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Use of selective laser trabeculoplasty as an alternative in patients who developed ocular hypertension after intravitreal dexamethasone implants: a series of 35 eyes

  • Medical Ophthalmology
  • Published:
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Abstract

Purpose

Steroid-induced ocular hypertension (OHT) occurs in about a third of cases after dexamethasone implant (DEXi) intravitreal injection (IVI), for which treatment discontinuation may be required. The aim of this study was to assess the benefit of selective laser trabeculoplasty (SLT) in patients who developed transient OHT after DEXi injection to prevent subsequent steroid-induced OHT peaks during reinjections.

Methods

A real-life, retrospective, and observational study was conducted to assess the intraocular pressure (IOP) after SLT in steroid responders after DEXi injection (IOP > 21 mmHg). Were analyzed: IOP 1 and 2 months after SLT, maximum IOP (IOPmax) after each new DEXi IVI, and the number of prophylactic hypotensive treatments needed at the time of DEXi reinjections.

Results

Thirty-five eyes of 29 patients were included. The mean macular edema follow-up duration was 38.4 ± 28.4 months. SLT was performed after a mean number of 6.3 ± 4.7 DEXi IVIs. After SLT, the IOPmax measured after the first reinjection was lowered by 36.6 ± 14.7% (p < 0.0001). The mean number of hypotensive treatments was 2.1 ± 0.9 before versus 1.5 ± 0.8 after SLT. The post-reinjection lowering in OHT peak was maintained during the subsequent 3 DEXi IVIs: − 29.1 ± 25.5% (p = 0.0009), − 35.8 ± 13.1% (p = 0.0078), and − 45.4 ± 8.6% (p = 0.0312) after the second, third, and fourth DEXi reinjections. SLT allowed continuing injections in 88.6% of patients.

Conclusion

The use of 180° SLT in this indication could be an effective therapeutic alternative to control steroid-induced OHT and safely continue DEXi injections.

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Authors and Affiliations

  1. Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France

    Jérémy Billant, Emilie Agard, Ikrame Douma, Antoine Levron, Olivier Brunet, Charles-Henry Remignon, Lucas Sejournet & Corinne Dot

  2. French Military Health Service Academy, Val de Grâce, Paris, France

    Corinne Dot

Authors
  1. Jérémy Billant
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  2. Emilie Agard
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  3. Ikrame Douma
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  4. Antoine Levron
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  5. Olivier Brunet
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  6. Charles-Henry Remignon
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  7. Lucas Sejournet
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  8. Corinne Dot
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Correspondence to Jérémy Billant.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by an international review board (Ethics Committee of the French Society of Ophthalmology IRB 00008855, French Ophthalmology Society IRB#1).

Conflict of interest

Prof Dot C is consultant for Abbvie, Bayer, Novartis, and Horus Pharma. All other authors have no relevant financial or nonfinancial interests to disclose.

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A part of the results was presented at the 127th Congress of the French Society of Ophthalmology (SFO 2021, Paris, France).

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Billant, J., Agard, E., Douma, I. et al. Use of selective laser trabeculoplasty as an alternative in patients who developed ocular hypertension after intravitreal dexamethasone implants: a series of 35 eyes. Graefes Arch Clin Exp Ophthalmol 260, 3665–3673 (2022). https://doi.org/10.1007/s00417-022-05725-3

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  • DOI: https://doi.org/10.1007/s00417-022-05725-3

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