Medication Utilization Post Selective Laser Trabeculoplasty or Minimally Invasive Glaucoma Surgeries in Patients With Open-Angle Glaucoma or Ocular Hypertension: A Systematic Review of Recent Literature

Author(s)

Mitisha Panda, BA1, Ashna Talwar, MS, PhD2, Teresa Brevetti, MD2, Abhishek Nair, MS, PhD2.
1University of Virginia, Charlottesville, VA, USA, 2Bausch + Lomb Americas Inc., Bridgewater, NJ, USA.

Presentation Documents

OBJECTIVES: Glaucoma is a group of neurodegenerative eye diseases that cause progressive vision loss. Procedures such as Selective Laser Trabeculoplasty (SLT) and Minimally Invasive Glaucoma Surgery (MIGS) effectively lower intraocular pressure (IOP). However, patients may still require IOP-lowering topical treatment post-procedure. The study aimed to systematically review the utilization of IOP-lowering medications post-SLT or MIGS among patients with open-angle glaucoma (OAG) or ocular hypertension (OHT).
METHODS: A systematic literature search was conducted in the EMBASE, PubMed, Scopus, and Cochrane Library databases to identify clinical trials and retrospective database studies identifying OAG or OHT patients and quantifying their IOP-lowering topical medication use in the immediate, short- and long-term period post-SLT or MIGS. The search included English language articles published between January 2019 and December 2024. Study was conducted using the PRISMA guidelines and quality was assessed using Cochrane Collaboration guidelines.
RESULTS: Of the 68 articles meeting the inclusion criteria for IOP-lowering medication use post-procedure, 8 were post-SLT, 57 post-MIGS and 3 post-MIGS and SLT. Outcomes included the following periods: immediate (1-day to 1-month), short-term (6 to 18 months), and long-term (>18 months to ≥36 months) post-procedure. Mean (SD) baseline IOP-lowering medication use was 2.33 (0.77). In the 21 studies reporting immediate outcomes, the mean medication count decreased to 0.59 (0.47) post-procedure. In the 55 studies reporting short-term outcomes, mean medication use was 0.84 (0.71) at 6-9 months gradually increasing to 0.96 (0.61) by 12-18 months post-procedure. Twenty-five studies reported the long-term outcomes with mean medication use at 1.07 (0.60) between >18-36 months and 1.08 (0.77) beyond 36 months.
CONCLUSIONS: The findings highlight a decline in IOP-lowering medication use immediately after surgery, followed by a gradual increase over a 36-month period indicating a need for topical treatment post-SLT and MIGS in glaucoma patients.

Conference/Value in Health Info

2025-05, ISPOR 2025, Montréal, Quebec, CA

Value in Health, Volume 28, Issue S1

Code

CO29

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy, Relating Intermediate to Long-term Outcomes

Disease

SDC: Sensory System Disorders (Ear, Eye, Dental, Skin), STA: Multiple/Other Specialized Treatments, STA: Surgery

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