Five-year outcomes of selective laser trabeculoplasty: A retrospective study

Area of Science:

• Ophthalmology
• Glaucoma Research
• Medical Therapy

Background:

• Selective laser trabeculoplasty (SLT) is effective for short-term intraocular pressure (IOP) reduction as adjuvant therapy.
• Long-term efficacy of SLT in preventing glaucoma progression, specifically Humphrey visual field (HVF) worsening and retinal nerve fiber layer (RNFL) thinning, requires further investigation.

Purpose of the Study:

• To assess the long-term efficacy of SLT as adjuvant therapy in glaucoma patients on continued medical therapy.
• To evaluate the impact of SLT on IOP, visual field parameters (HVF), and RNFL thickness over 3- and 5-year follow-up periods.

Main Methods:

• Retrospective chart review of 51 eyes from 39 glaucoma patients treated with SLT.
• Data collected included IOP, visual acuity, glaucoma medications, subsequent surgical interventions, HVF (MD, PSD), and OCT (RNFL thickness).
• Analysis included 3- and 5-year follow-up outcomes.

Main Results:

• Mean IOP decreased significantly at 3 and 5 years in eyes not requiring further intervention.
• However, mean glaucoma medications increased by 5 years, and HVF parameters (MD, PSD) showed significant worsening.
• Inferior quadrant RNFL thickness also significantly decreased at 5 years post-SLT.

Conclusions:

• While SLT can control IOP long-term in some glaucoma patients, it does not prevent progression of visual field defects or RNFL thinning.
• Increased medication use and progression of glaucoma metrics were observed despite SLT.
• Age at the time of SLT was associated with the risk of requiring subsequent surgical intervention.