Title: Efficacy And Safety Of Direct Selective Laser Trabeculoplasty (Dslt) In Patients With Glaucoma And Ocular Hypertension

To evaluate the efficacy and safety of a novel automated laser trabeculoplasty technology, DSLT, in patients with open-angle glaucoma (OAG) and ocular hypertension (OHT).

Glaucoma service, Hospital Clinico San Carlos, Madrid, Spain.

Prospective study including patients with OAG and OHT. Both Newly diagnosed and untreated (naive) patients and patients treated with ocular hypotensive medication were included. Automated DSLT was performed (120 spots, 360º translimbal, energy 1.8 mJ, 2 seconds per treatment). Demographic and clinical data were collected at baseline, 1 month and 6 months after DSLT.

39 eyes (22 patients) were included, 42.6% (18 eyes) with primary open angle glaucoma (POAG), 25.6% (10 eyes) had OHT and 28.2% (11 eyes) had other OAG (pigmentary, pseudoexfoliative and myopic). Of these, 28.2% (11 eyes) were naïve. Mean IOP was reduced from 21.95±2.86mHg (baseline) to 17.56±2.60 mmHg (19.97%) at 6 months. According to the type of glaucoma, IOP reduction was -5.56mmHg (23.9%), -3.90mmHg (17.41%) and -3.45mmHg (17.33%) for POAG, HTO or other OAG, respectively. The mean number of medications used decreased by approximately 40%. The most frequent immediate adverse effect was mild hyperemia and/or subconjunctival hemorrhages. No significant adverse reactions were found in any of the patients at 6 months.

DSLT is an effective and safe option for the treatment of OAG and OHT in both naïve and medically treated patients. IOP reduction was approximately 20% in the enrolled patients. As laser trabeculoplasty gains acceptance as a first-line treatment, DSLT is a promising tool to expand the accessibility of laser trabeculoplasty.