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Direct Selective Laser Trabeculoplasty for Primary Angle Closure Glaucoma.

Dana Garzozi1, Sharon Braudo, Moshe Carmel

  • 1Department of Ophthalmology, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel.

Journal of Glaucoma
|December 16, 2025
PubMed
Summary
This summary is machine-generated.

Direct selective laser trabeculoplasty (DSLT) effectively lowered intraocular pressure (IOP) in patients with primary angle-closure glaucoma (PACG). This safe, non-contact laser therapy showed promising results for phakic patients with a patent laser peripheral iridotomy.

Keywords:
direct selective laser trabeculoplastyglaucoma laserintraocular pressureprimary angle closure glaucoma

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Laser Therapy

Background:

  • Primary angle-closure glaucoma (PACG) is a significant cause of vision loss.
  • Effective IOP management is crucial in PACG patients.
  • Laser peripheral iridotomy (LPI) is often a prerequisite for other glaucoma interventions.

Purpose of the Study:

  • To evaluate the efficacy and safety of direct selective laser trabeculoplasty (DSLT) in phakic patients with PACG and a patent LPI.
  • To assess the reduction in intraocular pressure (IOP) and glaucoma medication usage post-DSLT.
  • To identify any complications associated with DSLT in this patient cohort.

Main Methods:

  • Retrospective single-center case series.
  • Inclusion of twelve eyes from eight phakic PACG patients with patent LPI.
  • DSLT procedure performed as the primary intervention.

Main Results:

  • Mean IOP reduced from 17.0±2.3 mmHg to 13.6±3.0 mmHg at 2 months (20.3% reduction, P=0.0024).
  • Treatment success (≥20% IOP reduction or decreased medications) achieved in 58.3% of eyes.
  • Mean glaucoma medication use decreased, with complete discontinuation in three eyes.
  • Transient mild anterior chamber reaction and subconjunctival hemorrhage were the most common findings; no serious complications occurred.

Conclusions:

  • DSLT appears to be a safe, well-tolerated, and potentially effective non-contact laser therapy for phakic PACG patients with patent LPI.
  • Preliminary findings suggest DSLT can reduce IOP and medication burden.
  • Larger prospective studies with longer follow-up are needed to confirm these outcomes.