https://doi.org/10.4081/ejtm.2024.12931
Effectiveness of laser therapy among patients with open-angle glaucoma: a systematic review and meta-analysis study
Submitted: 16 August 2024
Accepted: 20 September 2024
Published: 22 October 2024
Accepted: 20 September 2024
Abstract Views: 46
PDF: 13
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
This study aims to evaluate the efficacy of selective laser trabeculoplasty in improving the intraocular pressure in patients diagnosed with open-angle glaucoma. A comprehensive search was performed across electronic databases, including PubMed, Scopus, and Web of Science, until June 2024, using keywords related to "selective laser trabeculoplasty" and "open-angle glaucoma." Studies were chosen based on set eligibility criteria. Data extraction was carried out by two independent reviewers, and statistical analyses were performed using a random-effects model to calculate the pooled mean differences in IOP reduction and overall success rates. The initial search yielded 3111 articles, with 23 studies included in the systematic review and 22 in the meta-analysis. The pooled MD in IOP reduction between the SLT and control groups was -1.44 mm Hg (95% CI: -2.19 to -0.70, p < 0.01). Subgroup analyses revealed a MD of -0.76 mm Hg (95% CI: -1.31 to -0.21, p < 0.01) when comparing SLT to medication, and -0.42 mm Hg (95% CI: -0.64 to -0.19, p < 0.01) when comparing 180-degree SLT to 360-degree SLT. The pooled success rate favored SLT with an odds ratio (OR) of 0.71 (95% CI: 0.51 to 0.99, p = 0.05). There was significant heterogeneity among the studies (I² = 71%). SLT is effective in lowering IOP in OAG patients, demonstrating significant efficacy compared to medication and different SLT protocols. The findings underscore SLT's potential as a reliable treatment option. However, the observed heterogeneity underscores the necessity for standardized protocols in future research to improve comparability and verify SLT's long-term effectiveness.
Tawfique K, Khademi P, Quérat L, Khadamy J, Chen EP. Comparison between 90-degree and 360-degree selective laser trabeculoplasty (SLT): A 2-year follow-up. Acta Ophthalmologica 2019;97:427-9.
DOI: https://doi.org/10.1111/aos.13949
Ayala M, Chen E. Comparison of selective laser trabeculoplasty (SLT) in primary open angle glaucoma and pseudoexfoliation glaucoma. Clin Ophthalmol 2011;5:1469-73.
DOI: https://doi.org/10.2147/OPTH.S25636
Prasad N, Murthy S, Dagianis JJ, Latina MA. A comparison of the intervisit intraocular pressure fluctuation after 180 and 360 degrees of selective laser trabeculoplasty (SLT) as a primary therapy in primary open angle glaucoma and ocular hypertension. J Glaucoma 2009;18:157-60.
DOI: https://doi.org/10.1097/IJG.0b013e3181752c97
Ong K, Ong L, Ong LB. Corneal endothelial abnormalities after selective laser trabeculoplasty (SLT). J Glaucoma 2015;24:286-90.
DOI: https://doi.org/10.1097/IJG.0b013e3182946381
Mucciolo JT, Frenkel REP. The effect of selective laser trabeculoplasty (SLT) in open angle glaucoma patients with previous 360 degree argon laser trabeculoplasty (ALT) treatment. Investigative Ophthalmol Visual Sci 2003;44:U375-U.
Klamann MK, Gonnermann J, Maier AK, et al. Influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and Trabectome outcomes. Graefes Arch Clin Exp Ophthalmol 2014;252:627-31.
DOI: https://doi.org/10.1007/s00417-014-2569-7
Maier AKB, Arani P, Pahlitzsch M, et al. Influence of Selective Laser Trabeculoplasty (SLT) on the iStent inject® outcomes. BMC Ophthalmol 2020;20:457.
DOI: https://doi.org/10.1186/s12886-020-01723-3
Ayala M. Intraocular pressure reduction after initial failure of selective laser trabeculoplasty (SLT). Graefes Arch Clin Experimental Ophthalmol 2014;252:315-20.
DOI: https://doi.org/10.1007/s00417-013-2522-1
Dahlgren T, Ayala M, Zetterberg M. Optimal Performance of Selective Laser Trabeculoplasty: Results from the Swedish Optimal SLT Multicenter Randomized Controlled Trial. Ophthalmol Glaucoma 2023;7:105-15.
DOI: https://doi.org/10.1016/j.ogla.2023.10.004
Lee JW, Wong MO, Liu CC, Lai JS. Optimal selective laser trabeculoplasty energy for maximal intraocular pressure reduction in open-angle glaucoma. J Glaucoma 2015;24:e128-31.
DOI: https://doi.org/10.1097/IJG.0000000000000215
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71.
DOI: https://doi.org/10.1136/bmj.n71
Shibata M, Sugiyama T, Ishida O, et al. Clinical results of selective laser trabeculoplasty in open-angle glaucoma in Japanese eyes: comparison of 180 degree with 360 degree SLT. J Glaucoma 2012;21:17-21.
DOI: https://doi.org/10.1097/IJG.0b013e3181fc8020
Robin AZ, Syar P, Darwish D, et al. Comparison of success rate and intraocular pressure spikes between selective laser trabeculoplasty and micropulse laser trabeculoplasty in African American and Hispanic patients. Int J Ophthalmol 2023;16:75-80.
DOI: https://doi.org/10.18240/ijo.2023.01.11
Özen B, Öztürk H, Yüce B. Comparison of the effects of 180° and 360° applications of selective laser trabeculoplasty on intraocular pressure and cornea. Int Ophthalmol 2020;40:1103-10.
DOI: https://doi.org/10.1007/s10792-019-01275-6
Goyal S, Beltran-Agullo L, Rashid S, et al. Effect of primary selective laser trabeculoplasty on tonographic outflow facility: a randomised clinical trial. Br J Ophthalmol 2010;94:1443-7.
DOI: https://doi.org/10.1136/bjo.2009.176024
Nirappel A, Klug E, Ye R, et al. Effectiveness of selective laser trabeculoplasty applied to 360° vs. 180° of the angle. J Ophthalmol 2021;2021:8860601.
DOI: https://doi.org/10.1155/2021/8860601
Wong MOM, Lai ISW, Chan PP, et al. Efficacy and safety of selective laser trabeculoplasty and pattern scanning laser trabeculoplasty: a randomised clinical trial. Br J Ophthalmol 2021;105:514.
DOI: https://doi.org/10.1136/bjophthalmol-2020-316178
Rosenfeld E, Shemesh G, Kurtz S. The efficacy of selective laser trabeculoplasty versus argon laser trabeculoplasty in pseudophakic glaucoma patients. Clinical Ophthalmol 2012:1935-40.
DOI: https://doi.org/10.2147/OPTH.S34193
Schmidl D, Hommer N, Hommer A. An exploratory retrospective data analysis comparing the outcomes of selective laser trabeculoplasty and argon laser trabeculoplasty in patients with open-angle glaucoma or ocular hypertension in Vienna, Austria, from the year 2012 to 2022. Medicina (Kaunas) 2023;59.
DOI: https://doi.org/10.3390/medicina59122075
Lai JS, Chua JK, Tham CC, Lam DS. Five‐year follow up of selective laser trabeculoplasty in Chinese eyes. Clin Experimental Ophthalmol 2004;32:368-72.
DOI: https://doi.org/10.1111/j.1442-9071.2004.00839.x
Nagar M, Luhishi E, Shah N. Intraocular pressure control and fluctuation: the effect of treatment with selective laser trabeculoplasty. Br J Ophthalmol 2009;93:497.
DOI: https://doi.org/10.1136/bjo.2008.148510
Martini K, Baillif S, Nahon-Esteve S, et al. Intraoperative iStent versus postoperative selective laser trabeculoplasty in early glaucoma patients undergoing cataract surgery: A retrospective comparative study. J Francais D Ophtalmol 2024;47.
DOI: https://doi.org/10.1016/j.jfo.2023.03.042
Bovell AM, Damji KF, Hodge WG, et al. Long term effects on the lowering of intraocular pressure: selective laser or argon laser trabeculoplasty? Can J Ophthalmol 2011;46:408-13.
DOI: https://doi.org/10.1016/j.jcjo.2011.07.016
Christie WC, Basha MM, Ho QC, et al. Phase 3, randomized study comparing intracameral bimatoprost implant 15 μg and selective laser trabeculectomy in patients with open-angle glaucoma or ocular hypertension. Clin Ophthalmol 2023;17:3023-36.
DOI: https://doi.org/10.2147/OPTH.S427976
Nagar M, Ogunyomade A, O’Brart DPS, et al. A randomised, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol 2005;89:1413.
DOI: https://doi.org/10.1136/bjo.2004.052795
Kent SS, Hutnik CM, Birt CM, et al. A randomized clinical trial of selective laser trabeculoplasty versus argon laser trabeculoplasty in patients with pseudoexfoliation. J Glaucoma 2015;24:344-7.
DOI: https://doi.org/10.1097/IJG.0b013e31829e55e4
Kaplowitz K, Wang S, Bilonick R, Oatts JT, Grippo T, Loewen NA. Randomized Controlled Comparison of Titanium-Sapphire Versus Standard Q-Switched Nd: YAG Laser Trabeculoplasty. J Glaucoma 2016;25:e663-7.
DOI: https://doi.org/10.1097/IJG.0000000000000317
Michaelov E, Sachdeva R, Raniga A, Lin TY. A randomized, controlled comparison of 180 versus 360 degrees selective laser trabeculoplasty in open angle glaucoma and glaucoma suspects. J Glaucoma 2023;32:252-6.
DOI: https://doi.org/10.1097/IJG.0000000000002184
Philippin H, Matayan E, Knoll KM, et al. Selective laser trabeculoplasty versus 0·5% timolol eye drops for the treatment of glaucoma in Tanzania: a randomised controlled trial. Lancet Global Health 2021;9:e1589-e99.
DOI: https://doi.org/10.1016/S2214-109X(21)00348-X
Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet 2019;393:1505-16.
DOI: https://doi.org/10.1016/S0140-6736(18)32213-X
Katz LJ, Steinmann WC, Kabir A, et al. Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma: a prospective, randomized trial. J Glaucoma 2012;21:460-8.
DOI: https://doi.org/10.1097/IJG.0b013e318218287f
Pimentel RL, Alves RRA, Lima W, et al. Selective laser trabeculoplasty versus micropulse laser trabeculoplasty for intraocular pressure control in patients with primary open angle glaucoma: a 12-month retrospective comparative study. Lasers Med Sci 2023;38.
DOI: https://doi.org/10.1007/s10103-023-03771-9
Landim DFC, Neto CAD, Sabino LRD, et al. Selective Laser Trabeculoplasty (SLT) for IOP Control in a Patient with Bilateral Acute Iris Transillumination (BAIT). Ocular Immunology and Inflammation. 2023.
DOI: https://doi.org/10.1080/09273948.2023.2198000
Pillunat KR, Kretz FTA, Koinzer S, Ehlken C, Pillunat LE, Klabe K. Effectiveness and safety of VISULAS(®) green selective laser trabeculoplasty: a prospective, interventional multicenter clinical investigation. Int Ophthalmol 2023;43:2215-24.
DOI: https://doi.org/10.1007/s10792-022-02617-7
Zhou RX, Sun Y, Chen HY, et al. Laser trabeculoplasty for open-angle glaucoma: a systematic review and network meta-analysis. Am J Ophthalmol 2020;229:301-13.
DOI: https://doi.org/10.1016/j.ajo.2020.07.046
Zhu D, Shah P, Wong A, et al. 180° versus 360° Selective Laser Trabeculoplasty in Open Angle Glaucoma and Ocular Hypertension: A Systematic Review and Meta-Analysis. J Glaucoma 2024;33:566-75.
DOI: https://doi.org/10.1097/IJG.0000000000002415
Narayanaswamy A, Sood SR, Thakur S. Selective laser trabeculoplasty: An updated narrative review. Indian J Ophthalmol 2024;72:312-9.
DOI: https://doi.org/10.4103/IJO.IJO_2104_23
Takusagawa HL, Hoguet A, Sit AJ, et al. Selective laser trabeculoplasty for the treatment of glaucoma a report by the American Academy of Ophthalmology. Ophthalmology 2024;131:37-47.
DOI: https://doi.org/10.1016/j.ophtha.2023.07.029
Dendumrongsup W. Identifying baseline predictors of selective laser trabeculoplasty effectiveness: an alternative mathematical approach. Cureus 2024;16:e54116.
DOI: https://doi.org/10.7759/cureus.54116
Hallaj S, Sinha S, Mehran NA, et al. Intraocular pressure profile following selective laser trabeculoplasty in pigmentary and primary open-angle glaucoma. Eur J Ophthalmol 2024. doi: 10.1177/11206721241237305. Epub ahead of print.
DOI: https://doi.org/10.1177/11206721241237305
Kurnaz E. Selective laser trabeculoplasty in the treatment of juvenile open angle glaucoma patients under 25 years of age. Int Ophthalmol 2024;44:201.
DOI: https://doi.org/10.1007/s10792-024-03108-7
How to Cite
Safarpour Lima, B., & Sayanjali, S. (2024). Effectiveness of laser therapy among patients with open-angle glaucoma: a systematic review and meta-analysis study. European Journal of Translational Myology. https://doi.org/10.4081/ejtm.2024.12931
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.