More than 70 million people around the world suffer from glaucoma, a condition in which poor eye fluid drainage causes a buildup of pressure—damaging the optic nerve and eventually causing blindness. Treatment options usually start with eye drops to control fluid production, with stepwise escalation to surgery. 

A type of laser treatment, called selective laser trabeculoplasty (SLT), has also been available, but specialists have been hesitant to use it. “There’s been a lack of evidence about how well SLT works, how safe it is,” said Jella An, MD, an assistant professor of ophthalmology and a glaucoma specialist at the University of Missouri School of Medicine and MU Health Care. “Our research findings have helped me redefine the ideal patient for this procedure.”

This 2020 study, of which Dr. An is a co-author, has determined which glaucoma patients may most benefit from a non-invasive treatment, called selective laser trabeculoplasty, to alter eye tissue and improve fluid drainage.*

What they did

The study followed 198 adults with open-angle glaucoma (OAG) who underwent 252 SLT procedures. Dr. An’s team looked at what percentage of these non-invasive procedures resulted in a 20% or greater reduction in intraocular pressure (IOP). 

What they found

Success was met for:

• 33.6% of patients after two months 
• 38.5% of patients after six months

Less than 5% experienced the common spike in IOP following the procedure. Patients with higher eye pressure at baseline had greater reductions in pressure from the treatment. Age and severity of vision loss were not significant factors in predicting outcomes.

What it means

The team discovered that patients with the highest IOP stand to benefit the most from this therapy, and the safety factor recommends it as a first-line treatment.

“This study really increased my comfort level to offer SLT as a primary therapy,” said Dr. An. “Prior to this research, I would prescribe these patients multiple medications…Now I offer this laser first if they are a good candidate…If it doesn’t work, we can always move forward with other options.”

*University of Missouri-Columbia. (2020, Aug. 5). Researchers Discover Predictor of Laser Treatment Success in Patients with Glaucoma: Pre-Treatment Eye Pressure is Best Gauge of Laser Effectiveness. ScienceDaily. www.sciencedaily.com/releases/2020/08/200805110110.htm

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