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Selective laser trabeculoplasty versus medication for open-angle glaucoma: systematic review and meta-analysis of randomised clinical trials
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  • Published on:
    RE : Chi et al : Selective Laser Trabeculoplasty Versus Medication for Open-Angle Glaucoma: Systematic Review and Meta-Analysis of Randomised Clinical Trials
    • Sina Elahi, Ophthalmologist Swiss Glaucoma Research Foundation, Swiss Visio Montchoisi
    • Other Contributors:
      • Kaweh Mansouri, Ophthalmologist

    We read with great interest this comparison between selective laser trabeculoplasty (SLT) and medication for Open-Angle Glaucoma (OAG). (1)
    The recent LiGHT trial (2), an important landmark in the management of glaucoma, suggests that SLT represents an ideal first-line treatment option of ocular hypertension (OHT) and open angle glaucoma (OAG) in terms of decreased costs, with similar efficacy and quality of life when comparing to medication. The strength of the trial resides in its methodology, limiting most of the bias seen in the previous retrospective studies on the subject. Despite the fact that their conclusions seemed to be echoing various other authors (3,4) there is still debate as to whether SLT should become a first-line treatment.
    The current powerful meta-analysis by Chi et al on 1229 patients (14 articles, 8 randomized clinical trials), may become the final argument on the debate demonstrating that not only is SLT not inferior to medical therapy in terms of IOP-lowering effect or safety, but it allows for significantly lesser use of medication. (1)
    The longer duration of effect, minimized cost, and safety of SLT are especially important in settings with difficult access to care, such as in developing countries, or in patients with decreased mobility. A recent study on incarcerated patients showed that even when measures are taken to administer and control patients’ adherence to treatment, substantial nonadherence persists. (5)
    It is ri...

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    Conflict of Interest:
    None declared.