SALT Trial: Steroids after Laser Trabeculoplasty

Groth, Sylvia L.; Albeiruti, Eiyass; Mariana, Nuñez; Fajardo, Roman G.; Sharpsten, Lucie; Loewen, Nils A.; Schuman, Joel S.; Goldberg, Jeffrey L.

doi:10.1016/j.ophtha.2019.05.032

Cited by 32 publications

(27 citation statements)

References 30 publications

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“…The differences between the treatment and placebo groups were statistically significant. Post-SLT treatment with prednisolone or ketorolac proved to positively contribute to the IOP-lowering effect [ 23 ].…”

Section: Postoperative Treatmentmentioning

confidence: 99%

“…The results of the SALT study contradict those of a similarly constructed study by Jinapriya et al, who found no statistically significant difference between groups treated with 1.0% prednisolone acetate, 0.5% ketorolac tromethamine and artificial tears at the one-month follow-up. In this study, SLT was less effective, and the most probable reason was a low baseline IOP [ 23 , 24 ]. Similar results were shown in a prospective randomized trial by de Keyser et al, who performed SLT in both eyes of 66 patients.…”

Section: Postoperative Treatmentmentioning

confidence: 99%

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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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Section: Postoperative Treatmentmentioning

confidence: 99%

Section: Postoperative Treatmentmentioning

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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Section: Discussionmentioning

confidence: 99%

“…Groth et al, in their randomized, double-masked, placebo-controlled clinical trial, evaluated 96 eyes with either POAG (72 eyes), PXFG (4 eyes), or OHT (20 eyes) following 180° SLT (34 eyes), 270° SLT (11 eyes), or 360° SLT (50 eyes) [ 24 ]. Of these, 28 eyes (20 POAG, 8 OHT) were treated with ketorolac 0.5%, 37 eyes (28 POAG, 3 PXFG, 6 OHT) with prednisolone 1%, or 31 eyes (24 POAG, 1 PXFG, 6 OHT) with placebo four times per day for 5 days after SLT [ 24 ]. No significant difference in IOP decrease among groups was observed at week 6 of follow-up; both the nonsteroidal anti-inflammatory drug and steroid groups showed a significantly greater decrease in IOP at week 12 of follow-up compared with the placebo group [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Symptomatic or asymptomatic anterior chamber inflammation after SLT may occur, but usually resolves without treatment [ 1 , 5 , 19 , 20 , 21 , 22 , 23 ]. Treatment with topical steroids or nonsteroidal anti-inflammatory agents after SLT in most reports has not shown to cause a significant reduction in inflammation or improved efficacy, but it still remains a controversy in clinical practice [ 20 , 21 , 22 , 23 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Short-Term Topical Steroid Therapy on Selective Laser Trabeculoplasty Efficacy

Gračner

2021

JCM

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Background: To evaluate whether short-term use of topical steroid therapy affected the efficacy of selective laser trabeculoplasty (SLT) for primary open-glaucoma (POAG). Methods: 25 eyes of 25 patients, who used a drop of dexamethasone 0.1% 4 times a day for 7 days as post-laser therapy, formed the Steroid SLT group and 24 eyes of 24 patients, where no topical steroids or nonsteroidal anti-inflammatory agents as post-laser therapy were used, formed the No-steroid SLT group. Success was defined as an intraocular pressure (IOP) lowering exceeding 20% of pretreatment IOP. Results: The mean follow-up time was 21.24 months for the Steroid SLT group and 20.25 months for the No-steroid SLT group (p = 0.990). No significant difference was found between the two groups for mean pretreatment IOP (22.20 mmHg vs. 22.33 mmHg), and for mean IOP reductions during whole follow-up period. At all follow-up visits, the mean IOP reductions were smaller in the Steroid SLT group than in the No-steroid SLT group. At all follow-up visits, the mean percent IOP reduction was smaller in the Steroid SLT group than in the No-steroid SLT group, and such a difference was significant at 12 months (25.4% vs. 29.6%, p = 0.047) and 24 months (25.3% vs. 29.7%, p = 0.024). According to the Kaplan–Meier survival analysis, the 24-month success rate was 84% in the Steroid SLT group and 79.2% in the No-steroid SLT group, with no differences between the groups (p = 0.675). Conclusion: Short-term use of topical steroid therapy had no impact on the efficacy of SLT for POAG.

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