Efficacy of Selective Laser Trabeculoplasty vs Eye Drops as a First Line Treatment of Primary Open Angle Glaucoma

Purpose: Selective laser trabeculoplasty (SLT) is a quick, outpatient procedure with minimal recovery time and a good safety profile. However, the role of laser trabeculoplasty in the treatment of glaucoma is still not well defined. This study is done to compare the effectiveness of selective laser...

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Main Authors: Neeharika Shah, Jinal Makwana, Sanket Oza, Nilam Makwana
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-07-01
Series:Delhi Journal of Ophthalmology
Subjects:
Online Access:https://journals.lww.com/10.4103/dljo.dljo_36_23
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author Neeharika Shah
Jinal Makwana
Sanket Oza
Nilam Makwana
author_facet Neeharika Shah
Jinal Makwana
Sanket Oza
Nilam Makwana
author_sort Neeharika Shah
collection DOAJ
description Purpose: Selective laser trabeculoplasty (SLT) is a quick, outpatient procedure with minimal recovery time and a good safety profile. However, the role of laser trabeculoplasty in the treatment of glaucoma is still not well defined. This study is done to compare the effectiveness of selective laser trabeculoplasty as a first line treatment of Primary Open Angle Glaucoma (POAG) against conventional medical treatment with eye drops. Methods: A prospective comparative study was performed at a tertiary care centre in western India from October 2019 to October 2021. Study included 64 patients of mild to moderate severity newly diagnosed open angle glaucoma randomly given SLT or medical treatment as a first line treatment and followed up on 1st week,1st month,3rd month,6th month and 1 year to determine whether laser treatment; Achieves the desired level of intra-ocular pressure (IOP) in comparison to topical antiglaucoma medications, leads to non-progression of visual field during course of treatment, achieves equivalent levels of visual function after 1 year, is well or better tolerated by patients, needs any adjuvant treatment during course of treatment, costs less than the conventional treatment pathway of antiglaucoma medications or not. Results: In both study groups (treatment with SLT and treatment with eyedrops) we did not observe significant differences in Shaffer grading of angle width on gonioscopy, in cup-disc ratio, in visual field examination and pachymetry after 1 year of follow up but IOP was significantly decreased with increasing follow up. Only one patient needed repeat SLT and no patient of SLT group needed any adjuvant treatment. In eyedrops group pre-treatment mean IOP value was 19.125 and that of SLT group was 19.66, and at the end of follow-up in eyedrops group mean IOP value was 15.47 and in SLT group it was 15.84. So, in both groups of study IOP decreased significantly. We observed similar decrease of IOP between two groups (P-value 0.2703) from pre-treatment to post-treatment. Conclusion: SLT is possibly as effective as topical anti glaucoma medications in the treatment of patients with primary open angle glaucoma.
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spelling doaj-art-e4c78d09e36946d5b725661280dbefd82025-08-20T02:11:18ZengWolters Kluwer Medknow PublicationsDelhi Journal of Ophthalmology0972-02002454-27842022-07-01325263010.4103/dljo.dljo_36_23Efficacy of Selective Laser Trabeculoplasty vs Eye Drops as a First Line Treatment of Primary Open Angle GlaucomaNeeharika ShahJinal MakwanaSanket OzaNilam MakwanaPurpose: Selective laser trabeculoplasty (SLT) is a quick, outpatient procedure with minimal recovery time and a good safety profile. However, the role of laser trabeculoplasty in the treatment of glaucoma is still not well defined. This study is done to compare the effectiveness of selective laser trabeculoplasty as a first line treatment of Primary Open Angle Glaucoma (POAG) against conventional medical treatment with eye drops. Methods: A prospective comparative study was performed at a tertiary care centre in western India from October 2019 to October 2021. Study included 64 patients of mild to moderate severity newly diagnosed open angle glaucoma randomly given SLT or medical treatment as a first line treatment and followed up on 1st week,1st month,3rd month,6th month and 1 year to determine whether laser treatment; Achieves the desired level of intra-ocular pressure (IOP) in comparison to topical antiglaucoma medications, leads to non-progression of visual field during course of treatment, achieves equivalent levels of visual function after 1 year, is well or better tolerated by patients, needs any adjuvant treatment during course of treatment, costs less than the conventional treatment pathway of antiglaucoma medications or not. Results: In both study groups (treatment with SLT and treatment with eyedrops) we did not observe significant differences in Shaffer grading of angle width on gonioscopy, in cup-disc ratio, in visual field examination and pachymetry after 1 year of follow up but IOP was significantly decreased with increasing follow up. Only one patient needed repeat SLT and no patient of SLT group needed any adjuvant treatment. In eyedrops group pre-treatment mean IOP value was 19.125 and that of SLT group was 19.66, and at the end of follow-up in eyedrops group mean IOP value was 15.47 and in SLT group it was 15.84. So, in both groups of study IOP decreased significantly. We observed similar decrease of IOP between two groups (P-value 0.2703) from pre-treatment to post-treatment. Conclusion: SLT is possibly as effective as topical anti glaucoma medications in the treatment of patients with primary open angle glaucoma.https://journals.lww.com/10.4103/dljo.dljo_36_23selective laser trabeculoplastyprimary open angle glaucomaintraocular pressure
spellingShingle Neeharika Shah
Jinal Makwana
Sanket Oza
Nilam Makwana
Efficacy of Selective Laser Trabeculoplasty vs Eye Drops as a First Line Treatment of Primary Open Angle Glaucoma
Delhi Journal of Ophthalmology
selective laser trabeculoplasty
primary open angle glaucoma
intraocular pressure
title Efficacy of Selective Laser Trabeculoplasty vs Eye Drops as a First Line Treatment of Primary Open Angle Glaucoma
title_full Efficacy of Selective Laser Trabeculoplasty vs Eye Drops as a First Line Treatment of Primary Open Angle Glaucoma
title_fullStr Efficacy of Selective Laser Trabeculoplasty vs Eye Drops as a First Line Treatment of Primary Open Angle Glaucoma
title_full_unstemmed Efficacy of Selective Laser Trabeculoplasty vs Eye Drops as a First Line Treatment of Primary Open Angle Glaucoma
title_short Efficacy of Selective Laser Trabeculoplasty vs Eye Drops as a First Line Treatment of Primary Open Angle Glaucoma
title_sort efficacy of selective laser trabeculoplasty vs eye drops as a first line treatment of primary open angle glaucoma
topic selective laser trabeculoplasty
primary open angle glaucoma
intraocular pressure
url https://journals.lww.com/10.4103/dljo.dljo_36_23
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AT sanketoza efficacyofselectivelasertrabeculoplastyvseyedropsasafirstlinetreatmentofprimaryopenangleglaucoma
AT nilammakwana efficacyofselectivelasertrabeculoplastyvseyedropsasafirstlinetreatmentofprimaryopenangleglaucoma