UK retrospective research: SLT by optometrists secure
August 06, 2025
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Key takeaways:
- Success charges ranged upward of 65%, with a 2.2% charge of antagonistic occasions.
- The principle antagonistic occasions have been uveitis and IOP spike.
Optometrists can safely carry out selective laser trabeculoplasty, with 2.2% of eyes experiencing antagonistic occasions, in response to a retrospective research printed in Eye.
“It’s anticipated that the variety of sufferers with [ocular hypertension] and [primary open-angle glaucoma] is on the rise,” Alexander Geoffrey Swystun, PhD, of York and Scarborough Educating Hospitals NHS Basis Belief, and colleagues wrote. “This, compounded with workforce shortages inside ophthalmic providers and SLT turning into the first-line therapy for [ocular hypertension] and [primary open-angle glaucoma], has led to optometrists being utilized in delivering SLT in some components of the U.Ok.”
Optometrists can safely carry out selective laser trabeculoplasty, with a research discovering antagonistic occasions in 2.2% of eyes. Picture: Adobe Inventory
Swystun and colleagues used digital clinic information to investigate the success of SLT procedures carried out by optometrists between Dec. 1, 2021, and July 16, 2024. The ultimate evaluation included 869 eyes that underwent SLT — first-line therapy for 344 eyes and escalation therapy for 525 eyes — of 568 sufferers, who had a median age of 72 years.
The SLT procedures have been carried out by three optometrists, one in every of whom carried out 594 (68.4%) of the procedures. In instances of therapy escalation, success was outlined as a 20% or higher IOP discount or a discount of at the least one glaucoma medicine. In instances of first-line therapy, success was outlined as a 20% or higher IOP discount in sufferers with early glaucoma or ocular hypertension or 30% or higher in sufferers with average glaucoma or worse.
General, the success charges have been 70.9% for first-line SLT and 65.3% for therapy escalations. The distinction between the teams was not statistically important, with “much less stringent success standards” used for therapy escalation.
There have been antagonistic occasions in 2.2% of eyes, specifically uveitis (0.92%), IOP spike (0.45%), allergic response to iopidine (0.23%), dry eye (0.23%), headache (0.11%), vitreomacular traction (0.11%) and hyphema (0.11%).
For every 1 mm Hg improve in preoperative IOP above 23.5 mm Hg, the probability of success elevated by 2.9%.
“The current research helps the notion that optometrists can present a secure and efficient SLT service,” Swystun and colleagues wrote.
Perspective
Selective laser trabeculoplasty is now acknowledged as a viable, and infrequently preferable, first-line therapy choice for glaucoma in applicable sufferers. The pivotal LiGHT trial demonstrated that SLT is just not solely as efficient as topical remedy in reducing IOP but additionally presents superior cost-effectiveness, diminished medicine burden and improved high quality of life.
Because the inhabitants ages and the demand for glaucoma care will increase, entry to well timed therapy is a rising concern, notably in rural and underserved areas dealing with a scarcity of ophthalmologists. Increasing optometric scope of apply to incorporate SLT has the potential to handle this hole, nevertheless it stays a topic {of professional} debate, notably round coaching, security and collaborative care.
In a retrospective research of 880 eyes of 574 sufferers, Swystun and colleagues discovered that SLT carried out by optometrists was efficient and secure, with antagonistic occasions being unusual. These findings help the position of skilled optometrists in delivering this low-risk, high-value process.
A team-based care mannequin, through which optometrists handle applicable instances and ophthalmologists deal with advanced surgical wants, can optimize scientific assets, scale back therapy delays and finally enhance outcomes for sufferers with glaucoma.
Lisa M. Younger, OD, FAAO
Disclosures: Younger studies no related monetary disclosures.
Sources/Disclosures
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Disclosures:
Swystun studies no related monetary disclosures. Please see the research for all different authors’ related monetary disclosures.
