Direct selective laser trabeculoplasty: A retrospective study

Eur J Ophthalmol. 2024 Nov 25:11206721241301935. doi: 10.1177/11206721241301935. Online ahead of print.

Abstract

Purpose: To investigate the effectiveness and safety profiles of Direct Selective Laser Trabeculoplasty (DSLT).

Materials and methods: Retrospective study of 15 eyes of 10 patients diagnosed with open angle glaucoma (OAG) or ocular hypertension (OHT) who underwent DSLT in June 2023 at University Hospitals of Leicester, UK. We defined success as IOP reduced ≥20% from baseline with no additional medications needed or as a decrease in the number of anti-glaucoma medications while maintaining target IOP. We also considered secondary outcomes such as final BCVA and final number of anti-glaucoma medications.

Results: At the fourth month visit, success was reached in 11 eyes (73.3%). We registered 4 failures (26.7%). Mean IOP at baseline was 22.7 ± 4.4 mmHg and was reduced to 18.7 ± 4.2 mmHg (p = 0.008). The absolute mean reduction of IOP in the group of eyes that maintained unchanged the number of medications was 5.4 ± 2.7 mmHg, as baseline IOP was 21.4 ± 4.3 mmHg, and final IOP was 15.9 ± 2.3 mmHg, with a 25.7% reduction (p = 0.003). Mean BCVA remained unchanged (0.1 ± 0.1 logMAR, p = 1.00). No significant adverse events requiring surgical or clinical intervention were observed.

Conclusion: DSLT showed profiles of effectiveness and safety comparable with those of SLT in the literature and consistent with the results obtained in previous studies on DSLT itself. DSLT may represent a valid alternative to traditional SLT.

Keywords: GLAUCOMA; Laser surgery < GLAUCOMA; aqueous humor dynamics < GLAUCOMA; biochemistry/physiology of aqueous < GLAUCOMA; glaucoma medical therapies < GLAUCOMA.