As the evidence supporting selective laser trabeculoplasty (SLT) as a first-line treatment for patients with glaucoma continues to grow, researchers in Canada decided to look into patient characteristics and factors associated with the procedure. Patient demography, ocular history and comorbidity each played a significant role.

The study included all patients 66 years and older in Ontario who received initial therapy for glaucoma with either SLT or topical medication between April 2007 and March 2019 (n=194,759).

Using odds ratios (OR) to evaluate the factors associated with prioritizing one treatment over the other, the researchers found that older patients (≥81 years old vs. 66 to 70 years old) were less likely to be treated with SLT (OR=0.49). Previous ocular surgeries were also associated with a decreased probability of treatment with SLT, including cataract surgery (OR=0.31), corneal transplantation (OR=0.39) and retina surgery (OR=0.46). In addition, patients with more comorbidities were less likely to receive SLT (OR=0.94).

Observing other patient demographics, the study highlighted that women were more likely than men to receive SLT (OR=1.42). SLT was less likely among patients who were of higher socioeconomic status (OR=0.86) or who resided rurally (OR=0.92).

The researchers also observed the prevalence of SLT as an option as they noted its increasing use over time (OR=1.05 per year).

Quinn MP, Johnson D, Whitehead M, et al. Predictors of initial glaucoma therapy with laser trabeculoplasty versus medication: a population-based study. Ophthalmology. December 21, 2020. [Epub ahead of print].