This study assessed whether short-term use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) or steroid therapy affects the efficacy of selective laser trabeculoplasty (SLT).

Study design

This is a double-masked randomized placebo-controlled study that included 85 patients (96 eyes). Patients receiving SLT were randomized to ketorolac 0.5%, prednisolone 1%, or saline drops after laser. The primary outcome was IOP at 12 weeks, with secondary outcomes of IOP at 1 and 6 weeks, presence of pain and anterior chamber inflammation.

Outcomes

There was no clinically significant difference in IOP among the three groups at 6 weeks. By week 12, however, both the NSAID and steroid group showed a statistically significant lowering of IOP compared with controls (-6.2 mm Hg, -5.2 mm Hg, and -3 mm Hg, respectively; P=0.02). Patient-reported pain was similar between all groups at 1 hour and 1 week after the procedure. Anterior chamber inflammation was not significantly different between the groups and was not detected in any of the patients enrolled in the study at weeks 1, 6, or 12.

Limitations

The main limitations of this study are the relatively short follow-up period and the small sample size. Additionally, there was no way to monitor patient compliance with medications.

Clinical significance

Treating patients with a short course of anti-inflammatory medications (NSAID or steroid) after SLT treatment results in a statistically significant reduction in IOP from baseline at 12 weeks. Patient-reported pain and anterior chamber inflammation were not significantly different between any of the treatment arms.