Baseline IOP key to choosing between SLT and eye drops in glaucoma treatment

The effectiveness of selective laser trabeculoplasty (SLT) and prostaglandin analogue (PGA) eye drops in lowering intraocular pressure (IOP) depends on the patient’s baseline IOP, according to a study presented at AAO 2024.

The study found that SLT is more effective at higher baseline IOPs, while PGA drops are better at reducing IOP when baseline levels are lower.

The analysis used data from 1,146 eyes of 662 participants in the Laser in Glaucoma and Ocular Hypertension Trial (LiGHT).

Key Findings:

• Both SLT and PGA eye drops were more effective at lowering IOP in patients with higher baseline IOP.
• For patients with baseline IOP ≤17 mmHg, PGA eye drops achieved a significantly greater percentage of IOP reduction.
• SLT was more likely to achieve a ≥20% reduction in IOP at baseline IOP ≥23.4 mmHg.

The authors concluded that SLT showed superior success at higher baseline IOP, while PGA drops provided better IOP reduction at lower baseline IOP, indicating that pretreatment IOP levels can help guide treatment choice in glaucoma management.

Reference
Fahy ET, et al. The Impact of Baseline IOP on Treatment Response in the LiGHT Trial: SLT versus Medication. Poster presented at: American Academy of Ophthalmology Annual Meeting; October 2024; Chicago.