Low-energy SLT may be safer treatment option for reducing IOP

Ophthalmic Surg Lasers Imaging. 2011;42(1):59-63.

Low-energy selective laser trabeculectomy may lower IOP with as much efficacy as conventional selective laser trabeculectomy but with fewer complications, a study found.

The prospective case series consisted of 74 patients with ocular hypertension, suspected glaucoma or primary open-angle glaucoma. Thirty-nine patients were treated at 100 points over 360° of the trabecular meshwork with half conventional laser energy, and 35 controls received conventional laser energy.

Patients were observed for 1 year, and while the effective rate of treatment for the low-energy group was slightly lower initially (64.1% vs. 71.43% for the control group at 1 month), the effective rate became closer over time, according to the study.

At 12 months, the rates were 48.72% in the low-energy group and 48.57% in the conventional group.

No statistically significant difference was found between the two groups in terms of efficacy at any postoperative exam. However, low-energy SLT caused fewer complications and was not associated with any severe complications.

In the control group, transient IOP spikes occurred in three eyes on the day of treatment and partial peripheral anterior synechiae occurred in one eye at 1 month.

Future research will focus on determining the optimal range of the trabecular meshwork to treat and the optimal number of laser shot points, the study authors wrote.