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Saba Al-Hashimi, Laiyin Ma, Manishi Desai; Do patients have a prejudice against selective laser trabeculoplasty?. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6125.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the patient perspective on whether resistance to selective laser trabeculoplasty (SLT) exists and if it relates to the word “laser”. SLT has been demonstrated as a safe and effective alternative to medical therapy for initial treatment of primary open angle glaucoma (POAG) or ocular hypertension. Anecdotal clinical experience at Boston Medical Center suggests that when given the option between SLT or medical management, most patient opt for starting drops initially. We investigate whether substituting the word “laser” with “light assisted therapy” causes more patients to choose the option of SLT.
A survey was given at random to English speaking patients in clinic. Those with glaucoma or history of SLT were excluded. Two identifical forms were distributed except Form A used the word “laser” while Form B described SLT as “light assisted therapy”. Patients were given a hypothetical situation in which they were newly diagnosed with POAG and given the option between initiation of medical management or SLT. The risks and benefits of each were described as stated in the American Academy of Ophthalmology pamphlet for laser trabeculoplasty and glaucoma.
A total of 47 patients participated, 24 used Form A and 23 used Form B with an equal number of males and females in each group. The mean age of respondents was 55.34 (54.3 Group A, 56.3 Group B) with a range from 18-84 years old. No significant difference was found between responses from Form A and Form B (p=0.44) with medical management being the more popular choice (54% and 65% respectively). In a subgroup analysis for age, sex and level of education there was also no significance (p=0.67, 0.91, 0.44 respectively).
When asked why patients opted for medical management, most stated that it seemed safer and that “damage to the cornea, iris, or retina” as stated in the AAO pamphlet detoured them from choosing SLT. For those that did choose SLT, the most popular reason was to remain free from daily use of eye drops. Although exceedingly rare, the risks of laser trabeculoplasty as stated, were enough to detour most patients. It appears as though there is still a disjunction between how patients and ophthalmologists feel about the opinion of SLT. This appears to involve more than just a fear of the word “laser” although a larger sample group may have lead to statistical significance.
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