Real-world outcomes of selective laser trabeculoplasty in a tertiary referral glaucoma service.

Introduction: Selective laser trabeculoplasty (SLT) is an effective treatment option in open-angle glaucoma (OAG) and ocular hypertension (OHT). The purpose of this study was to evaluate the real-world treatment outcomes of SLT in a tertiary referral glaucoma service.

Methods: We reviewed the medical records of consecutive patients who had undergone SLT in the glaucoma service at the Royal Victoria Eye and Ear Hospital, Dublin. All patients in this study were using topical IOP-lowering medications prior to SLT. The primary outcome measure was the mean change in intraocular pressure (IOP) at 6 to 8 weeks following the procedure.

Results: 71 eyes of 44 patients were included in this study. There was a mean reduction in IOP of 4.0 mmHg (SD 3.6), from 19.1 mmHg (SD 3.6) at baseline to 15.1 mmHg (SD 4.0) at 6 to 8 weeks post-SLT (p < 0.001). The diagnosis was primary open-angle glaucoma (POAG) in 69.0% of eyes, pseudoexfoliation glaucoma (PXFG) in 5.6%, pigment dispersion glaucoma (PDG) in 2.8%, normal tension glaucoma (NTG) in 5.6%, ocular hypertension (OHT) in 15.5%, and pseudoexfoliation OHT in 1.4%. 100% of eyes were on topical IOP-lowering medication (mean number of agents 2.7). In addition, 8.5% had one previous SLT procedure. No immediate (< 1 h) post-SLT IOP spikes occurred in this study. Pearson correlation analysis revealed a moderate correlation (r = -0.4021, p < 0.001) between higher baseline IOP and greater IOP reduction.

Conclusion: SLT is an effective IOP-lowering treatment in open-angle glaucoma and ocular hypertension in a real-world setting.