Outcomes of pattern scanning laser trabeculoplasty and selective laser trabeculoplasty: Results from the lausanne laser trabeculoplasty registry

Purpose To compare the long-term safety and efficacy of pattern scanning laser trabeculoplasty (PSLT) and selective laser trabeculoplasty (SLT). Methods This was a retrospective database analysis (Lausanne Laser Trabeculoplasty Registry) of patients having had laser trabeculoplasty (LT) prior to 2017 with a minimum follow-up of 1 year. Inclusion criteria were age >= 40 years and diagnosis of ocular hypertension (OHT) and open-angle glaucoma (OAG). Selective laser trabeculoplasty (SLT) eyes were matched to PSLT eyes according to baseline intraocular pressure (IOP), baseline number of ocular hypotensive medications (OHM) and glaucoma diagnosis. Success was defined as an IOP <= 20% from baseline or an IOP equal or lower than baseline accompanied by a reduction in OHM. Multivariate regression models were used to study associations between success and baseline clinical parameters. Results From 280 eyes in the database, 81 eyes had PSLT and were matched with 81 SLT eyes (162 patients). Mean age was 69.4 +/- 12.1 years, and 56.2% were female. Mean IOP was 18.6 +/- 5.3 and 18.2 +/- 4.1 mmHg at baseline and 15.9 +/- 3.0 and 16.0 +/- 3.4 mmHg at 12 months and 15.2 +/- 2.7 and 16.2 +/- 3.4 mmHg at 24 months, for PSLT and SLT, respectively. 60.5% of PSLT and 65.4% of SLT eyes achieved treatment success (p = 0.20). Number of OHM was 1.0 +/- 1.0 and 1.4 +/- 1.2, respectively (p = 0.052). Baseline IOP (OR = 1.23, p < 0.01) and number of OHM (OR = 1.67, p < 0.01) were associated with success in both PSLT and SLT, while LT modality was not [OR = 0.81 (0.43-1.53), p = 0.52], and a diagnosis of primary OAG was negatively associated (OR = 0.42, p = 0.04). Conclusion Our study did not find any significant differences between PSLT and SLT in terms of safety and efficacy in patients with OHT and glaucoma. Baseline IOP was associated with higher success rates in both procedures. Additional studies are needed to evaluate the outcomes of PSLT in non-Caucasian populations and the ability of repeat PSLT to achieve additional IOP reduction.