In treating glaucoma, the typical route is often to prescribe medications.
If topical drops fail to achieve a reduction in intraocular pressure (IOP), then the alternative is to try laser trabeculoplasty, and finally surgery.
From 2019 to 2020, I co-chaired the European Glaucoma Society (EGS) Guidelines Committee with Carlo Traverso. The 5th Edition of the EGS guidelines was published in October 2020, after a superb team effort among a large number of colleagues (1). We aimed to promote evidence-based clinical practice and, to that end, followed GRADE methodology, including identification of key questions, critical evaluation of published literature, and formulation of recommendations.
Glaucoma management has traditionally taken a stepped approach based on the level of risk involved. The low-risk treatment option is medication. Next are laser/selective laser trabeculoplasty (SLT), MIGS, and incisional surgery. It ends with the highest risk option of cyclodestructive procedures.
Download the EGS Guidelines on the European Glaucoma Society website.
To compare visual field outcomes of ocular hypertensive and glaucoma patients treated first with medical therapy with those treated first with selective laser trabeculoplasty (SLT).
Glaucoma specialists have traditionally viewed topical therapy as first-line treatment for glaucoma. Recently, however, this paradigm has been challenged. Selective laser trabeculoplasty (SLT), though FDA approved since 2001, has gained acceptance as first-line treatment over the last 5 to 10 years.
Prof. Mark A. Latina
Tufts University School of Medicine, Boston, MA (USA)
Since 1993, Quantel Medical develops, manufactures and markets innovative medical laser and ultrasound solutions.
World leader in ophthalmology, its lasers and ultrasounds are designed to diagnose and treat the four main causes of blindness: cataracts, glaucoma, diabetic retinopathy and macular degeneration; and also dry eye disease.
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