Long-term follow-up of laser trabeculoplasty in multi-treated glaucoma patients

Erika Rasmuson*, Boel Bengtsson, Christina Lindén, Anders Heijl, Johan Aspberg, Sabina Andersson-Geimer, Gauti Jóhannesson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate the long-term effect of laser trabeculoplasty (LTP) in patients randomized to multi-treatment in the Glaucoma Intensive Treatment Study (GITS). Methods: Patients with untreated newly diagnosed open-angle glaucoma were treated with three intraocular pressure (IOP)-lowering substances for 1 week and then 360° argon or selective LTP was performed. IOP was measured just before LTP and repeatedly during the 60-month study period. Our previous report on 12 months follow-up data revealed no effect of LTP in eyes having an IOP <15 mmHg before the laser treatment. Results: Before LTP, the mean IOP ± standard deviation in all 152 study-eyes of 122 multi-treated patients was 14.0 ± 3.5 mmHg. Three eyes of three deceased patients were lost to follow-up during the 60 months. After exclusion of eyes that received increased therapy during follow-up, the IOP was significantly reduced at all visits up to 48 months in eyes with pre-LTP IOP ≥15 mmHg; 2.6 ± 3.1 mmHg at 1 month and 1.7 ± 2.8 mmHg at 48 months, n = 56 and 48, respectively. No significant IOP reduction was seen in eyes with pre-LTP IOP <15 mmHg. Seven eyes, i.e., <13%, with pre-LTP IOP ≥15 mmHg at baseline had required increased IOP-lowering therapy at 48 months. Conclusion: LTP performed in multi-treated patients may provide a useful IOP reduction that is maintained over several years. This was true on a group level when the initial IOP was ≥15 mmHg, but if the pre-laser IOP was lower than that, chances of LTP success were small.

Original languageEnglish
JournalActa Ophthalmologica
Early online date6 Jun 2023
Publication statusE-pub ahead of print - 6 Jun 2023

Bibliographical note

Funding Information:
This research was financially supported through regional agreements between Umeå University and Västerbotten County Council and between Lund University and Skåne Regional Council (ALF). Financial support was also provided by grants from Ingrid Nordmark's Foundation, Crown Princess Margareta's Foundation, the Swedish Medical Society Foundation, King Gustav V and Queen Victoria's Freemason Foundation, Ögonfonden, Herman Järnhardt Foundation, Insamlingsstiftelserna vid Umeå universitet, the Cronqvist Foundation, the Foundation for Visually Impaired in Former Malmöhus County, foundations and donations administered by Skåne University Hospital, the Margit and Kjell Stolz Foundation and the Swedish Society for Medical Research. None of the funding organizations or sponsors had any role in the design or conduct of the research. Erika Rasmuson reports speaking honoraria from Thea. Boel Bengtsson is entitled to royalties from and is a consultant of Carl Zeiss Meditec. Anders Heijl is entitled royalties from and is a consultant of Carl Zeiss Meditec and is also a consultant of Abbvie. Gauti Jóhannesson has received speaking honoraria and/or consulting from Thea, Santen, Abbvie, Alcon/Novartis and Oculis. Johan Aspberg, Sabina Andersson‐Geimer and Christina Lindén have nothing to disclose.

Publisher Copyright:
© 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

Other keywords

  • ALT
  • intraocular pressure
  • laser trabeculoplasty
  • long-term follow-up
  • multi-therapy
  • open-angle glaucoma
  • pseudoexfoliation glaucoma
  • SLT


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