Very short-term efficacy of selective laser trabeculoplasty in primary open-angle glaucoma

Primary open-angle glaucoma (POAG) is the second leading cause of blindness worldwide. Despite the efficacy of glaucoma eye drops, their use is not without risks. Selective laser trabeculoplasty (SLT) is a promising therapeutic option. The goal of our study was to investigate the effect of SLT in the very short-term (seven days) on intraocular pressure (IOP).

This was an interventional, prospective study including glaucoma patients with an IOP higher than their target IOP and/or an Ocular Surface Disease Index score>33 and/or a tear film breakup time≤5seconds. We performed SLT with 100 spots on the pigmented trabecular meshwork over 360°. Patients were monitored after one week and two months to quantify changes in intraocular pressure. A reduction≥20% in IOP from the initial level was considered a good response on the seventh day post-SLT and deemed a therapeutic success at two months post-SLT.

In a sample of 40 eyes of 21 patients, the mean decrease in IOP on the seventh day post-SLT was 20.26±21.4%. A good response was achieved in 22 eyes. Male sex and an initial IOP≥16.5mmHg were associated with a good response on the seventh day (both P=0.04). A good response at one week was a significant predictor of therapeutic success at two months, with an odds ratio of 5.343 (P=0.017).

SLT shows a hypotensive effect within just seven days of treatment, consolidating its role as a primary therapy for POAG management.