Prior LTP may compromise glaucoma surgery success

Prior laser trabeculoplasty (LTP) may be associated with a higher likelihood of subsequent glaucoma surgery following angle-based minimally invasive glaucoma surgery (ab-MIGS), regardless of whether ab-MIGS is performed as a standalone procedure or in combination with phacoemulsification, according to a study.

A recent retrospective cohort study, using data from the IRIS Registry, included a total of 164,965 unique MIGS procedures. Propensity score matching (PSM) was used to delineate 4 cohorts: standalone ab-MIGS without prior LTP, standalone ab-MIGS with prior LTP, ab-MIGS combined with phacoemulsification without prior LTP, and ab-MIGS combined with phacoemulsification with prior LTP.

Findings revealed that eyes undergoing standalone ab-MIGS with prior LTP exhibited a higher likelihood of subsequent glaucoma reoperation compared to those without prior LTP, particularly evident at 6- and 12-months post-surgery. Similarly, for eyes undergoing ab-MIGS combined with phacoemulsification, the presence of prior LTP correlated with an increased likelihood of reoperation at 12, 24, and 36 months.

Multivariable analyses indicated that the presence of prior LTP was associated with a higher risk of subsequent glaucoma surgery over the 36-month period following ab-MIGS, with adjusted hazard ratios of 1.53 (P = 0.004).

Reference
Mitchell W, Yang SA, Ondeck C, et al. Effectiveness of angle based minimally invasive glaucoma surgery after laser trabeculoplasty: an analysis of the IRIS® Registry. Ophthalmol Glaucoma. 2024;S2589-4196(24)00048-6. doi: 10.1016/j.ogla.2024.03.003. Epub ahead of print. PMID: 38519027.