Medical therapy is usually the first choice for reducing IOP to manage open-angle glaucoma, but selective laser trabeculoplasty (SLT) is often employed as first-line therapy if meds seem ill-advised. Now, a meta-analysis validates that practice, showing SLT as a safe and effective alternative therapy with a lower incidence of ocular side effects. Despite the positive findings, researchers still warn that clinicians should consider cost-effectiveness and patient characteristics before considering laser in lieu of medication for their glaucoma patients.

A team of researchers took a closer look at the literature to better understand the potential of SLT as a first-line treatment, and identified eight randomized controlled trials comprising a total of 1,229 patients. The researchers found SLT and medical therapy were roughly equivalent regarding IOP reduction and control. They found that the group undergoing SLT therapy required significantly fewer medications than those receiving medication, with a mean difference of -1.06.

However, the study was unable to assess adverse events and quality of life due to the lack of available data.

Chu Chi S, Kang YN, Hwang DK, et al. Selective laser trabeculoplasty versus medication for open-angle glaucoma: systematic review and meta-analysis of randomized clinical trials. Br J Ophthalmol. February 12, 2020. [Epub ahead of print].