Real-Life Effectiveness and Safety of Selective Laser Trabeculoplasty as Primary, Adjunctive, and Substitutive Therapy

Objectives: To assess real-world outcomes of selective laser trabeculoplasty (SLT) in naive patients compared to SLT as adjunctive treatment (AT), investigating SLT’s intraocular pressure (IOP) reduction and its potential to decrease topical medication. Materials and Methods: Patients undergoing SL...

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Main Authors: David Oliver-Gutierrez, Osvaldo Guevara-Chavarría, Shirin Djavanmardi, Gloria Segura-Duch, Marta Castany, Stefania Piludu, Carlos A. Arciniegas-Perasso, Elena Ávila, Elena Milla, Susana Duch
Format: Article
Language:English
Published: Galenos Publishing House 2025-06-01
Series:Türk Oftalmoloji Dergisi
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Online Access:https://oftalmoloji.org/articles/real-life-effectiveness-and-safety-of-selective-laser-trabeculoplasty-as-primary-adjunctive-and-substitutive-therapy/doi/tjo.galenos.2025.75570
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author David Oliver-Gutierrez
Osvaldo Guevara-Chavarría
Shirin Djavanmardi
Gloria Segura-Duch
Marta Castany
Stefania Piludu
Carlos A. Arciniegas-Perasso
Elena Ávila
Elena Milla
Susana Duch
author_facet David Oliver-Gutierrez
Osvaldo Guevara-Chavarría
Shirin Djavanmardi
Gloria Segura-Duch
Marta Castany
Stefania Piludu
Carlos A. Arciniegas-Perasso
Elena Ávila
Elena Milla
Susana Duch
author_sort David Oliver-Gutierrez
collection DOAJ
description Objectives: To assess real-world outcomes of selective laser trabeculoplasty (SLT) in naive patients compared to SLT as adjunctive treatment (AT), investigating SLT’s intraocular pressure (IOP) reduction and its potential to decrease topical medication. Materials and Methods: Patients undergoing SLT with no prior glaucoma surgery or laser treatment were grouped based on the intended objective: SLT as primary treatment (PT), SLT as AT, and SLT as substitutive treatment (ST). Survival in the PT and AT groups was defined as ≥20% IOP reduction from baseline and IOP ≤21 on two consecutive visits with the same or fewer medications and no additional glaucoma procedure, including repeat SLT. Survival in the ST group was defined as decreasing topical medication while maintaining or reducing IOP. Results: The study included 120 eyes of 120 patients with a mean follow-up of 32.7 months. The PT group showed superior IOP reduction than the AT group at 24-36 months (22.1% vs. 14.5%, p=0.039). Non-responders comprised 28.6% of the PT group and 37.0% of the AT group. The PT group demonstrated better survival rates than the AT group at 12, 24, and 36 months (69.0% vs. 47.1%, 38.8% vs. 31.4%, and 31.1% vs. 23.5%, respectively). In the ST group, 34.2% of patients were successful at 12 months, increasing to 38.3% at 24 months. At 24 months, 50.0% of patients had reduced at least one medication. Conclusion: SLT showed two-thirds effectiveness, with one-third being non-responders. It was more effective as PT, with higher IOP reduction and success rates. SLT reduced topical medication in half of patients.
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spelling doaj-art-d3ebcdfd03ca4e98be2d7811381941fe2025-08-20T03:51:08ZengGalenos Publishing HouseTürk Oftalmoloji Dergisi1300-06592147-26612025-06-0155313214010.4274/tjo.galenos.2025.75570Real-Life Effectiveness and Safety of Selective Laser Trabeculoplasty as Primary, Adjunctive, and Substitutive TherapyDavid Oliver-Gutierrez0https://orcid.org/0000-0002-0492-8645Osvaldo Guevara-Chavarría1https://orcid.org/0000-0002-8173-0958Shirin Djavanmardi2Gloria Segura-Duch3https://orcid.org/0000-0002-8842-8604Marta Castany4https://orcid.org/0000-0002-6832-4496Stefania Piludu5https://orcid.org/0000-0002-4765-4963Carlos A. Arciniegas-Perasso6Elena Ávila7https://orcid.org/0000-0003-0105-7052Elena Milla8https://orcid.org/0000-0002-5171-165XSusana Duch9https://orcid.org/0000-0001-5965-8315Innova Ocular Verte Barcelona, Barcelona, SpainInnova Ocular Verte Barcelona, Barcelona, SpainInnova Ocular Verte Barcelona, Barcelona, SpainInnova Ocular Verte Barcelona, Barcelona, SpainVall D’hebron University Hospital, Clinic of Ophthalmology, Barcelona, SpainInnova Ocular Verte Barcelona, Barcelona, SpainInnova Ocular Verte Barcelona, Barcelona, SpainInnova Ocular Verte Barcelona, Barcelona, SpainInnova Ocular Verte Barcelona, Barcelona, SpainInnova Ocular Verte Barcelona, Barcelona, SpainObjectives: To assess real-world outcomes of selective laser trabeculoplasty (SLT) in naive patients compared to SLT as adjunctive treatment (AT), investigating SLT’s intraocular pressure (IOP) reduction and its potential to decrease topical medication. Materials and Methods: Patients undergoing SLT with no prior glaucoma surgery or laser treatment were grouped based on the intended objective: SLT as primary treatment (PT), SLT as AT, and SLT as substitutive treatment (ST). Survival in the PT and AT groups was defined as ≥20% IOP reduction from baseline and IOP ≤21 on two consecutive visits with the same or fewer medications and no additional glaucoma procedure, including repeat SLT. Survival in the ST group was defined as decreasing topical medication while maintaining or reducing IOP. Results: The study included 120 eyes of 120 patients with a mean follow-up of 32.7 months. The PT group showed superior IOP reduction than the AT group at 24-36 months (22.1% vs. 14.5%, p=0.039). Non-responders comprised 28.6% of the PT group and 37.0% of the AT group. The PT group demonstrated better survival rates than the AT group at 12, 24, and 36 months (69.0% vs. 47.1%, 38.8% vs. 31.4%, and 31.1% vs. 23.5%, respectively). In the ST group, 34.2% of patients were successful at 12 months, increasing to 38.3% at 24 months. At 24 months, 50.0% of patients had reduced at least one medication. Conclusion: SLT showed two-thirds effectiveness, with one-third being non-responders. It was more effective as PT, with higher IOP reduction and success rates. SLT reduced topical medication in half of patients.https://oftalmoloji.org/articles/real-life-effectiveness-and-safety-of-selective-laser-trabeculoplasty-as-primary-adjunctive-and-substitutive-therapy/doi/tjo.galenos.2025.75570selective laser trabeculoplastyglaucomasltlaser glaucoma therapy
spellingShingle David Oliver-Gutierrez
Osvaldo Guevara-Chavarría
Shirin Djavanmardi
Gloria Segura-Duch
Marta Castany
Stefania Piludu
Carlos A. Arciniegas-Perasso
Elena Ávila
Elena Milla
Susana Duch
Real-Life Effectiveness and Safety of Selective Laser Trabeculoplasty as Primary, Adjunctive, and Substitutive Therapy
Türk Oftalmoloji Dergisi
selective laser trabeculoplasty
glaucoma
slt
laser glaucoma therapy
title Real-Life Effectiveness and Safety of Selective Laser Trabeculoplasty as Primary, Adjunctive, and Substitutive Therapy
title_full Real-Life Effectiveness and Safety of Selective Laser Trabeculoplasty as Primary, Adjunctive, and Substitutive Therapy
title_fullStr Real-Life Effectiveness and Safety of Selective Laser Trabeculoplasty as Primary, Adjunctive, and Substitutive Therapy
title_full_unstemmed Real-Life Effectiveness and Safety of Selective Laser Trabeculoplasty as Primary, Adjunctive, and Substitutive Therapy
title_short Real-Life Effectiveness and Safety of Selective Laser Trabeculoplasty as Primary, Adjunctive, and Substitutive Therapy
title_sort real life effectiveness and safety of selective laser trabeculoplasty as primary adjunctive and substitutive therapy
topic selective laser trabeculoplasty
glaucoma
slt
laser glaucoma therapy
url https://oftalmoloji.org/articles/real-life-effectiveness-and-safety-of-selective-laser-trabeculoplasty-as-primary-adjunctive-and-substitutive-therapy/doi/tjo.galenos.2025.75570
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