Viable first-line therapy?
The aforementioned approach puts SLT at the front line of management. Though it offers the significant benefit of acting as a diagnostic aid, its effectiveness as a stand-alone treatment must also be closely scrutinized.
One study showed SLT provides at least a 20% reduction in IOP in 75% of primary-open angle glaucoma (POAG) eyes.
This was in line with a control group treated with latanoprost, which demonstrated a similar reduction in 73% of eyes.3
Another study comparing SLT and prostaglandin eye drops reported a drop in IOP of 29.9% and 25.4%, respectively.4
Overall, the data to this point have shown that SLT is equally capable of reducing IOP compared with first-line topical medications.
Given the similar efficacies of these approaches, other intangibles should be considered so that management decisions can be made on a patient-to-patient basis. While effective at lowering IOP, ocular hypotensive medications are not without downsides.
Prolonged use of such medications has been shown to negatively affect quality of life. In addition, some formulations contain inactive ingredients that have been associated with ocular surface disease. The patient’s tolerance to local side effects—such as hyperemia changes in periocular pigmentation, tearing, and foreign body sensation—should be assessed, as these are all common occurrences with first-line medication use.