SLT as primary glaucoma treatment may offer reduced cost, better efficacy than eye drops

 

Selective laser trabeculoplasty may be more effective and cheaper than eye drops when used as primary glaucoma management, Nathan Radcliffe, MD, said at the virtual OSN New York meeting.

“In most cases, the laser is going to be more cost-effective than either the generic or the brand-name drops,” Radcliffe said.

Eye drops are associated with low adherence, improper application, unwanted side effects and wasted dosing.

The LiGHT trial, which investigated laser therapy vs. medications in patients with newly diagnosed ocular hypertension and glaucoma, randomly assigned 718 patients into eye drop and laser groups. At 3 years, 74.2% of patients in the laser group did not require eye drops to maintain IOP at target, and there was a 97% probability of laser therapy being more cost-effective than medications when used as first treatment.

A total of 5.8% of patients treated with medications experienced disease deterioration compared with 3.8% of patients treated with laser therapy. Eleven glaucoma surgeries were needed in patients treated with eye drops, whereas none were required in the laser therapy group, making the risk for needing glaucoma surgery after medications “infinity times higher than after SLT,” Radcliffe said.

The number of steps and room for patient error in eye drop application make laser therapy a comparable option for treating glaucoma, Radcliffe said.

“With SLT laser, you simply treat the patient, and the rest is history,” Radcliffe said.