SLT still effective in 50% of eyes at 5 years

LONDON — Selective laser trabeculoplasty has a survival rate of 50% at 5 years after treatment, according to a study presented here.

After a single 180° treatment, the average "life" of a selective laser trabeculoplasty (SLT) procedure was 31 months, said Rahul Yadav, MBBS, MSOphth, who presented the study results at the European Society of Cataract and Refractive Surgeons meeting. "SLT successfully reduces IOP as a primary or secondary treatment," Mr. Yadav said. "IOP reduction is very strongly related to baseline IOP, and the probability that an eye will successfully complete 5 years after one treatment of SLT is 0.5."

Mr. Yadav reported the results of a retrospective study of all 546 eyes treated with SLT at Clayton Hospital in Wakefield, England, from 2000 to 2006. He said IOP before SLT averaged 26.6 mm Hg. IOP decreased an average of 24% at 1 week, 29% at 6 months, 28% at 1 year and 33.8% at 5 years follow-up.

As a primary treatment in 279 eyes with "virgin trabecular meshworks," there was a 33% mean IOP reduction from baseline at a mean follow-up of 32 months, he said. As a secondary treatment in 167 eyes of patients with glaucoma uncontrolled using one medication, there was a 29% mean IOP decrease at a mean follow-up of 24.6 months.

The reductions in both groups were "statistically and clinically significant," Mr. Yadav said. The difference in IOP reductions between the two groups was not statistically significant, he noted.

The researchers also found a 50% probability of survival at 5 years for SLT-treated eyes. "Although there was a steep attrition rate in the early period ... after 3 years, the rate drops to less than 5% per year," Mr. Yadav said.

The survival rate in this study appears similar to rates reported for argon laser trabeculoplasty, but SLT is a less invasive treatment, he noted.