Diurnal IOP Fluctuation Drops After SLT, Study Finds

A small prospective study using home tonometry showed sustained reductions in intraocular pressure variability through 18 months.

By: Jim Gallagher, senior managing editor

Glaucoma Physician February 20, 2026

Clinical Report: Diurnal IOP Fluctuation Drops After SLT, Study Finds

Overview

A small prospective study demonstrated that selective laser trabeculoplasty (SLT) significantly reduces intraocular pressure (IOP) variability for up to 18 months. The findings suggest that SLT may enhance pressure control beyond mean IOP reductions, which is critical for glaucoma management.

Background

Intraocular pressure variability is a known risk factor for glaucoma progression, making effective management essential. Traditional clinic measurements may not capture true IOP fluctuations, necessitating alternative assessment methods. This study aimed to evaluate the impact of SLT on diurnal IOP fluctuations using home tonometry.

Data Highlights

{'6 Weeks': {'Mean IOP Reduction': 'Specify value', 'Maximum IOP Reduction': 'Specify value', 'IOP Range Reduction': 'Specify value', 'Standard Deviation Reduction': 'Specify value'}, '3 Months': {'Mean IOP Reduction': 'Specify value', 'Maximum IOP Reduction': 'Specify value', 'IOP Range Reduction': 'Specify value', 'Standard Deviation Reduction': 'Specify value'}, '6 Months': {'Mean IOP Reduction': 'Specify value', 'Maximum IOP Reduction': 'Specify value', 'IOP Range Reduction': 'Specify value', 'Standard Deviation Reduction': 'Specify value'}, '12 Months': {'Mean IOP Reduction': 'Specify value', 'Maximum IOP Reduction': 'Specify value', 'IOP Range Reduction': 'Specify value', 'Standard Deviation Reduction': 'Specify value'}, '18 Months': {'Mean IOP Reduction': 'Specify value', 'Maximum IOP Reduction': 'Specify value', 'IOP Range Reduction': 'Specify value', 'Standard Deviation Reduction': 'Specify value'}}

Key Findings

SLT resulted in sustained reductions in mean and maximum IOP at all post-treatment time points.
IOP variability, including range and standard deviation, significantly decreased through 18 months after SLT.
Peak IOP values frequently occurred outside typical clinic hours, indicating potential underestimation of IOP variability in standard assessments.
Age, sex, glaucoma subtype, and medication burden did not predict IOP fluctuation reduction post-SLT.
Home tonometry proved effective for monitoring IOP response to SLT treatment.

Clinical Implications

The findings underscore the importance of considering IOP variability in glaucoma management and suggest that SLT may offer more comprehensive pressure control than previously understood. Clinicians should consider home tonometry as a valuable tool for assessing patient responses to treatment.

Conclusion

Overall, SLT demonstrates a durable effect on reducing IOP fluctuations, which may enhance glaucoma management strategies. Future research is warranted to further explore SLT's impact on IOP control.

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