Anti-inflammatory Therapy after Selective Laser Trabeculoplasty : A Randomized, Double-Masked, Placebo-Controlled Clinical Trial

PurposeTo investigate the effect of anti-inflammatory therapy on selective laser trabeculoplasty (SLT) outcomes.DesignRandomized, double-masked, placebo-controlled trial.ParticipantsPatients with primary open-angle or pseudo-exfoliation glaucoma.MethodsPatients undergoing SLT were randomized to receive placebo (artificial tears), prednisolone acetate 1%, or ketorolac tromethamine 0.5% eye drops 4 times per day for 5 days commencing immediately after SLT.Main Outcome MeasuresChange in intraocular pressure (IOP) from baseline to the 1-month post-SLT visit.ResultsMean change in IOP at the 1-month primary outcome time point, as well as all other time points, was not significantly different among groups (P = 0.99). Likewise, a repeated-measures, mixed-effects model did not find significant differences in IOP outcome at the 1-month time point (P = 0.95). The IOP was reduced in all groups at the 1-month post-SLT time point and all other time points, and no significant differences were found between groups using separate unadjusted cross-sectional analyses of variance (P > 0.15 for analyses at all time points). Treatment failure rates were not different among groups (P = 0.75), and at 1 year after SLT, the percentage of patients maintaining a 20% IOP reduction ranged from 18% to 22% in the 3 study groups.ConclusionsAnti-inflammatory therapy after SLT does not seem to substantially influence the IOP-lowering effect of SLT. In this study of patients with low baseline IOP, SLT showed limited efficacy in achieving a sustained reduction in IOP.