August 06, 2025
1 min learn
Key takeaways:
- Success charges ranged upward of 65%, with a 2.2% fee of antagonistic occasions.
- The primary antagonistic occasions have been uveitis and IOP spike.
Optometrists can safely carry out selective laser trabeculoplasty, with 2.2% of eyes experiencing antagonistic occasions, based on a retrospective examine printed in Eye.
“It’s anticipated that the variety of sufferers with [ocular hypertension] and [primary open-angle glaucoma] is on the rise,” Alexander Geoffrey Swystun, PhD, of York and Scarborough Educating Hospitals NHS Basis Belief, and colleagues wrote. “This, compounded with workforce shortages inside ophthalmic providers and SLT turning into the first-line remedy for [ocular hypertension] and [primary open-angle glaucoma], has led to optometrists being utilized in delivering SLT in some elements of the U.Ok.”
Optometrists can safely carry out selective laser trabeculoplasty, with a examine discovering antagonistic occasions in 2.2% of eyes. Picture: Adobe Inventory
Swystun and colleagues used digital clinic information to research the success of SLT procedures carried out by optometrists between Dec. 1, 2021, and July 16, 2024. The ultimate evaluation included 869 eyes that underwent SLT — first-line remedy for 344 eyes and escalation remedy for 525 eyes — of 568 sufferers, who had a median age of 72 years.
The SLT procedures have been carried out by three optometrists, considered one of whom carried out 594 (68.4%) of the procedures. In circumstances of remedy escalation, success was outlined as a 20% or higher IOP discount or a discount of a minimum of one glaucoma treatment. In circumstances of first-line remedy, success was outlined as a 20% or higher IOP discount in sufferers with early glaucoma or ocular hypertension or 30% or higher in sufferers with reasonable glaucoma or worse.
Total, the success charges have been 70.9% for first-line SLT and 65.3% for remedy escalations. The distinction between the teams was not statistically important, with “much less stringent success standards” used for remedy escalation.
There have been antagonistic occasions in 2.2% of eyes, particularly uveitis (0.92%), IOP spike (0.45%), allergic response to iopidine (0.23%), dry eye (0.23%), headache (0.11%), vitreomacular traction (0.11%) and hyphema (0.11%).
For every 1 mm Hg enhance in preoperative IOP above 23.5 mm Hg, the chance of success elevated by 2.9%.
“The current examine helps the notion that optometrists can present a secure and efficient SLT service,” Swystun and colleagues wrote.
Perspective
Selective laser trabeculoplasty is now acknowledged as a viable, and sometimes preferable, first-line remedy possibility for glaucoma in applicable sufferers. The pivotal LiGHT trial demonstrated that SLT is just not solely as efficient as topical remedy in decreasing IOP but additionally affords superior cost-effectiveness, lowered treatment burden and improved high quality of life.
Because the inhabitants ages and the demand for glaucoma care will increase, entry to well timed remedy is a rising concern, significantly in rural and underserved areas going through a scarcity of ophthalmologists. Increasing optometric scope of observe to incorporate SLT has the potential to deal with this hole, but it surely stays a topic {of professional} debate, significantly round coaching, security and collaborative care.
In a retrospective examine of 880 eyes of 574 sufferers, Swystun and colleagues discovered that SLT carried out by optometrists was efficient and secure, with antagonistic occasions being unusual. These findings help the function of educated optometrists in delivering this low-risk, high-value process.
A team-based care mannequin, through which optometrists handle applicable circumstances and ophthalmologists concentrate on complicated surgical wants, can optimize medical assets, scale back remedy delays and finally enhance outcomes for sufferers with glaucoma.
Lisa M. Younger, OD, FAAO
Disclosures: Younger stories no related monetary disclosures.
Sources/Disclosures
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Disclosures:
Swystun stories no related monetary disclosures. Please see the examine for all different authors’ related monetary disclosures.
