SLT Compared with Medication for IOP Control

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Primary selective laser trabeculoplasty (SLT) controlled intraocular pressure (IOP) and led to a lower rate of disease progression and less intraocular surgery than medication in a prospective, multicenter, randomized controlled trial involving more than 700 individuals. The results were presented by Gus Gazzard, MD, a consultant ophthalmologist with Moorfields Eye Hospital in London, during the American Academy of Ophthalmology’s 2018 annual meeting in Chicago.

Participants were randomized to receive either primary SLT (355 patients; 611 eyes) or medication (362 patients; 622 eyes), followed by treatment as needed. Investigators followed a ‘treat in pursuit of control’ strategy, with target IOP and treatment escalations tailored according severity of disease. Among the results:

  • Both groups had similar IOP and mean deviation at baseline and 3 years.
  • SLT-treatment produced more patient visits at target (93% vs 91%).
  • It also led to less disease progression (5% vs 7%); fewer trabeculectomies (0% vs 2%) and fewer cataract surgeries (2% vs 4%).
  • 78% were drop-free at target at 3 years. 



Gazzard G. Clinical Outcomes From the Laser in Glaucoma and Ocular Hypertension Trial (LiGHT). Talk presented at: AAO 2018 annual meeting; October 26-30, 2018; Chicago.

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