Predictors of selective laser trabeculoplasty success in open angle glaucoma or ocular hypertension: does baseline tonography have a predictive role?

Alaghband, Pouya; Galvis, Elizabeth; Daas, Arij; Nagar, Anindyt; Beltran‐Agullo, Laura; Khawaja, Anthony P.; Goyal, Saurabh; Ks, Lim

doi:10.1136/bjophthalmol-2019-315489

Cited by 13 publications

(9 citation statements)

References 32 publications

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“…After proposing another success definition (the one used in this study) and comparing both analyses with the different definitions, baseline IOP still remained a predictor of success. This was also confirmed by Alaghband et al (2020) and Kuley et al (2020).…”

Section: Discussionsupporting

confidence: 76%

Outcomes of pattern scanning laser trabeculoplasty and selective laser trabeculoplasty: Results from the lausanne laser trabeculoplasty registry

Elahi¹,

Rao

Paillard³

et al. 2020

Acta Ophthalmologica

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Purpose To compare the long‐term safety and efficacy of pattern scanning laser trabeculoplasty (PSLT) and selective laser trabeculoplasty (SLT). Methods This was a retrospective database analysis (Lausanne Laser Trabeculoplasty Registry) of patients having had laser trabeculoplasty (LT) prior to 2017 with a minimum follow‐up of 1 year. Inclusion criteria were age ≥40 years and diagnosis of ocular hypertension (OHT) and open‐angle glaucoma (OAG). Selective laser trabeculoplasty (SLT) eyes were matched to PSLT eyes according to baseline intraocular pressure (IOP), baseline number of ocular hypotensive medications (OHM) and glaucoma diagnosis. Success was defined as an IOP ≤ 20% from baseline or an IOP equal or lower than baseline accompanied by a reduction in OHM. Multivariate regression models were used to study associations between success and baseline clinical parameters. Results From 280 eyes in the database, 81 eyes had PSLT and were matched with 81 SLT eyes (162 patients). Mean age was 69.4 ± 12.1 years, and 56.2% were female. Mean IOP was 18.6 ± 5.3 and 18.2 ± 4.1 mmHg at baseline and 15.9 ± 3.0 and 16.0 ± 3.4 mmHg at 12 months and 15.2 ± 2.7 and 16.2 ± 3.4 mmHg at 24 months, for PSLT and SLT, respectively. 60.5% of PSLT and 65.4% of SLT eyes achieved treatment success (p = 0.20). Number of OHM was 1.0 ± 1.0 and 1.4 ± 1.2, respectively (p = 0.052). Baseline IOP (OR = 1.23, p < 0.01) and number of OHM (OR = 1.67, p < 0.01) were associated with success in both PSLT and SLT, while LT modality was not [OR = 0.81 (0.43–1.53), p = 0.52], and a diagnosis of primary OAG was negatively associated (OR = 0.42, p = 0.04). Conclusion Our study did not find any significant differences between PSLT and SLT in terms of safety and efficacy in patients with OHT and glaucoma. Baseline IOP was associated with higher success rates in both procedures. Additional studies are needed to evaluate the outcomes of PSLT in non‐Caucasian populations and the ability of repeat PSLT to achieve additional IOP reduction.

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Section: Discussionsupporting

confidence: 76%

Outcomes of pattern scanning laser trabeculoplasty and selective laser trabeculoplasty: Results from the lausanne laser trabeculoplasty registry

Elahi¹,

Rao

Paillard³

et al. 2020

Acta Ophthalmologica

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“…SLT seems to be generally accepted as effective; however, some patients in the studies performed better than others. Two recent studies [111,112] determined that pretreatment IOP was the only predictor of success after primary SLT. Hirabayashi et al [113] stated that baseline IOP of >18 mmHg was significantly associated with increased success and that the IOP-lowering effect was greatest at 2 months and 6 months of follow-up.…”

Section: Other Considerations: Retreatment Predictors Of Success Cost...mentioning

confidence: 99%

A Review of Selective Laser Trabeculoplasty: “The Hype Is Real”

Šarenac

Turkanović

Ferme

et al. 2022

JCM

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Presently, there is no efficacious treatment for glaucomatous optic neuropathy; the current treatment is focused on lowering intraocular pressure (IOP). Studies have demonstrated the safety and efficacy of selective laser trabeculoplasty (SLT) in reducing the IOP in eyes with open-angle (OAG) glaucoma or ocular hypertension (OH). Moreover, the European Glaucoma Society has instated SLT as the first-line or adjunctive treatment in OAG or OH, reiterating its clinical significance. In this review, we outline the old and the new roles of SLT, with an emphasis on clinical practice, and look further into its renewed appeal and future developments.

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“…These results are consistent with three other trials. The results of a post hoc analysis of the LIGHT study by Garg et al (mentioned above in the subsection “SLT as first-line therapy”) showed that early absolute IOP reduction was positively correlated with baseline IOP and negatively correlated with female gender [ 13 , 14 , 31 , 62 , 63 , 64 , 65 , 66 ].…”

Section: Predictive Factorsmentioning

confidence: 99%

Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

Zgryźniak

Przeździecka-Dołyk

Szaliński

et al. 2021

JCM

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Selective laser trabeculoplasty (SLT) is a glaucoma treatment that reduces intraocular pressure (IOP). Its mechanism is based on the biological effects of the selective application of laser energy to pigmented trabecular meshwork (TM) cells, resulting in increased outflow facility. Herein, we review current publications on SLT and summarize its efficacy and safety for different indications in open-angle glaucoma (OAG) and ocular hypertension (OHT) treatment. SLT effectively reduces IOP when used as a primary treatment. In patients whose IOP is medically controlled, SLT helps to reduce medication use, and when maximally tolerated topical therapy is ineffective, SLT facilitates the realization of the target IOP. SLT is a repeatable procedure for which the vast majority of complications are mild and self-limiting. With effective IOP reduction, low complication rates and the potential to repeat the procedure, SLT offers the possibility of delaying the introduction of medical therapy and other more invasive treatment modalities while simultaneously avoiding the accompanying complications. With this knowledge, we suggest that SLT be considered as an essential primary treatment option in OAG and OHT, switching to other treatment modalities only when laser procedures are insufficient for achieving the required target IOP.

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Predictors of selective laser trabeculoplasty success in open angle glaucoma or ocular hypertension: does baseline tonography have a predictive role?

Cited by 13 publications

References 32 publications

Outcomes of pattern scanning laser trabeculoplasty and selective laser trabeculoplasty: Results from the lausanne laser trabeculoplasty registry

Outcomes of pattern scanning laser trabeculoplasty and selective laser trabeculoplasty: Results from the lausanne laser trabeculoplasty registry

A Review of Selective Laser Trabeculoplasty: “The Hype Is Real”

Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

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