Transscleral Selective Laser Trabeculoplasty Without a Gonioscopy Lens

Area of Science:

• Ophthalmology
• Glaucoma Research
• Laser Therapy

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• Selective laser trabeculoplasty (SLT) is a common treatment for lowering intraocular pressure (IOP).
• Conventional SLT requires a gonioscopy lens for precise application to the trabecular meshwork.

Purpose of the Study:

• To evaluate the efficacy and safety of performing selective laser trabeculoplasty (SLT) directly on the sclera without a gonioscopy lens.
• To compare this novel technique with conventional SLT in patients with uncontrolled primary open-angle or pseudoexfoliation glaucoma.

Main Methods:

• A prospective, randomized, masked, controlled clinical trial was conducted.
• Adult patients with uncontrolled glaucoma were randomized into two groups: conventional SLT and scleral SLT.
• Intraocular pressure (IOP) and side effects were monitored for 12 months post-procedure.

Main Results:

• Both conventional and scleral SLT groups showed significant IOP reduction at 6 and 12 months.
• Success rates (≥15% IOP decrease) were comparable, with 85.7% in the scleral SLT group and 69.2% in the conventional SLT group.
• Mild and transient complications were observed, with a significantly lower incidence in the scleral SLT group.

Conclusions:

• Selective laser trabeculoplasty (SLT) applied directly to the perilimbal sclera demonstrates comparable efficacy to the conventional method for up to one year.
• This alternative SLT approach may offer a viable option for glaucoma management.
• Further research could explore long-term outcomes and broader applications of scleral SLT.