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Long-term Outcomes of Selective Laser Trabeculoplasty on Intraocular Pressure Control and Visual Field Progression
Kwanghyun Lee1, Esteban Morales2, Joseph Caprioli2
1Glaucoma Division, David Geffen School of Medicine, Stein Eye Institute, University of California at Los Angeles, Los Angeles, CA, USA; Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Republic of Korea.
American Journal of Ophthalmology
|August 12, 2026
Summary
Selective laser trabeculoplasty (SLT) shows long-term effectiveness in glaucoma management, but outcomes are less favorable with repeat procedures, asthma, or advanced disease. Higher laser energy and lower pre-SLT medication burden may improve results.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Laser Therapy
Background:
- Selective laser trabeculoplasty (SLT) is a common treatment for open-angle glaucoma.
- Long-term outcomes and factors influencing success require further investigation.
Purpose of the Study:
- To evaluate the long-term intraocular pressure (IOP) control and visual field (VF) progression after SLT.
- To identify factors associated with treatment failure and VF progression.
Main Methods:
- Retrospective case-control study of 500 eyes with a mean follow-up of 9.6 years.
- Kaplan-Meier survival and Cox regression analyses for time to treatment failure.
- Logistic regression to identify predictors of VF progression.
Main Results:
- Median time to failure was 4.6 years for initial SLT and 2.7 years for repeat SLT.
- Factors associated with higher failure risk include repeat SLT, prior glaucoma surgery, asthma, and advanced glaucoma.
- Higher laser energy intensity correlated with lower failure risk and less VF progression.
Conclusions:
- Long-term SLT outcomes are influenced by factors such as repeat procedures, patient comorbidities, disease severity, and treatment parameters.
- Higher pre-SLT medication burden and lower central corneal thickness are associated with increased VF progression risk.
- Findings aid in patient selection and post-SLT monitoring strategies.
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