Citation Information :
Lee EY, Farrokhyar F, Sogbesan E. Laser Trabeculoplasty Perceptions and Practice Patterns of Canadian Ophthalmologists. J Curr Glaucoma Pract 2020; 14 (3):81-86.
Aim: To describe the current practice patterns and perceptions of Canadian ophthalmologists using laser trabeculoplasty (LTP). Materials and methods: A cross-sectional survey of 124 members of the Canadian Ophthalmological Society (COS) who perform LTP was conducted. Descriptive statistics and Chi-square comparative analyses were performed on anonymous self-reported survey data. Results: Of the 124 respondents, 34 (27.4%) completed a glaucoma fellowship. Use of selective laser trabeculoplasty (SLT) (94.4%) was preferred over argon laser trabeculoplasty (ALT) (5.6%). The most frequently cited reasons for SLT preference was less damage to trabecular meshwork (30.7%), availability (16.2%), and repeatability (16.2%). In all, 47.6% of the respondents performed LTP concurrently with medical treatment, 33.9% used it after medical treatment, and 17.7% used it as first-line treatment. Majority (87.1%) of the respondents believed that SLT is effective when repeated. In suitable patients, 41.9% of the respondents stated on average they repeat SLT once, 26.6% twice, and 19.4% greater than 2 times, respectively. Of those who repeat SLT on patients, 80.7% found repeat SLT treatments have good outcomes for patients. In all, 105 (84.7%) ophthalmologists responded they would benefit from an LTP practice guideline. Significantly more ophthalmologists without glaucoma fellowships perceived they would benefit from a practice guideline (p value <0.001). Conclusion: This survey provides valuable practical information on how LTP is used in the treatment of glaucoma in Canada. Clinical significance: The findings may serve as a baseline survey to trend future practices.
Bourne RR, Stevens GA, White RA, et al. Causes of vision loss worldwide, 1990–2010: a systematic analysis. Lancet Global Health 2013;1(6):e339–e349. DOI: 10.1016/S2214-109X(13)70113-X.
Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol 1996;80(5):389–393. DOI: 10.1136/bjo.80.5.389.
Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006;90(3):262–267. DOI: 10.1136/bjo.2005.081224.
Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 2014;121(11):2081–2090. DOI: 10.1016/j.ophtha.2014.05.013.
Latina MA, de Leon JM. Selective laser trabeculoplasty. Ophthalmol Clin North Am 2005;18(3):409–419. , vi 10.1016/j.ohc.2005.05.005.
Latina MA, Park C. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and cw laser interactions. Exp Eye Res 1995;60(4):359–371. DOI: 10.1016/S0014-4835(05)80093-4.
Agarwal HC, Sihota R, Das C, et al. Role of argon laser trabeculoplasty as primary and secondary therapy in open angle glaucoma in indian patients. Br J Ophthalmol 2002;86(7):733–736. DOI: 10.1136/bjo.86.7.733.
Wise JB, Witter SL. Argon laser therapy for open-angle glaucoma. A pilot study. Arch Ophthalmol 1979;97(2):319–322. DOI: 10.1001/archopht.1979.01020010165017.
Bovell AM, Damji KF, Hodge WG, et al. Long term effects on the lowering of intraocular pressure: selective laser or argon laser trabeculoplasty? Can J Ophthalmol 2011;46(5):408–413. DOI: 10.1016/j.jcjo.2011.07.016.
Damji KF, Bovell AM, Hodge WG, et al. Selective laser trabeculoplasty vs argon laser trabeculoplasty: results from a 1 year randomised clinical trial. Br J Ophthalmol 2006;90(12):1490–1494. DOI: 10.1136/bjo.2006.098855.
Damji KF, Shah KC, Rock WJ, et al. Selective laser trabeculoplasty v argon laser trabeculoplasty: a prospective randomised clinical trial. Br J Ophthalmol 1999;83(6):718–722. DOI: 10.1136/bjo.83.6.718.
Pham H, Mansberger S, Brandt JD, et al. Argon laser trabeculoplasty vs selective laser trabeculoplasty. Surv Ophthalmol 2008;53(6):641–646. DOI: 10.1016/j.survophthal.2008.08.020.
Birt CM. Selective laser trabeculoplasty retreatment after prior argon laser trabeculoplasty: 1 year results. Can J Ophthalmol 2007;42(5):715–719. DOI: 10.3129/i07-131.
Russo V, Barone A, Cosma A, et al. Selective laser trabeculoplasty vs argon laser trabeculoplasty in patients with uncontrolled open-angle glaucoma. Eur J Ophthalmol 2009;19(3):429–434. DOI: 10.1177/112067210901900317.
Rosenfeld E, Shemesh G, Kurtz S. The efficacy of selective laser trabeculoplasty vs argon laser trabeculoplasty in pseudophakic glaucoma patients. Clin Ophthalmol 2012;6:1935–1940. DOI: 10.2147/OPTH.S34193.
Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, et al. Selective vs argon laser trabeculoplasty: hypotensive efficacy, anterior chamber inflammation, and postoperative pain. Eye (Lond) 2004;18(5):498–502. DOI: 10.1038/sj.eye.6700695.
Hutnik C, Crichton A, Ford B, et al. Selective laser trabeculoplasty vs argon laser trabeculoplasty in glaucoma patients treated Previously with 360 degrees selective laser trabeculoplasty: a randomized, single-blind, equivalence clinical trial. Ophthalmology 2018;126(2):223–232. DOI: 10.1016/j.ophtha.2018.09.037.
Juzych MS, Chopra V, Banitt MR, et al. Comparison of long-term outcomes of selective laser trabeculoplasty vs argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology 2004;111(10):1853–1859. DOI: 10.1016/j.ophtha.2004.04.030.
Kent SS, Hutnik CM, Birt CM, et al. A randomized clinical trial of selective laser trabeculoplasty vs argon laser trabeculoplasty in patients with pseudoexfoliation. J Glaucoma 2015;24(5):344–347. DOI: 10.1097/IJG.0b013e31829e55e4.
Song JSA, Vianna J, Shuba L, et al. Evaluating selective laser trabeculoplasty vs argon laser trabeculoplasty in pseudoexfoliation glaucoma patients. Can J Ophthalmol 2018;53(1):70–75. DOI: 10.1016/j.jcjo.2017.07.004.
Wang H, Cheng JW, Wei RL, et al. Meta-analysis of selective laser trabeculoplasty with argon laser trabeculoplasty in the treatment of open-angle glaucoma. Can J Ophthalmol 2013;48(3):186–192. DOI: 10.1016/j.jcjo.2013.01.001.
Wang W, He M, Zhou M, et al. Selective laser trabeculoplasty vs argon laser trabeculoplasty in patients with open-angle glaucoma: a systematic review and meta-analysis. PLoS One 2013;8(12):e84270. DOI: 10.1371/journal.pone.0084270.
Zhao JC, Grosskreutz CL, Pasquale LR. Argon vs selective laser trabeculoplasty in the treatment of open angle glaucoma. Int Ophthalmol Clin 2005;45(4):97–106. DOI: 10.1097/01.iio.0000176370.01511.6e.
Campbell RJ, Bell CM, Gill SS, et al. Clinic-based glaucoma care in the era of surgical subspecialization. Am J Ophthalmol 2014;157(3):631–9.e1-2. DOI: 10.1016/j.ajo.2013.11.019.
Prum Jr. BE, Lim MC, Mansberger SL, et al. Primary open-angle glaucoma suspect preferred practice pattern((R)) guidelines. Ophthalmology 2016;123(1):P112–P151. DOI: 10.1016/j.ophtha.2015.10.055.
Prum Jr. BE, Rosenberg LF, Gedde SJ, et al. Primary open-angle glaucoma preferred practice pattern((R)) guidelines. Ophthalmology 2016;123(1):P41–P111. DOI: 10.1016/j.ophtha.2015.10.053.
Szigiato AA, Trope GE, Jin Y, et al. Trends in glaucoma surgical procedures in Ontario: 1992–2012. Can J Ophthalmol 2015;50(5):338–344. DOI: 10.1016/j.jcjo.2015.07.005.
Rachmiel R, Trope GE, Chipman ML, et al. Laser trabeculoplasty trends with the introduction of new medical treatments and selective laser trabeculoplasty. J Glaucoma 2006;15(4):306–309. DOI: 10.1097/01.ijg.0000212233.11287.b3.
Arora KS, Robin AL, Corcoran KJ, et al. Use of various glaucoma surgeries and procedures in medicare beneficiaries from 1994 to 2012. Ophthalmology 2015;122(8):1615–1624. DOI: 10.1016/j.ophtha.2015.04.015.
Rolim de Moura C, Paranhos Jr. A, Wormald R. Laser trabeculoplasty for open angle glaucoma. Cochrane Database Syst Rev 2007;4:CD003919. DOI: 10.1002/14651858.CD003919.pub2.
Leahy KE, White AJ. Selective laser trabeculoplasty: current perspectives. Clin Ophthalmol 2015;9:833–841. DOI: 10.2147/OPTH.S53490.
McAlinden C. Selective laser trabeculoplasty (SLT) vs other treatment modalities for glaucoma: systematic review. Eye (Lond) 2014;28(3):249–258. DOI: 10.1038/eye.2013.267.
Nagar M, Ogunyomade A, O’Brart DP, et al. A randomised, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol 2005;89(11):1413–1417. DOI: 10.1136/bjo.2004.052795.
McIlraith I, Strasfeld M, Colev G, et al. Selective laser trabeculoplasty as initial and adjunctive treatment for open-angle glaucoma. J Glaucoma 2006;15(2):124–130. DOI: 10.1097/00061198-200604000-00009.
Melamed S, Ben Simon GJ, Levkovitch-Verbin H. Selective laser trabeculoplasty as primary treatment for open-angle glaucoma: a prospective, nonrandomized pilot study. Arch Ophthalmol 2003;121(7):957–960. DOI: 10.1001/archopht.121.7.957.
Katz LJ, Steinmann WC, Kabir A, et al. Selective laser trabeculoplasty vs medical therapy as initial treatment of glaucoma: a prospective, randomized trial. J Glaucoma 2012;21(7):460–468. DOI: 10.1097/IJG.0b013e318218287f.
Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. Selective laser trabeculoplasty vs eye drops for first-line treatment of ocular hypertension and glaucoma (light): a multicentre randomised controlled trial. Lancet 2019;393(10180):1505–1516. DOI: 10.1016/S0140-6736(18)32213-X.
Lee R, Hutnik CM. Projected cost comparison of selective laser trabeculoplasty vs glaucoma medication in the Ontario health insurance plan. Can J Ophthalmol 2006;41(4):449–456. DOI: 10.1016/S0008-4182(06)80006-2.
Schwartz GF, Quigley HA. Adherence and persistence with glaucoma therapy. Surv Ophthalmol 2008;53(Suppl 1):S57–S68. DOI: 10.1016/j.survophthal.2008.08.002.
Leung EW, Medeiros FA, Weinreb RN. Prevalence of ocular surface disease in glaucoma patients. J Glaucoma 2008;17(5):350–355. DOI: 10.1097/IJG.0b013e31815c5f4f.
Skalicky SE, Goldberg I, McCluskey P. Ocular surface disease and quality of life in patients with glaucoma. Am J Ophthalmol 2012;153(1):1–9.e2. DOI: 10.1016/j.ajo.2011.05.033.
Sleath B, Blalock S, Covert D, et al. The relationship between glaucoma medication adherence, eye drop technique, and visual field defect severity. Ophthalmology 2011;118(12):2398–2402. DOI: 10.1016/j.ophtha.2011.05.013.
Friedman DS, Okeke CO, Jampel HD, et al. Risk factors for poor adherence to eyedrops in electronically monitored patients with glaucoma. Ophthalmology 2009;116(6):1097–1105. DOI: 10.1016/j.ophtha.2009.01.021.
Stein JD, Kim DD, Peck WW, et al. Cost-effectiveness of medications compared with laser trabeculoplasty in patients with newly diagnosed open-angle glaucoma. Arch Ophthalmol 2012;130(4):497–505. DOI: 10.1001/archophthalmol.2011.2727.
Woo DM, Healey PR, Graham SL, et al. Intraocular pressure-lowering medications and long-term outcomes of selective laser trabeculoplasty. Clin Exp Ophthalmol 2015;43(4):320–327. DOI: 10.1111/ceo.12452.
Goyal S, Beltran-Agullo L, Rashid S, et al. Effect of primary selective laser trabeculoplasty on tonographic outflow facility: a randomised clinical trial. Br J Ophthalmol 2010;94(11):1443–1447. DOI: 10.1136/bjo.2009.176024.
Prasad N, Murthy S, Dagianis JJ, et al. A comparison of the intervisit intraocular pressure fluctuation after 180 and 360 degrees of selective laser trabeculoplasty (SLT) as a primary therapy in primary open angle glaucoma and ocular hypertension. J Glaucoma 2009;18(2):157–160. DOI: 10.1097/IJG.0b013e3181752c97.
Jinapriya D, D’Souza M, Hollands H, et al. Anti-inflammatory therapy after selective laser trabeculoplasty: a randomized, double-masked, placebo-controlled clinical trial. Ophthalmology 2014;121(12):2356–2361. DOI: 10.1016/j.ophtha.2014.07.017.
De Keyser M, De Belder M, De Groot V. Randomized prospective study of the use of anti-inflammatory drops after selective laser trabeculoplasty. J Glaucoma 2017;26(2):e22–e29. DOI: 10.1097/IJG.0000000000000522.
Lai JS, Chua JK, Tham CC, et al. Five-year follow up of selective laser trabeculoplasty in Chinese eyes. Clin Exp Ophthalmol 2004;32(4):368–372. DOI: 10.1111/j.1442-9071.2004.00839.x.
Khouri AS, Lari HB, Berezina TL, et al. Long term efficacy of repeat selective laser trabeculoplasty. J Ophthalmic Vis Res 2014;9(4):444–448. DOI: 10.4103/2008-322X.150814.
Polat J, Grantham L, Mitchell K, et al. Repeatability of selective laser trabeculoplasty. Br J Ophthalmol 2016;100(10):1437–1441. DOI: 10.1136/bjophthalmol-2015-307486.
Francis BA, Loewen N, Hong B, et al. Repeatability of selective laser trabeculoplasty for open-angle glaucoma. BMC Ophthalmol 2016;16:128. DOI: 10.1186/s12886-016-0299-9.