Selective laser trabeculoplasty more effective for higher baseline IOP in glaucoma treatment

Selective laser trabeculoplasty (SLT) is more effective prostaglandin analogue (PGA) eye drops for achieving significant intraocular pressure (IOP) reduction in patients with higher baseline IOP, according to a study.

The post hoc analysis, which included 1146 eyes from 662 patients, found that both SLT and PGA drops achieved greater IOP reduction at higher baseline IOP levels and less reduction at lower baseline levels. SLT was found to be more effective at achieving at least a 20% reduction in IOP for patients with a baseline IOP greater than 22.51 mmHg compared to PGA drops. Conversely, at a lower baseline IOP (≤ 17 mmHg), PGA drops demonstrated a statistically significant advantage over SLT in terms of percentage IOP reduction.

Despite these differences, mean IOP was similar between the treatments at both baseline and after 8 weeks. The findings confirm previous observations that higher baseline IOP predicts greater treatment response for both SLT and PGA drops but suggest that SLT might be a superior first-line therapy for patients with higher baseline IOP.

Reference
Fahy ET, Montesano G, Garg A, et al; LiGHT Trial Study Group. The Impact of Baseline Intraocular Pressure on Initial Treatment Response in the LiGHT Trial: Selective Laser Trabeculoplasty versus Medication. Ophthalmology. 2024;S0161-6420(24)00393-2. doi: 10.1016/j.ophtha.2024.06.022. Epub ahead of print. PMID: 38964719.