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° 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.