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SLT considered for primary glaucoma treatment in the proper situation

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Robert Wooldridge

SALT LAKE CITY — While prostaglandins are still by far the primary glaucoma treatment option, selective laser trabeculoplasty is a viable and safe option in certain situations, according to a speaker here.

"SLT is a reasonable safe and effective alternative to drops in certain patients," Robert Wooldridge, OD, said in a presentation at Specialty Day during Optometry's Meeting here. "I do not use it in all patients, but there are cases with elderly patients who cannot use drops, for example, where laser is definitely an effective alternative."

Dr. Wooldridge cited a randomized prospective study that showed that SLT is an effective treatment for glaucoma, with 60% of eyes achieving a 30% reduction in IOP with no late complications.

Another prospective nonrandomized study showed an IOP reduction of 20% with SLT, with a sustained reduction in successful cases. In this study, only 4% of eyes did not respond to SLT.

However, Dr. Wooldridge said when patient compliance with medication is not an issue, his initial treatment is a prostaglandin due to their efficacy, safety, tolerability, cost and convenience.