Abstract
Purpose :
Direct selective laser trabeculoplasty (DSLT) is a non-contact automated procedure performed directly through the limbus. There are currently no known studies with follow-up longer than six months. This study evaluates the long-term safety and efficacy of the DSLT treatment.
Methods :
At the University of Genoa, between November 2018 and June 2019, as part of the GLAUrious trial NCT03750201, patients suffering from primary open-angle glaucoma (POAG), or ocular hypertension (OH) and treated with DSLT (120 spots on 360°, BELKIN Vision, Israel) were followed in the long-term. Intra-ocular pressure (IOP), IOP-lowering drugs, adverse events, and additional procedures were recorded.
Results :
Seven eyes from 7 patients with POAG (86%) or OHT (14%) were treated with DSLT. All DSLTs were delivered without severe adverse events. Before treatment, the mean medicated IOP (sd) was 19.1 (4.4) mmHg with 1.4 (0.8) IOP-lowering drugs. After wash-out, the pre-treatment IOP was 28.5 (4.4) mmHg. At six months, the washed-out IOP was 20.6 (4.7) mmHg with a reduction of -8.0 mmHg (p<0.01). An IOP-lowering medication was reintroduced after 78 (74) days. Patients were followed for an average of 42.2 (5.5) months. At the last follow-up, the medicated IOP was 16.3 (3.0) mmHg with 1.3 (0.9) IOP-lowering drugs. In one case, a perilimbal subconjunctival hemorrhage, noted immediately after DSLT treatment, was the only adverse event recorded. During follow-up, one patient was effectively retreated with traditional SLT.
Conclusions :
DSLT reduces IOP with efficacy and safety profiles like those expected from conventional SLT. DSLT could ease the choice of trabeculoplasty as the first-choice treatment for patients suffering from OAG or OH.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.