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A retrospective review of selective laser trabeculoplasty outcomes at Lancashire Teaching Hospitals, UK

Abstract

Introduction

Selective laser trabeculoplasty has been carried out at Lancashire Teaching Hospitals over the past seven years. This work aimed to review the use of SLT in this Trust. The primary objectives were to establish the efficacy of SLT in reducing intraocular pressure, to analyse how prior treatment with different topical medications can influence SLT outcomes and to analyse the outcomes in revisionary patients.

Method

We conducted a retrospective review of 288 eyes, with a known history of glaucoma or ocular hypertension and who underwent initial SLT laser treatment between October 2018 and January 2020. SLT was performed on known glaucoma and treatment naïve patients where IOP control was deemed sub-optimal. All patient data was fully anonymised.

Results

We found that SLT was effective in lowering IOP. Around two-thirds of the eyes (181/280, 65%) achieved a reduction in IOP of 10% or more. Just under half (127/280, 45%) achieved a reduction of 20% or more. For a pre-SLT IOP of 14.6 mmHg, we found that no mean change in IOP is expected, and for each 1 mmHg by which the pre-SLT IOP exceeds this threshold, the mean reduction in IOP is expected to be 0.61 mmHg. We also found that combination therapies of PGA plus aqueous suppressants gave better outcomes compared with PGA alone. We found that revisionary SLT compared favourably with the first treatment, although first-time outcomes were not a good predictor of success with revisionary SLT.

Conclusion

Primary and revisionary SLT has been shown to be effective across the cohort of patients in this study.

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Fig. 1: The relationship between pre SLT IOP and change in IOP post SLT.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and patient confidentiality but are available from the corresponding author upon reasonable request. Data are in controlled access data storage at Lancashire Teaching Hospitals NHS Trust.

References

  1. Gazzard G, Konstantakopoulou E, Garway-Heath D, Garg A, Vickerstaff V, Hunter R, et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet. 2019;393:1505–16.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Overview|Glaucoma: diagnosis and management|Guidance|NICE. NICE;2017. https://www.nice.org.uk/guidance/ng81.

  3. Ang GS, Fenwick EK, Constantinou M, Gan ATL, Man REK, Casson RJ, et al. Selective laser trabeculoplasty versus topical medication as initial glaucoma treatment: the glaucoma initial treatment study randomised clinical trial. Br J Ophthalmol. 2020;104:813–21.

    Article  PubMed  Google Scholar 

  4. Lee JWY, Wong MOM, Liu CCL, Lai JSM. Optimal selective laser trabeculoplasty energy for maximal intraocular pressure reduction in open-angle glaucoma. J Glaucoma. 2015;24:e128–131.

    Article  PubMed  Google Scholar 

  5. Sayin N, Alkin Z, Ozkaya A, Demir A, Yazici AT, Bozkurt E, et al. Efficacy of selective laser trabeculoplasty in medically uncontrolled glaucoma. ISRN Ophthalmol. 2013;2013:975281.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lee JW, Chan CW, Wong MO, Chan JC, Li Q, Lai JS. A randomized control trial to evaluate the effect of adjuvant selective laser trabeculoplasty versus medication alone in primary open-angle glaucoma: preliminary results. Clin Ophthalmol. 2014;8:1987–92.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Latina MA, Sibayan SA, Shin DH, Noecker RJ, Marcellino G. Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology. 1998;105:2082–8.

    Article  CAS  PubMed  Google Scholar 

  8. Garg A, Gazzard G. Selective laser trabeculoplasty: past, present, and future. Eye. 2018;32:863–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Siddique SS, Suelves AM, Baheti U, Foster CS. Glaucoma and uveitis. Surv Ophthalmol. 2013;58:1–10.

    Article  PubMed  Google Scholar 

  10. Roth M, Simmons RJ. Glaucoma associated with precipitates on the trabecular meshwork. Ophthalmology. 1979;86:1613–9.

    Article  CAS  PubMed  Google Scholar 

  11. Zhou Y, Pruet CM, Fang C, Khanna CL. Selective laser trabeculoplasty in steroid-induced and uveitic glaucoma. Can J Ophthalmol J Can Ophtalmol. 2022;57:277–83.

    Article  Google Scholar 

  12. Sherman ER, Cafiero‐chin M. Overcoming diagnostic and treatment challenges in uveitic glaucoma. Clin Exp Optom. 2019;102:109–15.

    Article  PubMed  Google Scholar 

  13. Kara N, Altan C, Satana B, Altinkaynak H, Bozkurt E, Demirok A, et al. Comparison of selective laser trabeculoplasty success in patients treated with either prostaglandin or timolol/dorzolamide fixed combination. J Ocul Pharm Ther J Assoc Ocul Pharm Ther. 2011;27:339–42.

    Article  CAS  Google Scholar 

  14. Alvarado JA, Iguchi R, Martinez J, Trivedi S, Shifera AS. Similar effects of selective laser trabeculoplasty and prostaglandin analogs on the permeability of cultured Schlemm canal cells. Am J Ophthalmol. 2010;150:254–64.

    Article  CAS  PubMed  Google Scholar 

  15. Singh D, Coote MA, O’Hare F, Walland MJ, Ghosh S, Xie J, et al. Topical prostaglandin analogues do not affect selective laser trabeculoplasty outcomes. Eye. 2009;23:2194–9.

    Article  CAS  PubMed  Google Scholar 

  16. Latina MA. IOP lowering effect of SLT may be influenced by the type of concomitant anti-glaucoma drops. Paper presented at The AAO Annual Meeting: New Orleans, LA;2004.

  17. Seymenoğlu G, Baser EF. Efficacy of selective laser trabeculoplasty in phakic and pseudophakic eyes. J Glaucoma. 2015;24:105–10.

    Article  PubMed  Google Scholar 

  18. De Keyser M, De Belder M, De Groot V. Selective laser trabeculoplasty in pseudophakic and phakic eyes: a prospective study. Int J Ophthalmol. 2017;10:593–8.

    PubMed  PubMed Central  Google Scholar 

  19. Jang HJ, Yu B, Hodge W, Malvankar-Mehta MS. Repeat selective laser trabeculoplasty for glaucoma patients: a systematic review and meta-analysis. J Curr Glaucoma Pr. 2021;15:117–24.

    Article  Google Scholar 

Download references

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Authors and Affiliations

Authors

Contributions

AS initiated this study, carried out the literature search and contributed to writing the paper. MKB carried out the statistical analysis and led the writing of the results section. FD led the data collection process and contributed to writing the paper. AS, MKB and FD all contributed to editing and agreeing the final document for submission. AA, AS and NS assisted with collecting the data and checking data integrity.

Corresponding author

Correspondence to Aysha Salam.

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The authors declare no competing interests.

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Salam, A., Butler, M.K., Davies, F. et al. A retrospective review of selective laser trabeculoplasty outcomes at Lancashire Teaching Hospitals, UK. Eye 38, 3357–3361 (2024). https://doi.org/10.1038/s41433-024-03307-7

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