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Glaucoma Physician

Article | 2026 American Glaucoma Society Meeting

Which Patients Benefit Most From Repeat SLT?

A retrospective observational study of more than 279,000 eyes may help guide patient selection for repeat SLT.

By: Wendy Liu, MD, PHD,
Glaucoma Physician February 20, 2026

Clinical Report: Which Patients Benefit Most From Repeat SLT?

Overview

A retrospective study of over 279,000 eyes evaluates the efficacy of repeat selective laser trabeculoplasty (SLT). The findings indicate that response rates vary significantly based on baseline intraocular pressure (IOP) and initial treatment response, with higher IOP correlating with better outcomes.

Background

Selective laser trabeculoplasty (SLT) is increasingly recognized as a first-line treatment for open-angle glaucoma and ocular hypertension. Understanding which patients benefit most from repeat SLT is crucial for optimizing treatment strategies and improving patient outcomes. This study leverages a large dataset to provide insights into real-world efficacy and patient selection for repeat SLT.

Data Highlights

Baseline IOPResponse RateMean IOP Reduction (mmHg)
<18 mmHg3.6%2.5
>24 mmHg38%2.5

Key Findings

  • Overall response rate for repeat SLT was 11% with a mean IOP reduction of 2.5 mmHg.
  • Higher baseline IOP significantly correlated with better response rates (3.6% for IOP <18 mmHg vs. 38% for IOP >24 mmHg).
  • Patients who responded to initial SLT had an 80% response rate to repeat SLT, compared to 7% for non-responders.
  • Socioeconomic factors, such as Medicaid insurance and type 2 diabetes, were associated with lower response rates.
  • Durability of response was longer in patients with higher baseline IOP.

Clinical Implications

Suggest strategies for clinicians to address socioeconomic disparities in treatment response.

Conclusion

This large-scale study provides valuable insights into the efficacy of repeat SLT, emphasizing the importance of patient selection based on baseline characteristics and previous treatment outcomes.

Related Resources & Content

  1. Glaucoma Physician, 2025 -- Reevaluating SLT: Updated Evidence and Clinical Pearls
  2. Glaucoma Physician, 2026 -- Things You Didn’t Know About SLT
  3. Ophthalmology Management, 2013 -- ALT vs. SLT: Is One Better Than the Other?
  4. BMJ Open Ophthalmology, 2020 -- First results of direct selective laser trabeculoplasty for the treatment of glaucoma
  5. PubMed, 2020 -- Efficacy of Repeat Selective Laser Trabeculoplasty in Medication-Naive Open-Angle Glaucoma and Ocular Hypertension during the LiGHT Trial
  6. Ophthalmic Professional — Smooth the way for SLT
  7. First results of direct selective laser trabeculoplasty for the treatment of glaucoma | BMJ Open Ophthalmology
  8. Efficacy of Repeat Selective Laser Trabeculoplasty in Medication-Naive Open-Angle Glaucoma and Ocular Hypertension during the LiGHT Trial - PubMed