Optimal Treatment Protocol for Selective Laser Trabeculoplasty

Optimal Treatment Protocol for Selective Laser Trabeculoplasty

A randomized controlled trial to evaluate which treatment protocol in selective laser trabeculoplasty that is most optimal in terms of efficacy and safety.

A randomized controlled trial in which individuals scheduled for SLT are randomized to one of four treatment protocols, which represent the most common variants of the treatment in clinical use.

Treatment is performed either at 360 degrees or 180 degrees and with a laser energy level either 0,1 millijoules (mJ) below the microbubble formation limit ("standard" energy) or at a level that gives microbubbles at 50-75% of laser effects ("high" energy). This gives four treatment arms: 180/standard, 180/high, 360/standard and 360/high. Group allocation is masked for the patient and is coded in the records.

The results for short and long term treatment effects are compared between the groups, as well as the complication rate and postoperative discomfort.

Inclusion Criteria:

• diagnosis primary open-angle glaucoma, pseudo-exfoliative glaucoma or ocular hypertension.
• intra-ocular pressure (IOP) at least 18 mmHg treatment day.
• treatment is performed by an experienced laser surgeon.
• SLT treatment and follow-up are expected to be possible to perform in an adequate way, considering anatomical factors, age and the general health of the patient.

Exclusion Criteria:

• change of IOP-lowering medication during the last three months.
• planned change of intra-ocular-pressure-lowering medication.
• previous glaucoma surgery (other than SLT and ALT)
• previous intra-ocular surgery during the last three months.
• previous intra-ocular inflammatory disease during the last year.
• planned intra-ocular surgery.
• hyper-pigmented anterior chamber angle.