1-year real-world results of the use of Selective Laser Trabeculoplasty as an alternative to eye drops in mild to moderate open-angle glaucoma

Objective:  To evaluate 1-year real-world results of effectiveness and safety of selective laser trabeculoplasty as an alternative to eye drops in patients with early to moderate open-angle glaucoma.

Methods:  This is a retrospective longitudinal study of a series of cases undergoing selective laser trabeculoplasty in patients with early to moderate open-angle glaucoma who were in use of topical anti-glaucoma therapy. The ability to reduce the intraocular pressure and the medication burden were evaluated, as well as the occurrence of complications or laser-related adverse effects. Success criterion was defined by the proportion of eyes that achieved intraocular pressure < 18 mmHg and intraocular pressure < 15 mmHg without medication (absolute success) and with medication (relative success).

Results:  The study population consisted of 155 eyes. Before selective laser trabeculoplasty, the mean ± standard deviation intraocular pressure and number of medications per eye were 15.5 ± 4.0 mmHg and 1.8 ± 1.0, respectively. The mean intraocular pressure was reduced by 12.3% between preoperative and final follow-up (13.6 mmHg; p < 0.001). The mean number of eye drops at final follow-up was 0.5, representing a mean reduction of 72.2% (p < 0.001). The absolute and relative success rates, respectively, were 64.6% and 89.1% for intraocular pressure < 15 mmHg and 71.4% and 94.6% for intraocular pressure < 18 mmHg. No complications or intercurrences related to the laser were observed.

Conclusion:  Selective laser trabeculoplasty demonstrated high safety and effectiveness up to 1 year of follow-up, both in controlling intraocular pressure and in reducing the number of glaucoma eye drops, confirming its potential use as a replacement therapy for hypotensive eye drops in real-world setting.

Keywords:
Glaucoma, open-angle; Intraocular pressure; Trabeculectomy; Lasers; Ophthalmic solutions