Real-World Outcomes of Selective Laser Trabeculoplasty in the UK

Abstract Objective Selective laser trabeculoplasty (SLT) is a common treatment option for managing glaucoma and ocular hypertension. We assessed the real-world effectiveness of SLT and baseline factors associated with treatment success in the United Kingdom (UK). Design Retrospective observational study of de-identified electronic medical records (Medisoft® Glaucoma module) from 5 UK ophthalmology teaching centers. Participants Adult patients undergoing their first recorded SLT. For bilateral SLT (same day), analyses included one randomly selected eye. Methods Patient demographics, procedure details and clinical outcomes data were extracted. Factors associated with treatment success were assessed using multivariable Cox regression. Main outcome measures Change from baseline in intraocular pressure (IOP) and glaucoma medication use at 12−18 and 24−36 months post-SLT. A Kaplan-Meier survival analysis was also conducted. SLT failure was defined as any further glaucoma procedure post-SLT or any of the following at 2 consecutive visits: IOP >21 mmHg, IOP reduction Results 831 SLT-treated eyes (mean baseline IOP 22.0 mmHg) of 831 patients were analyzed. At 12−18 and 24−36 months post-SLT, respectively, significant reductions in IOP (−4.2 [95% CI: −4.7 to −3.7] and −3.4 [95% CI: −4.1 to −2.7] mmHg; both P 21 mmHg vs ≤21 mmHg, 95% CI: 0.53–0.76; P Conclusion Most patients initially responded to SLT, but a majority failed within 1 year. SLT efficacy was better in patients with higher baseline IOP but did not differ by glaucoma severity or by concurrent use of IOP-lowering medication. These findings may help inform which patients are suitable for SLT therapy.