Selective laser trabeculoplasty positively impacts long-term intraocular pressure fluctuation in untreated open-angle glaucoma patients.

We sought to investigate the influence of selective laser trabeculoplasty (SLT), as a primary treatment option, on long-term (between visits) intraocular pressure (IOP) variation parameters in eyes with ocular hypertension (OH) or open-angle glaucoma (OAG). This multicenter, real-world data based, retrospective study consecutively enrolled untreated patients that had undergone a single SLT treatment and had a minimum follow-up of 24 months post-SLT. All included patients had to have at least 3 IOP measurements before (within 90 days) the SLT procedure. Patients requiring any glaucoma medication or procedure during the follow-up were excluded. Main outcome measurements were the comparison between pre and post-SLT IOP variation parameters (mean, peak and IOP fluctuation), based on data collected from each follow-up visit. Among 835 patients that had undergone SLT between January 2011 and December 2020, 67 eyes from 67 patients (mean age, 60.5 ± 16.8 years) fulfilled all study inclusion/exclusion criteria and were included in the final analysis. After 24 months of follow-up, mean baseline IOP was significantly reduced from 19.1 ± 2.9 mmHg to 13.6 ± 2.1 following SLT (IOP change, 29%; p < 0.001). Regarding IOP variation parameters, mean baseline IOP peak was significantly reduced from 20.7 ± 3.5 mmHg to 15.1 ± 2.5 mmHg (IOP change, 27%; p < 0.001). In addition, mean baseline IOP fluctuation (based on within subject standard deviation values) was significantly reduced from 1.8 ± 0.1 mmHg to 1.2 ± 0.1 mmHg (IOP change, 33%; p < 0.001). Our results, derived from real world data, suggest that SLT not only effectively reduces mean IOP values, but also positively impacts (by approximately 30%) both IOP fluctuation and peak. Even though our findings provide additional support for the use of SLT on clinical practice, they certainly warrant confirmation by a prospective study.