Review of Intraocular Pressure Control with Adjunctive Laser Trabeculoplasty in a Black Population- Nigeria (West Africa)

Aim: To evaluate the efficacy of frequency-doubled Nd:YAG 532-nm laser trabeculoplasty in reducing intraocular pressure (IOP) and antiglaucoma medication requirements in Nigerian patients with glaucoma. Methods: This retrospective, non-comparative interventional case series included patients who underwent frequency-doubled Nd:YAG 532-nm laser trabeculoplasty. Demographic characteristics, ocular history, anterior chamber angle status, visual acuity, IOP, antiglaucoma medications, and treatment parameters were retrieved from hospital case records. IOP, visual acuity, and medication requirements were assessed before treatment and during follow-up. Results: The study included 53 eyes of 42 patients. Before laser treatment, 56.6% of eyes had an IOP >=18 mmHg, compared with 94.3% having an IOP <18 mmHg following trabeculoplasty. Mean IOP was 12.3 +- 3.1 mmHg at 1 month, 11.9 +- 2.3 mmHg at 6 months, 12.2 +- 2.5 mmHg at 12 months, 12.7 +- 3.0 mmHg at 18 months, 11.2 +- 2.5 mmHg at 24 months, 12.5 +- 6.2 mmHg at 30 months, and 12.3 +- 7.5 mmHg at 36 months. The mean percentage IOP reduction was 31.70% SD 24.90 (p=0.0002). Visual acuity improved significantly following treatment (p=0.0001). Medication requirements decreased in 24 eyes (45.3%), remained unchanged in 17 (32.1%), and increased in 11 (20.8%); one eye (1.9%) required no medication before or after treatment. Conclusion: Frequency-doubled Nd:YAG 532-nm laser trabeculoplasty achieved substantial and sustained IOP reduction over 36 months. It may provide an effective adjunctive and medication-sparing treatment option for selected Nigerian patients with open-angle glaucoma and may help delay the need for incisional surgery.