Selective laser trabeculoplasty as primary treatment for open-angle glaucoma: A prospective, nonrandomized pilot study

Objective: To examine the safety and efficacy of selective laser trabeculoplasty as primary treatment for patients with open-angle glaucoma. Methods: Forty-five eyes of 31 patients with open-angle glaucoma or ocular hypertension (intraocular pressure [IOP] ≥ 23 mm Hg on 2 consecutive measurements) underwent selective laser trabeculoplasty as primary treatment. All patients underwent complete ophthalmic evaluation before and at intervals after treatment. This evaluation included visual acuity, slitlamp examination, ophthalmoscopy, gonioscopy, and visual field analysis. The IOP was measured 1 hour, 1 day, 1 week, and 1, 3, 6, 12, 15, and 18 months postoperatively. During the follow-up period, patients were treated with topical antiglaucoma medications as required. Results: Mean ± SD decreased by 7.7 ± 3.5 mm Hg (30%), from 25.5±2.5 mm Hg to 17.9±2.8 mm Hg (P<.001). Only 2 eyes (4%) did not respond to selective laser trabeculoplasty, and 3 eyes (7%) required topical medications to control their IOP at the end of the follow-up period. Forty eyes (89%) had a decrease of 5 mm Hg or more. Visual acuity, visual fields, and gonioscopic findings remained unchanged. Complications included conjunctival redness and injection within 1 day postoperatively in 30 eyes (67%). One hour after selective laser trabeculoplasty, an increase in IOP of more than 5 mm Hg was detected in 5 eyes (11%), while an increase in IOP between 2 and 5 mm Hg was measured in 3 eyes (7%). Conclusion: Selective laser trabeculoplasty is effective and safe as a primary treatment for patients with ocular hypertension and open-angle glaucoma.