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

Abstract

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.

Cost-Comparison of Two Trabecular Micro-Bypass Stents Versus Selective Laser Trabeculoplasty or Medications Only for Intraocular Pressure Control for Patients With Open-Angle Glaucoma

“…9 However, the long-term results are questionable, as failure rates have been reported in the range of 33-74%. [9][10][11] The introduction of Micro-Invasive Glaucoma Surgery (MIGS) implants offers a viable alternative for patients with mild to moderate OAG. iStent (Glaukos Corporation, Laguna Hills, CA, USA), one of the first and most commonly used MIGS devices, is a heparincoated, nonferromagnetic, titanium stent 1 mm in length and 0.3 mm in height.…”

Real-World Data from Selective Laser Trabeculoplasty in Brazil

“…18,19 Previous studies have investigated predictors of success and the use of SLT as rst line therapy, but to date, there is no real-world evidence based on large SLT data obtained from Glaucoma Services in Brazil. [20][21][22] Such results would certainly add clinicians regarding best clinical indications and predictors of success for SLT in Brazilian patients.…”

Cost-comparison of two trabecular micro-bypass stents versus selective laser trabeculoplasty or medications only for intraocular pressure control for patients with open-angle glaucoma

“…Among OAG patients who range from newly diagnosed to those on maximally tolerated medical therapy, SLT results in a 6.9-35.9% intraocular pressure (IOP) reduction and complications are rare 9 . However, the long-term results are questionable, as failure rates have been reported in the range of 33-74% [9][10][11] . The introduction of Micro-Invasive Glaucoma Surgery (MIGS) implants offers a viable alternative for patients with mild to moderate OAG.…”