In today’s world of value-based care and the trending patient-driven care models, it is more important than ever that optometrists embrace their roles as clinicians in healthcare teams. Optometry’s success in the 21st century will depend on advanced clinical outcome support in areas including refractions, contact lens services, medical management of anterior segment disease, retinal disorders, neuro-ophthalmic conditions, glaucoma and other ocular conditions.
Results showed that 93 percent of SLT-treated patients were at target IOP three years after the laser procedure, whereas 91 percent of patients who were treated topically were at target IOP in three years.
It is noteworthy to mention that none of those treated with SLT required a future trabeculectomy while 11 of the control members needed a trabeculectomy, seven of whom needed trabeculectomy revisions. In addition, the control group exhibited a higher need for cataract surgery. Participants were also surveyed about their quality of life using EQ-5D-5L questionnaires.
Overall, this study prompts the primary-care clinician to consider including SLT earlier in the typical OAG treatment regimen because it was effective in achieving IOP target goals. Study results also showed that SLT is a more cost-effective treatment and improves patient quality of life because SLT potentially reduces the need for invasive cataract surgery.2
Laser trabeculoplasty pipeline
While SLT has been the standard of procedural care for laser trabeculoplasty after its inception in the late 1990s—replacing argon laser trabeculoplasty (ALT)—a newer procedure, micropulse laser trabeculoplasty (MLT), holds promise as a possible replacement for SLT.
In ALT, a high-powered argon laser was used to burn trabecular meshwork (TM) tissue. The resulting contraction of scar tissue improved trabecular outflow but with the downside of a non-repeatable procedure that created thermal damage to the TM.
While ALT uses an argon green laser—the same laser used for retinopexy—SLT uses a Nd:YAG laser with a lower power density as a result of a larger (400 μm) spot size and very short (3 ns) pulse duration.
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