Using Icare HOME tonometry for follow-up of patients with open-angle glaucoma before and after selective laser trabeculoplasty

Importance Monitoring the results of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) using a home rebound tonometry. Background To evaluate the role of Icare HOME tonometry in open-angle glaucoma patients being treated with SLT. Design A clinic-based prospective case study. Participants Fourteen eyes from 14 patients diagnosed with primary open-angle glaucoma were recruited. Methods The trabecular meshwork of each eye was treated 360 degrees with a frequency-doubled Q-switched Nd:YAG laser. IOP was measured four times a day for a week before and after SLT. On the day of SLT, the patients were required to measure the IOP in the evening to record any IOP spikes. Main Outcome Measures The use of Icare HOME in following up patients post-laser trabeculoplasty without the need for clinic attendance. Results Icare HOME recorded a significant reduction of 5.12 mmHg in the mean IOP post-SLT (95% confidence interval [CI] 3.75-6.50 mmHg, P < .001). The maximum IOP was also reduced by 6.14 mmHg (95% CI 3.07-9.21, P < .001) with no IOP spikes recorded post-SLT. There was a reduction in IOP fluctuation post-SLT by 1.07 mmHg (95% CI 0.24-1.89 mmHg, P = .021). No adverse effects for using the Icare HOME were reported by the study participants. Conclusions and Relevance This methodology could be highly useful for facilitating safe follow-up of patients residing in remote and rural areas, thus reducing healthcare cost with better information on IOP.