A retrospective review of 354 eyes that underwent SLT using fixed high energy compared with a standard (titrated to “champagne” bubbles) approach found that the former had significantly greater IOP reduction both in medicated and medication-naïve patients. Writing in the Journal of Glaucoma, Boonkit Purt, MD, and colleagues said that the fixed high-energy SLT protocol used in a residency training program study was 1.2 mJ/spot while a standard titrated-energy protocol used was 0.8 mJ/spot titrating to champagne bubbles. Complication rates (IOP spike, iritis, and macular edema) were similar between the 2 groups.

There is no consensus on ideal SLT procedural laser energy settings, they said. The authors wrote, “This study demonstrates that fixed-energy SLT produces at least equivalent results compared with the standard-energy approach, without an increase in adverse outcomes. Particularly in the medication-naïve subpopulation, fixed-energy SLT was associated with a significantly greater IOP reduction at each respective time point.” They noted that the study is limited by overall poor response to standard-energy treatments, with results showing decreased IOP reduction compared with those of previous studies.