Early Intraocular Pressure Spikes Observed After Selective Laser Trabeculoplasty Treatment and Risk Factors

Objectives: To analyze the IOP spikes after selective laser trabeculoplasty (SLT). Materials and Methods: Two hundred eyes of 100 patients who applied to the clinic between 01.11.2010 and 31.10.2011 and who had primary SLT treatment with the diagnosis of primary open-angle glaucoma or ocular hypertension were enrolled in the study. Patients’ demographic data, iris color, angle pigmentation, and angle degree measurements with goniolens, pachymetry measurements by optic coherence tomography (OCT), cup/disk measurements (by indirect ophthalmoscopy), and IOP measurements (by applanation tonometry) were noted. The relations between iris color, angle pigmentation, pachymetry and total energy with IOP spike and anterior chamber reactions observed at the 1st and 2nd hour of treatment were evaluated. Results: Thirty-seven percent of the patients were male and 63% of the patients were female. The mean age of males and females was 61.24±11.33 (33-85) and 58.21±12.35 (22-80), respectively. Mean IOP spikes and anterior chamber reactions at the 1st and 2nd hour of the treatment were 3.35 and 2.21 mmHg, respectively, and they were positively correlated (p=0.0001). As the eyes were examined according to iris color, statistically significant higher IOP spikes were observed in brown eyes (3.77 mmHg) than in green (2.62 mmHg) and hazel eyes (1.85 mmHg) (p=0.0001). No significant relationship was found between IOP spikes and pachymetry and total energy whereas positive correlation was observed between IOP spikes and angle pigmentation (p1=0.904, p2=0.823, p3=0.0001). Conclusion: IOP spikes seen after SLT treatment were observed more frequently in dark colored eyes or in eyes with heavily pigmented angles. We believe, the follow-up of these patients requires attention. (Turk J Ophthalmol 2014; 44: 365-9