Industry

Low-energy DSLT yields comparable glaucoma control to SLT

Healio Optometry2d ago1 min read

KIAWAH ISLAND, S.C. — Despite using a lower energy setting, direct selective laser trabeculoplasty yielded comparable outcomes to traditional SLT among patients with primary open-angle glaucoma and ocular hypertension.At the Kiawah Eye and Retina meeting, Corbin Lee, MD, highlighted the differences between the two procedures. DSLT typically uses around 1.8 mJ of energy and usually reaches 21 mJ, 11% of which hit the trabecular meshwork (TM) across 120 shots. Traditional SLT, meanwhile, usually reaches around 28 mJ in total, 32% of which hits the TM across 100 shots, according to Lee.“So,

Read full article on Healio Optometry

AI Summary

Quick Take

Direct selective laser trabeculoplasty (DSLT) achieves intraocular pressure control comparable to traditional SLT in patients with primary open-angle glaucoma and ocular hypertension, despite delivering significantly less energy to the trabecular meshwork. While traditional SLT delivers approximately 28 mJ total with 32% hitting the target, DSLT uses about 21 mJ total with only 11% reaching the meshwork across 120 shots.

Why It Matters

As laser therapy increasingly moves toward first-line treatment for glaucoma following the LIGHT trial, refining the delivery method is a major industry focus. DSLT represents an evolution in technique that simplifies the procedure by eliminating the need for a gonioscopy lens, potentially reducing chair time and provider variability. These findings suggest that the clinical efficacy of laser trabeculoplasty is maintained even when the total energy load and direct tissue contact are reduced, which could have implications for long-term safety and repeatability.

Key Findings

DSLT demonstrated comparable clinical outcomes to traditional SLT for managing primary open-angle glaucoma (POAG) and ocular hypertension (OHT).
Traditional SLT typically delivers a total energy of approximately 28 mJ over 100 shots, with 32% of that energy successfully hitting the trabecular meshwork.
DSLT utilizes a lower energy profile, averaging 1.8 mJ per shot for a total of 21 mJ across 120 shots.
Only 11% of the total energy delivered during a DSLT procedure actually reaches the trabecular meshwork, yet it remains effective for IOP control.

Practice Implications

Clinicians should monitor the adoption of DSLT as a potentially more efficient alternative to SLT, particularly for patients who may have difficulty with gonio lens placement. The comparable efficacy despite lower energy delivery suggests that the therapeutic window for laser trabeculoplasty is broader than previously thought, allowing for effective treatment with less cumulative energy exposure.

Who's Affected

Glaucoma SpecialistsComprehensive OphthalmologistsOptometrists

What's Next

Further longitudinal data will likely be needed to confirm if the lower energy delivery of DSLT translates to better long-term tissue preservation or improved outcomes for repeat treatments compared to SLT.

Evidence StrengthModerate

AI-generated summary — always read the original source for full context

Discussion

No comments yet. Be the first to share your thoughts.