TABLE 3.
SLT Dose-Response and Race/Ethnicity
| References | Methodology | Laser Manufacturer | Sample Size | Race/Ethnicity | Glaucoma Type | Energy Range (mJ) | Energy per Spot in mJ (mean±SD) | Pattern | No. Spots (Mean±SD) | Total Energy in mJ (Mean±SD) | Follow-up (mo) | Medications After SLT | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Shibata et al50 | Retrospective | Lumenis, Inc Coherent Inc, Palo Alto, CA | 54 | Japanese | POAG, PE | 0.8–1.4 | — | 180 and 360 degrees | 75±22 and 121±19 in 180 and 360 degrees, respectively | 73±29 and 125±30 in 180 and 360 degrees, respectively | 36 | Apraclonidine 1% once. Fluorometholone 0.1% eye drops 4 times/d for 7 d | |
| Al-busaidi et al51 | Retrospective | Ellex, Adelaide, Australia | 36 | Omani | OHT, OAG | 0.4–0.9 | — | 360 degrees | 99.52±10.31 | 64.03±10.26 | 3 | Apraclonidine 0.5% once | |
| Lai et al52 | Prospective | Coherent Inc., Palo Alto CA | 32 | Chinese | POAG, OHT | — | 1.0±0.1 | 360 degrees | Approximately 100 (no SD reported) | 73.6±16.4 | 60 | One drop of 1% apraclonidine and 1% prednisolone acetate immediately postlaser. Prednisolone acetate 4 times daily for 7 d | |
| Miki et al53 | Retrospective | Ellex, Adelaide, Australia | 78 | Japanese | POAG, NTG, PE, SOAG | — | — | 360 degrees | — | 71.7±20.2 | 12 | Steroid eye drops administered at the discretion of the physician | |
| Ono et al54 | Retrospective | — | 65 | Japanese | POAG, NTG, PE | 0.7–1.0 | — | 360 degrees | ~100 (no SD reported) | — | 12 | — | |
| Realini et al55 | Prospective | Lumenis | 64 | African | POAG | — | — | 360 degrees | 104.5±4.1 in the right eye and 104.7±3.6 in the left eye | 78.4±14.8 in the right eye and 86.4±15.8 in the left eye | 12 | None | |
| Soboka et al56 | Prospective | Lumenis Inc., Santa Clara, CA | 61 | Ethiopian | POAG, PE, OHT | 0.4–1.5 | 0.79±0.23 | 360 degrees | 100 (no SD reported) | 89.82±29.64 | 12 | Daily topical NSAIDs for 1 wk | |
| Goosen et al57 | Retrospective | Lumenis; Yokneam, Inc., Israel | 82 | African, Indian (21/84), White (3/84) | — | 1.1–1.4 | — | 360 degrees | 120–140 (no SD reported) | — | 12 | Ketoralac eye drops 3 times daily for 28 d | |
| Funarunart et al58 | Retrospective | Optimis Fusion, Quantel Medical, Cournon d’Auvergne, France | 96 eyes (exact number of patients was not reported) | Thai | POAG, NTG, OHT, PE, JOAG | 0.5–1.0 | 0.73±0.11 | 180 and 360 degrees (depending on the surgeon’s preference) | — | 56.83±19.77 | 24 | — | |
| Realini et al59 | Retrospective | Lumenis Selecta II | 265 eyes | Afro-Caribbean | OAG | — | — | 360 degrees | R: 103.3±3.5 L: 103.1±3.1 | R: 82.5±18.8 L: 87.0±18.5 | 94 | Medication free survival rate of repeat SLT over 94 mo was 71.2% and 71.7% in right and left eye | |
| No. Glaucoma Medications | IOP (mm Hg) | ||||||||||||
| References | Pre-SLT (Mean±SD) | Post-SLT (Mean±SD) | Pre-SLT (Mean±SD) | Post-SLT (Mean±SD) | Reduction (Mean±SD) | Adverse Events | Definition of Success | Main Results | |||||
| Shibata et al50 | 3.0±1.0 and 2.8±0.7 in 180 and 360 degrees, respectively | — | 19.5±4.3 and 21.0±4.1 in 180 and 360 degrees, respectively | — | 2.6±4.0 and 5.6±4.3 and in 180 and 360 degrees at 6 mo, respectively | IOP spikes | IOP reduction by ≥20% of pretreatment IOP without additional medications, laser or surgery | IOP reduction was significantly greater in the 360 degree group than in the 180 degree group. Response rate between groups was similar. Success rate was higher in the 360 degree group at 1 and 2 y than in the 180 degree group. Total energy was not associated with IOP reduction. | |||||
| No. Glaucoma Medications | IOP (mm Hg) | ||||||||||||
| References | Pre-SLT (Mean±SD) | Post-SLT (Mean±SD) | Pre-SLT (Mean±SD) | Post-SLT (Mean±SD) | Reduction (Mean±SD) | Adverse Events | Definition of Success | Main Results | |||||
| Al-busaidi et al51 | 1±0.4 | — | 25.77±4.57 | 18.82±4.68, at 3 mo | 6.95 (no SD reported) | IOP spikes, redness, pain/discomfort, corneal epitheliopathy | At least 20% IOP reduction from baseline without further medications or interventions | Success rate was 51.5% at 5 wk and 72.7% at 12 wk postlaser | |||||
| Lai et al52 | — | — | 26.8±5.6 | — | 8.6±6.7 at 5 y | — | — | There was 32.1% reduction in IOP in the SLT group at 5 y. Eyes treated with SLT needed substantially fewer anti-glaucoma medications | |||||
| Miki et al53 | 3.4±1.3 | 3.1±1.1 | 23.9±6.2 | — | — | — | — | 54.7% eyes had IOP equal to or greater than baseline at the last visit, and 85.8% eyes had <20% IOP reduction on 2 consecutive visits. Energy dose was not associated with failure. | |||||
| Ono et al54 | 2.6±1.2 in the SLT group | 2.38 (no SD reported) in the SLT group, at 12 mo | 18.8±5.3 in the SLT group | — | — | IOP spikes | ≥20% reduction in IOP from baseline without any additional medication during post-treatment periods | There was 21% reduction in IOP at 6 mo and 18.5% reduction in IOP at 12 mo in the SLT group | |||||
| Realini et al55 | — | None | 21.4±3.6 in the right eye and 21.1±3.5 in the left eye | 13.1±3.3 in the right eye and 12.9±3.1 in the left eye, at 12 mo | 8.9±3.2 in the right eye and 8.9±3.3 in the left eye | IOP spikes, photophobia | 10% reduction in IOP from baseline after washout | IOP reduction ranged from 34.1% to 38.8% in the right eye and from 36.0% to 38.9% in the left eye. Success rate was 77.7% (≥10% reduction in IOP. Out of those, 93% had >20% IOP reduction) | |||||
| Soboka et al56 | 1.29±1.01 | 1.03±0.70 at 12 mo | 24.3±2.5 | 17.6±3.4 at 12 mo | 6.7±4.2 | - | IOP lowering of > 20% from baseline without repeat treatment | There was a 25.9% reduction at 12 mo with 60% success rate. There was a significant reduction in antiglaucoma medications | |||||
| Goosen et al57 | — | — | 27.7 in right eyes and 25.9 in left eyes (no SD reported) | 13.6 at 12 mo (no SD reported) | — | None | — | There was 49% reduction of IOP from pre-SLT baseline levels, at 12 mo. There was 42.2% reduction of IOP in Blacks and 27.7% in Indians. Approximately 90% of Black patients had>20% IOP reduction at 12 mo | |||||
| No. Glaucoma Medications | IOP (mm Hg) | ||||||||||||
| References | Pre-SLT (Mean±SD) | Post-SLT (Mean±SD) | Pre-SLT (Mean±SD) | Post-SLT (Mean±SD) | Reduction (Mean±SD) | Adverse Events | Definition of Success | Main Results | |||||
| Funarunart et al58 | 2.74±1.09 | 2.16±1.31 at 24 mo | 19.31±3.59 | 14.79±3.67 at 24 mo | — | IOP spikes | Reduced IOP of 20% or decreased number of antiglaucoma drugs usage after SLT | 59.4% met the definition of successful treatment at 3 mo, where 33.3% of treated eyes had at least 20% IOP reduction and 30.2% needed fewer antiglaucoma drugs | |||||
| Realini et al59 | R: 1.14±0.55 L: 1.14±0.54 | 0—study exculsion | R: 21.2±3.4 L: 21.2±3.9 | At 8 years R: 15.7±2.6 L: 14.7±2.5 | At 8 years R: 6.1±2.8 L: 7.4±5.6 | — | IOP controlled without medications | SLT treatments alone (no medications) were able to maintain IOP to 13−16 mm Hg in more than 70% of the patients over 8 y | |||||
IOP indicates intraocular pressure; JOAG, Juvenile open angle glaucoma; NSAIDs, Non-steroidal anti-inflammatory drugs; NTG, normal tension glaucoma; OAG, open angle glaucoma; OHT, ocular hypertension; PE, pseudo-exfoliation; POAG, primary open angle glaucoma; SLT, selective laser trabeculoplasty; SOAG, secondary open angle glaucoma.