Repeatability of selective laser trabeculoplasty

Polat, Julia; Grantham, Lindsay; Mitchell, Kenneth B.; Realini, Tony

doi:10.1136/bjophthalmol-2015-307486

Cited by 60 publications

(47 citation statements)

References 18 publications

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“…Looking close at the more recent literature, one can note several studies showing that SLT can be repeated with similar efficacy when compared to the first SLT treatment. In these studies, POAG patients presented a significant IOP reduction at 1 (46) , 4 (47) , 6 (46) , 12 (19,48) , 15 (46) , and 24 months after repeating SLT (26,49) . Corroborating these findings, Gandolfi and Ungaro demonstrated that repeated low power SLT as initial treatment postponed the initiation of medical therapy by a mean time of 6.2 years in patients with OHT (19) .…”

Section: Safety Duration and Repeatabilitymentioning

confidence: 99%

“…This procedure-related complication is influenced by technique and laser burns position (higher risk when laser is applied too posteriorly). Moreover, we believe that the ease of application (outcomes of physicians in training are comparable to those of glaucoma specialists) (25) and the possibility of repeating the procedure with relatively good success rates (in cases with good response to the first SLT treatment) (20,26) are two important advantages of SLT over ALT treatment. These factors have certainly contributed to the shift towards SLT use in the past decade and might explain the reason why ALT has not taken its place as a first line therapy.…”

Section: Laser Trabeculoplasty As Initial Treatment For Open Angle Glmentioning

confidence: 99%

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Selective laser trabeculoplasty as an initial treatment option for open-angle glaucoma

Freitas¹,

Ushida²,

Almeida³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Although eye drops are frequently used as an initial treatment option for open angle glaucoma (OAG), side effects, and poor adherence, among others, may compromise treatment efficacy. In this scenario, laser trabeculoplasty is an interesting therapeutic option for open angle glaucoma cases. Commonly used for many years as a last alternative prior to glaucoma incisional surgery, laser trabeculoplasty has been changing its indication after the advent of selective laser trabeculoplasty (SLT ). In the current review, we critically evaluated the published data regarding the use of laser trabeculoplasty as a first treatment option for open angle glaucoma patients. Studies using SLT as a first-line treatment have encouraging findings. One-year efficacy results are comparable to those obtained with prostaglandin analogues, with a good safety profile. Although the laser´s effect is known to be transitory, recent data suggest it can be successfully repeated in cases with good response to the first SLT treatment.

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Section: Safety Duration and Repeatabilitymentioning

confidence: 99%

Section: Laser Trabeculoplasty As Initial Treatment For Open Angle Glmentioning

confidence: 99%

Selective laser trabeculoplasty as an initial treatment option for open-angle glaucoma

Freitas¹,

Ushida²,

Almeida³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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“…The procedure may address issues with topical medication compliance and side effects [1], and it is considered a cost-effective treatment [2]. Although the effect of SLT wanes over time, repeating the procedure may lead to clinical success comparable to that achieved with the initial treatment [3–5]. …”

Section: Introductionmentioning

confidence: 99%

“…Efficacy results were similar to those achieved with ALT, with waning efficacy and a 50% failure rate after 2 years. The potential repeatability of SLT is thought to be one of its advantages over ALT [5], which was shown to have a success rate of only 14% after re-treatment [7]. …”

Section: Introductionmentioning

confidence: 99%

A Review of Selective Laser Trabeculoplasty: Recent Findings and Current Perspectives

Zhou

Aref

2017

Ophthalmol Ther

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Selective laser trabeculoplasty (SLT) has been widely used in the clinical management of glaucoma, both as primary and adjunctive treatment. As new evidence continues to arise, we review the current literature in terms of indications and efficacy, surgical technique, postoperative care, repeatability, and complications of this therapy. SLT has been shown to be effective in various glaucomas, including primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), steroid-induced glaucoma, pseudoexfoliation glaucoma (PXFG), and primary angle-closure glaucoma (PACG), as well as other glaucoma subtypes. Relatively high preoperative intraocular pressure (IOP) may predict surgical success, while other parameters that have been studied do not seem to affect the outcome. Different techniques for performing the procedure have recently been explored, revealing that minor modifications may lead to a more favorable or safer clinical outcome. The utilization of postoperative medications remains controversial based on the current evidence. A short-term IOP increase may complicate SLT and can also persist in certain cases such as in exfoliation glaucoma. The efficacy and safety of repeat SLT are shown in multiple studies, and the timing of repeat procedures may affect the success rate.

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“…The incidence of iritis, post-laser IOP spikes, and peripheral anterior synechiae is significantly reduced with SLT compared to ALT [71][72][73]. Furthermore, the lack of trabecular meshwork scarring makes SLT more amenable to repeat treatment [4,[74][75][76][77].…”

Section: Selective Laser Trabeculoplasty As Initial Treatmentmentioning

confidence: 99%

Laser Trabeculoplasty and Aqueous Dynamics

Lee¹,

Rahmatnejad²,

Waisbourd³

et al. 2016

Glaucoma - Intraocular Pressure and Aqueous Dynamics

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For the past four decades, laser trabeculoplasty has been a staple in the treatment armamentarium against glaucoma. Although the exact mechanism of laser trabeculoplasty has not been fully elucidated, its clinical utility in lowering intraocular pressure has been well established. Aqueous dynamic studies uniformly reveal an increase in aqueous outflow facility at the trabecular meshwork. Accumulating evidence suggests that the mechanism is the result of complex cellular and biochemical processes. Histopathological studies of the trabecular meshwork tissue after argon laser suggest an additional mechanical role. The traditional treatment algorithm for glaucoma placed laser trabeculoplasty as an intermediary between medical therapy and incisional surgery. However, because of the safety profile of selective laser trabeculoplasty, recent studies have challenged this treatment paradigm. One such study was a multicenter trial headed by our department that compared laser trabeculoplasty and medical therapy as initial treatment for glaucoma. We showed a similar efficacy between the two modalities, reinforcing the possibility of using laser as the initial treatment in the right clinical setting.

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Repeatability of selective laser trabeculoplasty

Abstract: Repeat SLT can restore IOP control in eyes with open-angle glaucoma that have previously undergone successful initial SLT. Repeat SLT achieves comparable absolute level of IOP control achieved by initial SLT.

Cited by 60 publications

References 18 publications

Selective laser trabeculoplasty as an initial treatment option for open-angle glaucoma

Selective laser trabeculoplasty as an initial treatment option for open-angle glaucoma

A Review of Selective Laser Trabeculoplasty: Recent Findings and Current Perspectives

Laser Trabeculoplasty and Aqueous Dynamics

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