Selective laser trabeculoplasty as replacement therapy in medically controlled glaucoma patients

PurposeWe examined selective laser trabeculoplasty (SLT) as a replacement therapy for medically controlled open-angle glaucoma (OAG) or ocular hypertensive patients. MethodsA prospective randomized interventional clinical trial on 143 glaucoma patients. Patients were randomized to either receiving SLT or to the control group that continued on pressure lowering medication. Data were recorded 1hr, 1week, 1, 3, 6, 12 and 18months after SLT. Primary outcome was number of medications at 12 and 18months while maintaining a predetermined target intraocular pressure (IOP). ResultsSelective laser trabeculoplasty (SLT) reduced number of medications from a mean of 1.5 at baseline, to 0.35 after 12months and 0.29 after 18months. Meanwhile, SLT achieved more than 20% IOP lowering in 95% of eyes and more than 30% IOP lowering in 86% of eyes after 18months. Seventy-seven per cent of our eyes no longer needed any medication after SLT at 18months. ConclusionSelective laser trabeculoplasty (SLT) enabled a reduction in number of medications while maintaining good IOP control. Selective laser trabeculoplasty (SLT) was able to completely replace medical therapy in 77% of eyes after 18months. Selective laser trabeculoplasty (SLT) as replacement therapy may reduce local and systemic side-effects and prevent adherence issues.