Study: SLT Slows Glaucoma Progression Compared to Topical Eye Drops
A new study presented at the American Academy of Ophthalmology (AAO) this past weekend found that selective laser trabeculoplasty (SLT) slowed glaucoma progression by 29% compared to patients using daily eye drops.[1]
“Selective laser trabeculoplasty should not only be considered an effective and safe alternative to medications as a first-line treatment for primary open-angle glaucoma but can also offer an advantage in reducing vision loss,” lead researcher Giovanni Montesano, MD, PhD, of Moorfields Eye Hospital in London, said in an AAO press release.
SLT is an adjunct therapy that reduces eye pressure by stimulating the trabecular meshwork.. Previous studies have shown that SLT is an equally effective treatment without the challenges of daily eye drops.
Dr. Montesano’s study identified the additional advantage of SLT over topical eye drops of significantly slowing disease progression. Montesano and his colleagues conducted a new analysis of the Laser in Glaucoma and Ocular Hypertension (LiGHT) trial—a landmark study that demonstrated SLT is a safe treatment for long-term glaucoma management and reduced the need for additional surgery over 6 years. The team revisited the visual field outcomes from the LiGHT trial using a more detailed and sensitive statistical approach.
“Since the first study, we developed an improved statistical technique to calculate the rate of progression of the Mean Deviation,” Dr. Montesano said. “This improved methodology, together with the longer follow-up, prompted us to test again the previously observed differences between the SLT-1st and the Medication-1st arms of the LiGHT trial.”
Their results showed a 29% decrease in the rate of mean deviation of progression in the better eye of patients treated with laser first over 6 years of follow-up. This translated to an estimated proportion of eyes with “fast progression” (greater than -0.5 dB/year) of 14% in the laser group compared to 25% in the eye drop group. According to the study authors, possible reasons for these improved outcomes include laser procedures provide continuous pressure control and do not rely on patient compliance with medication.
The AAO recently published an Ophthalmic Technology Assessment of SLT, which concluded SLT is an appropriate primary intervention for glaucoma, replacement for medications, or an additional therapy.
References
- Montesano G, Crabb DP, Wright DM, Rabiolo A, Ometto G, Garway-Heath DF. Estimating the distribution of true rates of visual field progression in glaucoma. Transl Vis Sci Technol. 2024 Apr 2;13(4):15. doi: 10.1167/tvst.13.4.15. PMID: 38591945; PMCID: PMC11008752.