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SLT (Selective Laser Trabeculoplasty) for Glaucoma

Laser surgery has become increasingly popular as an alternative method of treating pressure.

 

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New revolutionary device for the treatment of dry eyes due to Blepharitis/Meibomian gland dysfunction (MGD), the E-Eye IPL machine.

 

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Selective Laser Trabeculoplasty vs. Eye Drops

Selective Laser Trabeculoplasty vs. Eye Drops for first line treatment of Ocular Hypertension and Glaucoma: a multicentre randomised controlled trial

Gus Gazzard, Evgenia Konstantakopoulou, David Garway-Heath, Anurag Garg, Victoria Vickerstaff, Rachael Hunter, Gareth Ambler, Catey Bunce, Richard Wormald, Neil Nathwani, Keith Barton, Gary Rubin, Marta Buszewicz; on behalf of the LiGHT Trial Study Group*

 

Background:

Primary Open Angle Glaucoma and Ocular Hypertension are commonly treated with eye drops that lower eye pressure. SLT (Selective Laser Trabeculoplasty) is a safe alternative but is rarely used as first line treatment. This study compared the two.

Methods:

In this observer masked, randomized controlled trial treatment – naïve patients with open angle glaucoma or ocular hypertension and no ocular comorbidities were recruited between 2012 and 2014 at six UK hospitals.

They were randomly allocated (web-based randomisation) to initial treatment with SLT or to eye drops as first line treatment.

An objective target Intraocular Pressure was set according to the severity of the patient’s glaucoma.

The primary outcome was health-related quality of life (HRQoL) at 3 years (assessed by EQ-5D).

Secondary outcomes were cost and cost effectiveness, disease specific HRQoL, clinical effectiveness and safety.

Findings:

Of 718 patients enrolled, 356 were randomised to the selective laser Trabeculoplasty and 362 to the eye drops group.

652 (91%) returned the primary outcome questionnaire at 36 months. Average EQ-5D score was 0.86 (SD 0.18) in the Selective Laser Trabeculoplasty group versus 0.90 (SD 0.16) in the eye drops group. Therefore there was no significant difference to a patient’s quality of life.

At 36 months 74.2% of patients in the SLT group required no drops to maintain intraocular pressure at target.

Eyes of patients in the Selective Laser Trabeculoplasty group were within target intraocular pressure at more visits (93%) than in the eye drops group (91.3%).

No patients required glaucoma surgery to lower intraocular pressures in the SLT group, while 11 patients from the drops group required further surgical intervention.

Conclusion:

Selective Laser Trabeculoplasty should be offered as first line treatment for open angle glaucoma and ocular hypertension, supporting a change in clinical practice. At the cork eye clinic SLT is now our first line treatment offered to all suitable glaucoma and ocular hypertension patients.

 

www.thelancet.com Published online March 9, 2019 http://dx.doi.org/10.1016/S0140-6736(18)32213-X

 

 

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Clinic Location 

Cork Eye Clinic

Suite 7/8, Clinic A,
Cork Clinic, Western Road,
Cork, T12 VY83.

 

cork eye clinic

Tel:  021 434 1030
Fax: 021 434 1033
Email: bgolchin@corkeyeclinic.ie

 

VIEW ALLWhat Our Patients Say

I recently had a cataract removed by Mr Golchin. The experience, from start to finish of the procedure, was calm, reassuring and a success. Not only is Mr Golchin an excellent surgeon but also an active listener with excellent communication skills. On any of my visits to his clinic he encouraged questions, listened attentively and continued to reassure me. This was very important as I was extremely nervous about the whole procedure. Mr Golchin performed an outstanding surgery. I had absolutely no pain or irritation, 20/20 vision now in both eyes and feeling 10 years younger. What more can you ask of an excellent surgeon.

Rose Donnery (July 2019)

 
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