Researchers have found that patients with ocular hypertension, primary open-angle glaucoma or pseudoexfoliative glaucoma may not require 360˚ selective laser trabeculoplasty (SLT) treatment to lower intraocular pressure (IOP). Partial SLT may be just as effective.1
In a prospective randomized clinical trial, the investigators included 67 patients, 32 of whom received 90˚ SLT and 35 received 360˚ SLT. In monitoring the patients’ IOP and any post-op complications, they found the mean survival of the treatment effect was similar in the two groups.1
The study also revealed that ethnicity, type of glaucoma, history of previous argon laser trabeculoplasty, myopia, systemic diseases (diabetes and hypertension), simultaneous use of other eye drops, trabecular meshwork pigmentation and phakic/pseudophakic state of lens were not significant predictors of survival treatment—but high pre-IOP was.2 The researchers note if both therapies have comparable efficacy, 90˚ SLT would be preferable to 360˚ treatment.
“While awaiting the outcome of further investigations, [this] superb paper has given me the impetus to consider using a 90˚ SLT instead of the 180˚ SLT to treat future patients who have uncontrolled IOP,” Joseph M Ortiz, MD, said in a PracticeUpdate commentary.2 Performing 90˚ SLT could avoid many of the side effects of 360˚ SLT such as a higher incident of postoperative iritis, IOP spike and ocular discomfort, he said.
1. Tawfique K, Khademi P, Quérat L, et al. Comparison between 90-degree and 360-degree selective laser trabeculoplasty (SLT): A 2-year follow-up. Acta Ophthalmol. October 15, 2018. [Epub ahead of print].
2. Comparison between 90-degree and 360-degree selective laser trabeculoplasty. PracticeUpdate. November 29, 2018.