at 1 Year

Covariates	Relative Risk	95% CI	P-value
Laser (SLT compared to MLT)	1.37	0.75–2.48	0.30
Baseline IOP (per mmHg)	1.01	0.97–1.05	0.62
Baseline glaucoma medications (per 1 medication)	1.13	0.94–1.36	0.18
Baseline central corneal thickness (per mm)	1.00	0.99–1.00	0.13

Abbreviations: SLT, selective laser trabeculoplasty; MLT, micropulse laser trabeculoplasty; CI, confidence interval; IOP, intraocular pressure.