This study found that SLT is not only underused, but both patients and physicians need more education on the treatment option. Photo: Nathan Lighthizer, OD. Click image to enlarge.
Despite glaucoma’s high prevalence worldwide, selective laser trabeculoplasty (SLT) is often underused in the US and other countries. In a recent study conducted in China, researchers explored the perception of SLT among physicians and patients and the acceptance of using this option as a first-line treatment for glaucoma.
A total of 11 glaucoma specialists and 12 glaucoma patients were interviewed. Four themes were identified: physician preferences for treatment types, patient views on treatment types, decision-making during the physician-patient encounter and feasibility of SLT as a first-line therapy.
The physicians indicated that open-angle glaucoma accounts for only 30% of cases seen in their clinics, likely due to the disease’s insidious onset, which makes a timely diagnosis difficult.
Advantages of SLT include safety and repeatability with limited side effects. However, physicians and patients frequently mentioned concerns about the durability of the effect of the treatment. Factors such as practice preference, personal motivation and patient characteristics may influence treatment choice.
“Although reliable studies have verified the effectiveness, safety and cost-effectiveness of SLT, many physicians in our study believe it has poor treatment efficacy and short-term effectiveness based on their clinical experiences,” the authors explained. “Therefore, they expressed doubt SLT would meet patients’ high expectations for treatment success.” This barrier could be overcome by more widely sharing evidence-based research and existing SLT treatment guidelines” they suggested, to improve physician understanding of its effectiveness. “Providing evidence of SLT’s efficacy and safety to patients can also increase the selection of this treatment,” the researchers added.
Chen Y, Lohfeld L, Song D, et al. Facilitators and barriers to using selective laser trabeculoplasty (SLT) as first-line treatment for glaucoma: physician and patient views gathered during an exploratory descriptive qualitative study. Ophthalmic Epidemiol. January 24, 2022. [Epub ahead of print].