Selective laser trabeculoplasty: A review and comparison to argon laser trabeculoplasty

Selective laser trabeculoplasty is performed using a short-pulsed frequency-doubled Nd:YAG laser that lowers intraocular pressure in patients with open-angle glaucoma. This technique selectively targets pigmented cells within the trabecular meshwork so that the surrounding tissues are not damaged, and it uses much less energy than argon laser trabeculoplasty. This may be important for patients who require repeat laser treatments or future surgical therapies. We performed a randomized study in 132 eyes comparing selective laser trabeculoplasty (n=64) to argon laser trabeculoplasty (n=68) that showed equivalency in the primary outcome of lowering intraocular pressure at 6 months and 1 year. There was a trend towards selective laser trabeculoplasty being more effective in patients who had previous argon laser trabeculoplasty treatment (n=55), although these results did not reach statistical significance. The repeatability of these outcomes with selective laser trabeculoplasty needs to be confirmed with further patient studies. Selective laser trabeculoplasty appears to be a safe and effective therapy for lowering intraocular pressure, and it is a useful alternative to argon laser trabeculoplasty. This new technique may offer a benefit over argon laser trabeculoplasty for patients requiring repeat laser therapy.