Predictors of success in selective laser trabeculoplasty

Abstract Purpose Selective laser trabeculoplasty (SLT) is a common procedure to lower intraocular pressure (IOP) in patients with glaucoma. However, there are conflicting reports regarding what factors contribute to SLT success. The purpose of this study was to determine predictors of SLT success. Design Retrospective case series study. Subjects All patients treated with SLT between 1/1/2012 to 6/30/2018 by 3 glaucoma specialists (MRM, CS and MJP). Methods Baseline, demographic, procedural and ophthalmic examination data were recorded at time of first SLT. IOP and medication data were recorded at all follow-up visits. Main outcome measures SLT success was defined as IOP decrease ≥ 20% from baseline at all 3 of the 3-month, 6-month, and 12-month follow-up visits. Eyes were considered to have failed and were censored when additional SLT or glaucoma surgery was performed. Patients were excluded if they had less than 3 months follow-up. Results A total of 997 eyes in 677 patients were included in the study. Mean age was 70.2 (±11.5) years. SLT success was achieved in 227 (22.8%) eyes, while 770 (77.2%) failed to meet success criteria. Pre-SLT IOP was 21.9 ±5.2mmHg on 2.0 ±1.2 medications in eyes with successful SLT, compared to 19.0 ±5.0mmHg (p Conclusion In this large cohort of eyes undergoing SLT, greater pre-SLT IOP and angle pigment correlated positively with SLT success. Age, total SLT power, severity of glaucoma and prior treatments were not associated with SLT success or failure.