Repeat Selective Laser Trabeculoplasty for Glaucoma Patients: A Systematic Review and Meta-analysis

Hyunsoo J Jang; Brian Yu; William Hodge; Monali S Malvankar-Mehta

doi:10.5005/jp-journals-10078-1302

Repeat Selective Laser Trabeculoplasty for Glaucoma Patients: A Systematic Review and Meta-analysis

J Curr Glaucoma Pract. 2021 Sep-Dec;15(3):117-124. doi: 10.5005/jp-journals-10078-1302.

Authors

Hyunsoo J Jang¹, Brian Yu¹, William Hodge², Monali S Malvankar-Mehta³

Affiliations

¹ Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
² Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
³ Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.

Abstract

Aim and objective: To evaluate repeat selective laser trabeculoplasty (SLT) for treating primary open-angle glaucoma (POAG).

Materials and methods: PubMed, CINAHL, and EMBASE were systematically searched along with grey literature. All English articles that measured intraocular pressure (IOP) before and after repeat SLT on adult patients with POAG were included. Studies were not filtered by location or publication date. Covidence was used to screen imported articles. Risk of bias assessment and data extraction was performed after screening. Meta-analysis was performed using STATA 16.0. Fixed-effect or random-effects models were developed depending on the presence of heterogeneity.

Results: Database and grey literature search identified 512 unique studies. After duplicate removal and screening, 12 articles were included and data from included studies were synthesized. Nine articles were included in the meta-analysis. Three studies were prospective observational studies, and nine studies were retrospective chart reviews. Due to the presence of heterogeneity, a random-effects model has been utilized that suggested significant IOP reduction (IOPR) by repeat SLT at 24 months follow-up.

Conclusion: Based on our results, repeat SLT could be an effective procedure in reducing IOP for patients with glaucoma for up to 24 months. Efficacy of third, fourth, or further SLT remains to be verified. More data from long-term, high-quality randomized-controlled trials (RCTs) are required to make conclusions.

Clinical significance: Repeat SLT may be an effective treatment for lowering IOP with minimal complications or safety issues. This may allow the use of SLT as a primary treatment for POGA, allowing the discontinuation of medications or eye drops and lead to additional benefits.

How to cite this article: Jang HJ, Yu B, Hodge W, et al. Repeat Selective Laser Trabeculoplasty for Glaucoma Patients: A Systematic Review and Meta-analysis. J Curr Glaucoma Pract 2021;15(3):117-124.

Keywords: Glaucoma; Intraocular pressure; Laser; Meta-analysis; Repeat selective laser trabeculoplasty; Selective laser trabeculoplasty; Systematic review; Trabeculoplasty.