Direct vs Standard SLT for Glaucoma: A Noninferiority Trial

A Randomized Controlled Trial Comparing Direct Selective Laser Trabeculoplasty (DSLT) and Selective Laser Trabeculoplasty (SLT) in Reducing Intraocular Pressure in Open-Angle Glaucoma

This study compares two FDA-approved laser treatments for glaucoma: Direct Selective Laser Trabeculoplasty (DSLT) and Selective Laser Trabeculoplasty (SLT). Both procedures aim to lower eye pressure and prevent vision loss. DSLT is a newer, non-contact technique that may improve comfort and efficiency. Participants will be randomly assigned to receive either DSLT or SLT and followed for 12 months to assess eye pressure, safety, and treatment outcomes.

Inclusion Criteria:

• Age ≥18 years
• Diagnosis of OAG (including exfoliative or pigmentary) or OHT
• Gonioscopically open angle (visible scleral spur 360°)
• Ability to consent and comply with follow-up

Exclusion Criteria:

• Angle-closure or secondary glaucomas
• IOP >35 mmHg despite therapy
• Corneal pathology interfering with laser or IOP measurement
• Recent ocular surgery (<6 months)
• Contraindications to study medications or procedures
• Cognitive impairment preventing consent