Topical NSAID treatment after selective laser trabeculoplasty of no benefit in glaucoma patients

The use of topical nonsteroidal anti-inflammatory drug (NSAID) does not seem to enhance the efficacy of selective laser trabeculoplasty (SLT) for patients with glaucoma, as shown in a study.

Researchers reviewed the medical records of 192 patients (192 eyes), among whom 96 received a course of NSAID eyedrops after SLT (mean age 71.8 years, 46 percent women) and 96 did not (mean age 73.4 years, 48 percent women). Absolute and relative reductions in intraocular pressure (IOP) reduction 3–12 weeks after trabeculoplasty were measured and compared.

Patients in the NSAID group were more likely to have SLT performed bilaterally. It was significantly more common that the NSAID-treated patients had SLT performed bilaterally, a larger mean number of laser spots, and a higher frequency of pseudoexfoliations compared with those in the control group.

The mean absolute IOP reduction did not significantly differ in the NSAID and control groups (4.3 vs 5.4 mm Hg, respectively; p=0.049). Of note, the relative IOP reduction was much smaller in the NSAID group (17.5 percent vs 21.8 percent; p=0.033).

Extensive subgroup analysis showed that the results tended to be superior in control eyes than in NSAID-treated eyes.

On multivariable linear regression analysis, NSAID treatment emerged as a negative predictor of IOP reduction (p=0.023). Survival analysis further showed a longer median time to treatment escalation in the control group, although the difference was not statistically significant when compared to that in the NSAID group.