SELECTIVE LASER TRABECULOPLASTY OUTCOMES IN A REAL-WORLD UK NATIONAL HEALTH SERVICE COHORT

Abstract

Background: Selective laser trabeculoplasty (SLT) is an established intervention to reduce intraocular pressure (IOP) in ocular hypertension and open-angle glaucoma. In addition to randomized trial evidence, routine-service outcome reporting helps departments understand real-world performance and variability of response. Methods: We conducted a retrospective observational analysis of consecutive eyes undergoing SLT in a UK National Health Service (NHS) glaucoma service. Eyes were included if baseline (pre-treatment) IOP and the first available post-treatment follow-up IOP were documented. The primary outcome was change in IOP from baseline to first follow-up. Absolute IOP reduction was calculated as baseline IOP minus follow-up IOP, and percentage IOP reduction as absolute reduction divided by baseline IOP multiplied by 100. The analysis evaluated overall outcomes and was not designed for glaucoma subtype comparisons. Results: A total of 117 eyes met inclusion criteria. Mean baseline IOP was 21.0 ± 5.2 mmHg, reducing to 15.5 ± 6.4 mmHg at first follow-up. Mean absolute IOP reduction was 5.5 mmHg, corresponding to a mean percentage reduction of 24.9%. The baseline-versus-follow-up scatter plot demonstrated that most eyes lay below the line of equality, indicating IOP reduction after SLT in the majority of treated eyes. Conclusions: In a real-world NHS cohort, SLT achieved a clinically meaningful reduction in IOP at first follow-up. The magnitude of IOP lowering is consistent with published evidence, supporting SLT as an effective option within routine glaucoma care pathways.