Evaluating selective laser trabeculoplasty versus argon laser trabeculoplasty in pseudoexfoliation glaucoma patients

Objective: Laser trabeculoplasty effectively reduces intraocular pressure (IOP) in primary open angle glaucoma, with argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) showing equivalent outcomes. However, it is unclear which laser modality is more effective in pseudoexfoliation (PXE) glaucoma. This study aims to compare the effectiveness of ALT and SLT in PXE glaucoma. Design: Retrospective cohort study. Methods: A chart review evaluating patients diagnosed with PXE glaucoma and treated with laser trabeculoplasty from 2005-2015. Patients with previous glaucoma surgery, other forms of secondary glaucoma, ocular surgery within six months of initial trabeculoplasty or lacking preoperative IOP measurements were excluded. Post-laser measurements were recorded until 24 months after initial intervention. Follow-up data was censored if the patient underwent a subsequent trabeculoplasty different from initial laser treatment. Results: We included 84 patients in the ALT group and 123 in the SLT group. The mean (SD) baseline IOP values were 22.7 (±5.6) and 21.6 (±4.8) respectively (p = 0.11), while number of medications were 2.0 (±1.0) and 1.8 (±1.3) for ALT and SLT groups respectively (p = 0.36). The mean IOP reduction for the ALT group at 6, 12 and 24 months were 5.2 (±6.1), 5.4 (±6.9), and 4.9(±7.7) respectively. The corresponding values for the SLT group were 3.4 (±5.2), 3.8 (±4.6), and 4.6 (±6.5). Comparison of both lasers at each time point revealed no significant differences (p > 0.05) in IOP reduction or reduction of glaucoma medication. Conclusions: Our study showed equivalent efficacy between ALT and SLT in patients with PXE glaucoma.