Real-World Results Of Zeiss Selective Laser Trabeculoplasty In Adult South African Primary Open-Angle Glaucoma Patients

To investigate the real-world efficacy and safety of Selective Laser Trabeculoplasty (SLT) with the Zeiss VISULAS green laser in medically treated primary open-angle glaucoma (POAG).

Retrospective, single-center study (Umhlanga Eye Institute, Durban, South Africa)

Recruited were POAG patients ≥18 years of age on at least one antiglaucoma medication prior to procedure, who underwent SLT with the Zeiss VISULAS green laser (Carl Zeiss Meditec, Jena, Germany). Medications were terminated or reinstated at subsequent follow-ups depending on the IOP control. The primary efficacy outcome measures were mean reduction in glaucoma medications and mean reduction in IOP at 3, 6, and 12 months compared to baseline. Safety outcomes evaluated were intra- or post-procedural complications.

156 eyes (156 patients, 66.5 years) were included. Mean meds reduced from 2.3±1.0 at baseline to 0.8±1.1 and 0.8±1.2 at 3M and 6M respectively (p<0.001). Mean IOP (mmHg) reduced from 16.6±3.1 at baseline to 15.4±3.8 at 3M and 15.1±3.3 at 6M (p<0.001). IOP reduction ≥20% was observed in 29% eyes at 3M and 28% eyes at 6M. In the 12M follow-up group (n=22), mean medications and IOP at baseline were 2.3±0.9 and 16.0±2.8, respectively, which decreased to 0.9±1.1 (p<0.001) and 14.5±1.9 (p=0.103), respectively. Both at 3M and 6M postop, 60% patients were meds-free compared to none at baseline. At 6M, 69% patients maintained IOP lower than or equal to preop IOP on lesser meds compared to baseline. No vision-threatening complications were noted.

SLT with the Zeiss VISULAS green laser resulted in a clinically and statistically significant reduction in number of medications needed for IOP control. The procedure had a good safety profile similar to that described in the literature for SLT, with no vision-threatening complications.