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Lucas Bonafede, Judie Tran, Lisa A Hark, Carina Sanvicente, Qiang Zhang, Rose Costello, L. Jay Katz; Beliefs and Attitudes of Ophthalmologists Regarding Selective Laser Trabeculoplasty as First Line Therapy for Glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2829.
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© ARVO (1962-2015); The Authors (2016-present)
Selective laser trabeculoplasty (SLT) is a safe and effective first line treatment for glaucoma, however, it is underutilized for this purpose. To evaluate barriers for the widespread adoption of this procedure, we assessed the beliefs and attitudes of ophthalmologists regarding SLT. We developed an educational slide presentation directed to physicians to increase the consideration of SLT earlier in the glaucoma treatment paradigm.
In this prospective study, an online survey and educational slide presentation was sent to a group of general ophthalmologists, ophthalmology residents, and glaucoma specialists in the Wills Eye Hospital physician contact database. Subjects were asked to respond to questions regarding their beliefs and attitudes towards SLT, before and after watching the educational slide presentation. Responses were compared between physician specialty groups.
A total of 53 subjects were enrolled. Prior to watching the slide presentation, 85% of participants stated they offer SLT to newly diagnosed patients, although only 26% preferred SLT over glaucoma medications (66%) or other treatments (8%). Although 52% of physicians reported between 0 – 10% of their newly diagnosed patients receive SLT, 47% said they would use SLT as a first line therapy for all or most newly diagnosed glaucoma patients, with good compliance (30%) and efficacy (28%) being the most commonly cited as reasons to use SLT as a first line therapy, and patient hesitancy (17%) the most common reason not to choose SLT.Most participants (94%) stated the educational slide presentation convinced them that SLT is appropriate as a first line therapy, reporting safety (53%), efficacy (51%), and adherence (49%) as the main reasons. Following the educational slide presentation, 32% of physicians were still reluctant to prescribe SLT as a first line treatment. Significant differences between specialty groups are shown on Table 1.
A better understanding of the different barriers for utilizing SLT as a first-line therapy provides valuable information to help increase the adoption of this safe and effective procedure.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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