Evaluation of Long-Term Effects of Selective Laser Trabeculoplasty in Patients With Primary Open Angle Glaucoma.

Précis: Data coming from this study suggest that selective laser trabeculoplasty could be a very important tool in the overall management of glaucoma patients at every stage, aiming to better control the visual field deterioration.

Purpose: To evaluate selective laser trabeculoplasty (SLT) effectiveness in lowering intraocular pressure (IOP) and in visual field defect progression in eyes affected by primary open angle glaucoma (POAG) at long-term follow-up.

Methods: A retrospective study was conducted with 67 eyes of 67 patients affected by POAG who underwent SLT between 2014 and 2021. Each patient was routinely observed in the Glaucoma Office of Università della Campania Luigi Vanvitelli and underwent a complete eye visit and visual field test with 30-2 SITA standard automated perimetry (SAP) every 6 months. When both eyes in the same patient were treated, only the eye with a lower mean deviation (MD) of SAP was included. Patients were observed at 6, 12, 18, 24, 30, 36, 42, 48, and 54 months.

Results: A mean significant ( P <0.01) lower IOP was detected at 6 months (12.92±2.7 mm Hg) and at 54 months (13.08±2.42 mm Hg) compared with baseline (17.91±4 mm Hg). Mean MD values showed significant ( P <0.01) reduction both at the 6-month follow-up (-0.07±0.21dB) and at the 54-month follow-up (-0.3±0.34dB), demonstrating satisfactory clinical deceleration of the progression of the disease.Mean IOP medical lowering therapy was 1.34±0.9 drugs, showing a significant ( P <0.01) decrease 6 months after SLT (0.87±0.85), that remained stable [ P = at 54  mo follow up (0.9±0.76)].

Conclusions: The results observed confirm not only the high level of effectiveness of SLT in lowering IOP and reducing the need for topical medications but also its role in decelerating visual field deterioration in eyes affected by POAG.