Selective laser trabeculoplasty (SLT) outcomes following topical therapy

Area of Science:

• Ophthalmology
• Glaucoma Management
• Laser Therapy

Background:

• Selective laser trabeculoplasty (SLT) is a common treatment for lowering intraocular pressure (IOP).
• Previous research suggests SLT is most effective in treatment-naïve eyes.
• The benefit of pre-SLT topical IOP-lowering agents remains unclear.

Purpose of the Study:

• To evaluate the efficacy of SLT in lowering IOP.
• To compare outcomes of SLT with and without prior topical therapy.
• To determine if prostaglandin analogue (PGA) drops improve SLT outcomes.

Main Methods:

• Retrospective review of 196 SLT-naïve eyes with ocular hypertension or primary open-angle glaucoma.
• Data collected from January 2022 to May 2022 at Lancashire Teaching Hospitals NHS Foundation Trust.
• Eyes were categorized based on prior treatment: no topical therapy, PGA drops alone, or other topical agents.

Main Results:

• No significant difference in IOP reduction between eyes treated with PGA drops prior to SLT (7.89 mmHg) and those receiving primary SLT (6.88 mmHg).
• Eyes treated with beta-blockers in addition to PGA showed a greater IOP reduction.
• SLT efficacy was comparable whether initiated as first-line treatment or after PGA therapy.

Conclusions:

• Using prostaglandin analogue (PGA) drops prior to selective laser trabeculoplasty (SLT) does not offer a significant additional benefit for lowering intraocular pressure (IOP).
• SLT as a first-line treatment is as effective as using PGA drops beforehand.
• Further investigation into combination therapies, like beta-blockers, may be warranted.