Short-term results of direct laser trabeculoplasty (DSLT) in clinical practice

Purpose To report the short-term results of direct selective-laser trabeculoplasty (DSLT) in clinical practice. Methods Retrospective review of patients treated with DSLT between December 2023 and May 2024 with >= 6 months follow-up. Eyes were divided according to the indication for DSLT: first-line treatment (group 1); treatment-burden reduction (group 2) and additional intraocular pressure (IOP) lowering effect (group 3). Success was defined as a decrease of >= 20% from baseline-IOP with no additional treatment, or as a reduction in hypotensive drugs with stable IOP. Results Seventy-six eyes from 44 patients were included. In group 1 (20 eyes) mean IOP dropped from 26.50 +/- 2.70 mmHg at baseline to 20.35 +/- 3.37 mmHg six months after DSLT (p < 0.001). No eye required topical treatment. In group 2 (28 eyes), mean baseline IOP was 15.36 +/- 4.34 mmHg and remained stable at 14.75 +/- 4.15 mmHg (p = 0.214). Mean number of hypotensive drugs dropped from 2.00 +/- 0.72 to 1.07 +/- 1.24 (p < 0.001). In group 3 (28 eyes), mean IOP dropped from 20.21 +/- 5.42 mmHg to 16.54 +/- 4.37 mmHg (p < 0.001), with mean number of drugs remaining stable: 1.71 +/- 0.76 at baseline and 1.57 +/- 0.88 six months after DSLT (p > 0.05). There were no serious adverse events. Success rates were 55% in group 1, 57.1% in group 2 and 39.3% in group 3. Conclusions DSLT produced an IOP reduction of almost 25% in naive eyes and 17% in already-treated eyes. It can also reduce treatment burden with a stable IOP. These results support DSLT as an option at all stages of glaucoma, although the duration of its effect remains to be proven.