SLT a consistent and effective treatment

Selective laser trabeculoplasty (SLT) is an effective treatment for glaucoma and offers good long term outlooks, according to Madhu Nagar of the Clayton Eye Centre, UK.

Nagar, speaking at the Ellex symposium, presented the results of a retrospective analysis of case notes from consecutive SLT procedures conducted between January 2000 and December 2005. A total of 546 eyes of 315 patients underwent the procedure, 80% of these had primary open-angle glaucoma, the remaining 20% had ocular hypertension. 279 eyes (51%) received SLT as a primary treatment, 267 (49%) as an adjunctive treatment and 89 eyes underwent it as a retreatment or enhancement (only 61 of these case notes were analysed).

In the primary group, a 33% mean reduction in intraocular pressure (IOP) was recorded. In the secondary group this figure was 32.6% and for those receiving SLT as a retreatment there was a 29% drop in IOP. The number of eye drops being used fell from 1.8 preoperatively, to 0.86 postoperatively.

Nagar found that the higher the preoperative IOP, the more successful the outcomes. She also found that the angle of treatment had an effect on the success of the procedure: those undergoing 90° treatment had an average IOP reduction of 26%, 180° treatment offered a 27.5% reduction and 360° provided an average reduction of 39%. She noted that 90° treatments were the most likely to fail, although this was still relatively uncommon.

Further analysis of the results found that, at week one, 5% (30/546) of the patients had not responded to the treatment and 20% were slow responders, however 60% of these became more responsive at month one.

Nagar concluded that SLT offers significant reductions in IOP and reduces the number of topical medications required by patients. She is now so confident in the procedure that she offers it as a standard treatment at her clinic.

Ophthalmology Times Europe reporting from the XXIV Congress of the ESCRS, London, 9-13 September, 2006.