Single treatment selective laser trabeculoplasty in a Southern African resource-constrained context
Background: In a resource-constrained environment, selective laser trabeculoplasty (SLT) is an attractive option. This study’s primary objective is to report real-world outcomes in terms of reduction in intraocular pressure, reduction in topical treatment and further surgery required. Methods: A re...
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AOSIS
2025-01-01
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| Series: | Journal of the Colleges of Medicine of South Africa |
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| Online Access: | https://jcmsa.org.za/index.php/jcmsa/article/view/118 |
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| author | Emma J. Pons Jonathan J. Pons Elly S. Grossman Daniel Louw Merle Werbeloff |
| author_facet | Emma J. Pons Jonathan J. Pons Elly S. Grossman Daniel Louw Merle Werbeloff |
| author_sort | Emma J. Pons |
| collection | DOAJ |
| description | Background: In a resource-constrained environment, selective laser trabeculoplasty (SLT) is an attractive option. This study’s primary objective is to report real-world outcomes in terms of reduction in intraocular pressure, reduction in topical treatment and further surgery required.
Methods: A retrospective case series of consecutive patients who received SLT between 01 January 2017 and 31 December 2018 was conducted. Patient data were captured for up to 21 months.
Results: In all, 59 eyes of 36 patients were analysed. The mean patient age was 57.8 years (± 10.0). Sixty four per cent of the patients had SLT on both eyes. 83% of the patients were black ethnicity or of mixed race ethnicity. There was a significant and sustained intraocular pressure reduction (median reduction = 25.8%, IQR = 5.3%, 40.4%) from pre-SLT to 10–15 months (Wilcoxon T = 27.5, p = 0.002). The Kaplan-Meier survival analysis estimated that 60% of patients required no treatment escalation for up to 21 months. Neither cup-disc ratio nor pre-treatment intraocular pressure were found to be a predictive factor of treatment success or failure (p = 0.675 and p = 0.128).
Conclusion: The results of this study support the use of SLT for patients with not only mild to moderate glaucoma but also advanced glaucoma in a Southern African, resource-limited context. The results demonstrate ongoing benefit for these patients up to 21 months following a single treatment.
Contribution: This research provides, for the first time, long-term data from a low-resourced setting on the use of SLT in the treatment of glaucoma in Eswatini. |
| format | Article |
| id | doaj-art-7e2070da18ad4a54a4977b526cf24307 |
| institution | Kabale University |
| issn | 2960-110X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Journal of the Colleges of Medicine of South Africa |
| spelling | doaj-art-7e2070da18ad4a54a4977b526cf243072025-02-11T13:24:18ZengAOSISJournal of the Colleges of Medicine of South Africa2960-110X2025-01-0131e1e710.4102/jcmsa.v3i1.11845Single treatment selective laser trabeculoplasty in a Southern African resource-constrained contextEmma J. Pons0Jonathan J. Pons1Elly S. Grossman2Daniel Louw3Merle Werbeloff4Department of Ophthalmology, Faculty of Medicine and Health Sciences, Walter Sisulu University, GqeberhaDepartment of Ophthalmology, Good Shepherd Hospital Eye Clinic, SitekiPort Elizabeth and East London Health Resource Centres, Faculty of Medicine and Health Sciences, Walter Sisulu University, GqeberhaFaculty of Health Sciences, Nelson Mandela University, GqeberhaWits School of Governance, University of the Witwatersrand, JohannesburgBackground: In a resource-constrained environment, selective laser trabeculoplasty (SLT) is an attractive option. This study’s primary objective is to report real-world outcomes in terms of reduction in intraocular pressure, reduction in topical treatment and further surgery required. Methods: A retrospective case series of consecutive patients who received SLT between 01 January 2017 and 31 December 2018 was conducted. Patient data were captured for up to 21 months. Results: In all, 59 eyes of 36 patients were analysed. The mean patient age was 57.8 years (± 10.0). Sixty four per cent of the patients had SLT on both eyes. 83% of the patients were black ethnicity or of mixed race ethnicity. There was a significant and sustained intraocular pressure reduction (median reduction = 25.8%, IQR = 5.3%, 40.4%) from pre-SLT to 10–15 months (Wilcoxon T = 27.5, p = 0.002). The Kaplan-Meier survival analysis estimated that 60% of patients required no treatment escalation for up to 21 months. Neither cup-disc ratio nor pre-treatment intraocular pressure were found to be a predictive factor of treatment success or failure (p = 0.675 and p = 0.128). Conclusion: The results of this study support the use of SLT for patients with not only mild to moderate glaucoma but also advanced glaucoma in a Southern African, resource-limited context. The results demonstrate ongoing benefit for these patients up to 21 months following a single treatment. Contribution: This research provides, for the first time, long-term data from a low-resourced setting on the use of SLT in the treatment of glaucoma in Eswatini.https://jcmsa.org.za/index.php/jcmsa/article/view/118glaucomacommunity eye healthselective laser trabeculoplastysub-saharan africaeswatini |
| spellingShingle | Emma J. Pons Jonathan J. Pons Elly S. Grossman Daniel Louw Merle Werbeloff Single treatment selective laser trabeculoplasty in a Southern African resource-constrained context Journal of the Colleges of Medicine of South Africa glaucoma community eye health selective laser trabeculoplasty sub-saharan africa eswatini |
| title | Single treatment selective laser trabeculoplasty in a Southern African resource-constrained context |
| title_full | Single treatment selective laser trabeculoplasty in a Southern African resource-constrained context |
| title_fullStr | Single treatment selective laser trabeculoplasty in a Southern African resource-constrained context |
| title_full_unstemmed | Single treatment selective laser trabeculoplasty in a Southern African resource-constrained context |
| title_short | Single treatment selective laser trabeculoplasty in a Southern African resource-constrained context |
| title_sort | single treatment selective laser trabeculoplasty in a southern african resource constrained context |
| topic | glaucoma community eye health selective laser trabeculoplasty sub-saharan africa eswatini |
| url | https://jcmsa.org.za/index.php/jcmsa/article/view/118 |
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