360 degree selective laser trabeculoplasty effective for reducing IOP in glaucoma

A new study by Michaelov Evan and team showed that in patients with open angle glaucoma and glaucoma suspects, 360 degrees selective laser trabeculoplasty (SLT) was more effective at lowering intraocular pressure (IOP) at 1 year compared to 180 degrees SLT with a similar safety profile. The findings of this study were published in Journal of Glaucoma.

When compared to 180 degree SLT, 360 degree selective laser trabeculoplasty (SLT) lowers intraocular pressure (IOP) more effectively with the same safety profile. Using a paired-eye design to reduce confounders, this study sought to ascertain whether there were any differences between the IOP lowering benefits and safety profiles of 180 versus 360 degrees SLT.

Patients presenting with open angle glaucoma or glaucoma suspects were enrolled in this single-center randomised control experiment. After enrollment, one eye was randomly assigned to receive 180 degrees of SLT, while the other received 360 degrees of SLT. Following a year of patient monitoring, changes in visual acuity, Goldmann IOP, thickness of the retinal nerve fibre layer, Humphrey visual fields, cup-to-disc ratio derived from optical coherence tomography, and any adverse events or needs for additional medical interventions were evaluated.

The key findings of this study were:

1. The study involved 40 individuals, or 80 eyes in all. At one year, the IOP in the 180 degree group decreased from 25.3±2.3 mm Hg to 21.5±2.7 mm Hg 360 degree group from 25.5 mm Hg to 19.9 mm Hg (P0.01).

2. The two groups did not significantly differ in the quantity of adverse events or major adverse events.

3. At a 1-year follow-up, there were no statistically significant differences in visual acuity, the Humphrey visual field mean deviation, the thickness of the retinal nerve fibre layer, or the C:D ratio.

In conclusion, with a similar safety profile, the 360° treatment of the anterior chamber angle with SLT may be more efficient than the 180° treatment.

Reference: 

Michaelov, E., Sachdeva, R., Raniga, A., & Lin, T. (2023). A Randomized, Controlled Comparison of 180 Versus 360 Degrees Selective Laser Trabeculoplasty in Open Angle Glaucoma and Glaucoma Suspects. In Journal of Glaucoma (Vol. 32, Issue 4, pp. 252–256). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/ijg.0000000000002184