Swystun Alexander Geoffrey, Langton Elizabeth, Kelly Susanne, Venugopal Divya, Burton David, van der Hoek Jan, Liput Joanna, Alaghband Pouya
York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK.
Hull-York Medical School, Heslington, York, UK.
Eye (Lond). 2025 May 20. doi: 10.1038/s41433-025-03857-4.
Selective laser trabeculoplasty (SLT) has been demonstrated to have an IOP-lowering effect similar to topical medication when used as a first-line treatment. Accordingly, demand for SLT has increased, requiring other allied health care professionals to be leveraged in the delivery of this service. Current evidence on the safety of optometrists performing SLT is sparse. The aim of this study was to assess the success rate of SLT delivered by optometrists in eyes with newly diagnosed ocular hypertension and/or glaucoma and individuals who had received SLT as a treatment escalation. The secondary aim of the study was to assess complications of SLT delivered by optometrists.
This was a retrospective study. Success rate was defined as ≥20% reduction in intraocular pressure (IOP), or the cessation of ≥1 class of anti-glaucoma medication in cases of treatment escalation. For the first-line treatment, success was quantified according to the disease diagnosis with specified levels of IOP reduction.
880 eyes of 574 patients were included in the analysis. The success rate was 70.9% (244/344) in eyes with first-line SLT, whilst 65.3% (343/525) in the treatment escalation group. Overall, adverse events were identified in 2.2% of cases, including uveitis (0.92%), post-procedure transient IOP spike (0.45%), allergic reaction (0.23%), dry eye (0.23%), headache (0.11%), hyphaema (0.11%), and vitreo-macular traction 0.11%).
Optometrists delivered a safe and effective selective laser trabeculoplasty treatment with low rates of adverse events. Inter-optometrist differences in success rates were identified that require further elucidation.
选择性激光小梁成形术（SLT）作为一线治疗方法时，已被证明具有与局部用药相似的降低眼压效果。因此，对SLT的需求增加，需要利用其他相关医疗保健专业人员来提供这项服务。目前关于验光师进行SLT安全性的证据很少。本研究的目的是评估验光师对新诊断的高眼压症和/或青光眼患者以及接受SLT作为治疗升级的患者进行SLT的成功率。该研究的次要目的是评估验光师进行SLT的并发症。
这是一项回顾性研究。成功率定义为眼压（IOP）降低≥20%，或在治疗升级的情况下停用≥1类抗青光眼药物。对于一线治疗，根据疾病诊断和特定的眼压降低水平对成功率进行量化。
分析纳入了574例患者的880只眼。一线SLT治疗的成功率为70.9%（244/344），而治疗升级组为65.3%（343/525）。总体而言，2.2%的病例出现不良事件，包括葡萄膜炎（0.92%）、术后短暂眼压峰值（0.45%）、过敏反应（0.23%）、干眼（0.23%）、头痛（0.11%）、前房积血（0.11%）和玻璃体黄斑牵引（0.11%）。
验光师进行的选择性激光小梁成形术安全有效，不良事件发生率低。已发现验光师之间成功率存在差异，需要进一步阐明。
