Home tonometry data suggest that this treatment blunts IOP spikes.
By Catherine Johnson, MD, MPH, and Barbara Wirostko, MD, FARVO
Originally published Glaucoma Today: Impact of Selective Laser Trabeculoplasty on Diurnal IOP Fluctuation – Glaucoma Today
Impact of Selective Laser Trabeculoplasty on Diurnal IOP Fluctuation
Home tonometry data suggests that selective laser trabeculoplasty (SLT) can reduce intraocular pressure (IOP) fluctuations. SLT is increasingly recognized as a viable first-line treatment for open-angle glaucoma and ocular hypertension (OHT), supported by evidence from studies like the The Laser in Glaucoma and Ocular Hypertension LIGHT trial. These studies show that SLT can reduce visual field progression, the need for trabeculectomy, and improve glaucoma symptoms compared to traditional IOP-lowering drops.
SLT and Diurnal IOP Fluctuations
Assessing the true effectiveness of SLT involves more than just measuring IOP at clinic visits, as spikes often occur outside standard hours. A study at the Moran Eye Center tracked IOP in 32 patients using the iCare HOME2 tonometer. Results showed significant reductions in maximum IOP, mean IOP, and IOP range, providing evidence that SLT reduces IOP fluctuations and provides a sustained IOP-lowering effect for up to 6 months.
Home Tonometry’s Role in Monitoring Treatment
Home tonometry, like the iCare HOME2, offers valuable insights into diurnal IOP variations, often capturing spikes missed during routine clinic visits. In the Moran study, 83% of IOP spikes occurred outside clinic hours. These findings underscore the importance of home-based measurements in providing a comprehensive view of treatment effectiveness, guiding better management of glaucoma.
Conclusion
SLT significantly reduces IOP fluctuation, supporting its use as a first-line treatment for glaucoma. Devices like the iCare HOME2 provide essential data on IOP before and after SLT, helping clinicians make more informed decisions about ongoing patient care.
