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SLT an effective initial treatment for open-angle glaucoma, ocular hypertension
A similar reduction in IOP at 9 to 12 months was observed after initial drug therapy vs. selective laser trabeculoplasty in patients with open-angle glaucoma or ocular hypertension, a study found.
“The reduction of IOP was similar in the SLT and medical arms of this comparative study after up to 1 year of follow-up,” the study authors said. “However, there were more steps necessary to maintain a target IOP range with additional glaucoma medications in the medical arm.”
The prospective, multicenter, randomized trial included 127 eyes of 69 patients with open-angle glaucoma or ocular hypertension who underwent either medical therapy with a prostaglandin analog or 360° SLT. Data collection terminated when 54 patients, 29 in the SLT group and 25 in the medical therapy group, reached 9 to 12 months of follow-up.
The primary outcome measure was achieving target IOP; the secondary outcome measure was the number of treatment steps needed to reach the target IOP. If target IOP was not reached by final follow-up, additional medication or SLT was performed.
In the SLT group, mean IOP dropped from 24.5 mm Hg to 18.2 mm Hg, with 11% of eyes receiving additional SLT. In the medical group, mean IOP dropped from 24.7 mm Hg to 17.7 mm Hg, with 27% of eyes requiring additional medication. The differences between the groups were not statistically significant.
“[This] study reinforces the potential use of SLT as an option in the first treatment for certain patients with OAG or high-risk ocular hypertension based on efficacy in lowering the IOP, its safety and lack of side effects,” the authors said. “Its use could ease concerns over adherence with medications, drug side effects and the costs of medical therapy.”