Safety and Efficacy of Selective Laser Trabeculoplasty for Glaucoma Patients at a UK Tertiary Hospital

Authors: Borna A. Assarian, Richard Imonikhe, Ali Ghoraba, Sameh A. Ibrahim, Marwa Albaroudi

Abstract:

Introduction: Glaucoma is characterised by increased intraocular pressure (IOP) and can cause irreversible vision loss if untreated. Selective laser trabeculoplasty (SLT) is a non-invasive treatment to lower IOP and slow glaucoma progression. The aim of this study was to evaluate the safety and efficacy of SLT in reducing IOP and the number of anti-glaucoma eye drops used in glaucoma patients at the University Hospital of Southampton. Method: Records of 100 eyes of glaucoma patients between 2020-2022 were reviewed. Pre- and post-treatment IOP and changes in the quantity of anti-glaucoma eye drops were analysed. Inclusion criteria required SLT treatment and IOP measurement with Goldmann applanation tonometry. Patients with adjustments made to anti-glaucoma drops before six weeks post-treatment or before IOP measurement were excluded. Results: 100 eyes of 62 glaucoma patients were studied and consisted of 60% primary open-angle glaucoma, 14% pigment dispersion syndrome, 11% ocular hypertension, 10% primary angle closure glaucoma, 4% normal-tension glaucoma, and 1% pseudoexfoliation syndrome. Overall, the average IOP reduction was 2.12 mmHg per eye. SLT was effective in reducing IOP across all types of glaucoma; degrees of effect were dependent on the type of pathology, with the greatest median decrease in primary open-angle glaucoma and ocular hypertension (3mmHg). IOP reduction also varied based on the number of anti-glaucoma eye drops used, with the largest median decrease (4mmHg) observed in patients who did not use any drops. SLT reduced the number of anti-glaucoma eye drops, with 10% of cases discontinuing use and 6% reduced by one eye drop. Adverse events were rare and included transient increases in IOP (2%) and corneal oedema (1%). Conclusion: SLT is a safe and effective treatment option for reducing IOP and the number of anti-glaucoma eye drops. The type of glaucoma and the number of anti-glaucoma eye drops used by patients can help predict the efficacy of SLT treatment.

Keywords: glaucoma, non-invasive treatment, raised intraocular pressure, selective laser trabeculoplasty