The incidence of serious complications after selective laser trabeculoplasty

To evaluate the incidence of serious complications after selective laser trabeculoplasty (SLT).

All patients who underwent SLT at the Department of Ophthalmology, Helsinki University Hospital, were eligible for the study from 1 January 2012 to 31 December 2018. Data regarding patients' demographics, procedure details, complications, predisposing factors and clinical outcomes were extracted retrospectively from electronic medical records. The primary outcome measures were serious complications, including corneal oedema, corneal scarring, hyperopic shift, synechia, anterior chamber bleeding and hyphema.

A total of 6081 SLTs (4601 eyes) of 2812 patients were analysed. Twelve patients had bleeding in the anterior chamber angle (incidence 2/1000 SLT laser treatments), and four of them developed hyphema (incidence 0.7/1000 SLT laser treatments). Corneal oedema or Descemet's membrane folds were reported in six treated eyes, resulting in an incidence of 1/1000. One myopic eye had a permanent corneal scarring, thinning and irregular astigmatism with a hyperopic shift (5.3 D with recovery to 1.25 D in three years), resulting in poor visual acuity (from preoperative 0.9 to 0.4 at the last control). The incidence was less than 0.2/1000 for all SLT treatments (95% CI ≤0.1 to 1.0) and 1/648 for SLT laser treatments in high myopia (spherical equivalent ≤-5.00 D).

After SLT, the number of complications was low, with only one permanent vision deterioration after 6081 treatments. These findings may help clinicians reassure patients about SLT safety when offering SLT as a first-line treatment for ocular hypertension or open-angle glaucoma.