Ophthalmologists should encourage patients to undergo SLT for glaucoma treatment
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CHICAGO — Evidence suggests that selective laser trabeculoplasty could be the standard of care for patients with glaucoma, according to a speaker here.
“I think evidence-based medicine shows that SLT is the better choice for the initial treatment of primary open-angle glaucoma and ocular hypertension for most patients,” Jonathan S. Myers, MD, said at Glaucoma Subspecialty Day at the American Academy of Ophthalmology meeting.
According to Myers, data from studies over the last 20 years show that SLT has consistently demonstrated a smaller chance of rapid visual field loss after the procedure, and it was less likely to be followed by cataract surgery.
As an example, Myers discussed the LiGHT trial, which compared eyes that underwent SLT with eyes treated with latanoprost as first-line therapy. After SLT, 69.8% of patients remained “drop free” over 6 years with less disease progression and fewer cataract surgeries.
Myers said ophthalmologists should encourage patients to consider SLT as their first choice of treatment and suggested providing patients with educational materials that show SLT is a cost-effective, convenient and repeatable treatment option.
Many patients respond well to natural treatments, and he suggested telling patients how SLT can improve the natural drainage channel of the eye.
“I think patients this day and age like natural treatments,” Meyers said. “They like to think about enhancing or restoring the functioning of the body rather than diverting or avoiding.”
Because Myers has internalized SLT as the best option, his patients are more likely to trust his judgment.
“I ask the question, why wouldn’t the patient have [SLT] as their first treatment, and why wouldn’t you choose that for them?” Myers said.
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Myers JS. Laser trabeculoplasty: How my practice has evolved. Presented at: American Academy of Ophthalmology meeting; Sept. 30-Oct. 3, 2022; Chicago.
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