DSLT Delivers Substantial IOP Reduction, Study Says

DSLT is an automated procedure that uses image-guided technology to lower IOP, typically taking about three seconds to complete. Photo: Alcon. Click image to enlarge. With selective laser trabeculoplasty (SLT) now regarded as a viable first-line therapy on par with medications, eye doctors are increasingly interested in offering this intervention or referring for it. The newer approach called direct SLT (DSLT), which foregoes a gonio lens by applying laser pulses through the peripheral cornea and limbus, has been less studied than the traditional approach. In a recent study published in JAMA Ophthalmology, researchers evaluated the safety and efficacy of DSLT in 218 eyes from 144 adults with ocular hypertension (OHT) or open-angle glaucoma (OAG). Participants underwent 360-degree DSLT and had a mean age of 72.29 years. The cohort was evenly split 50-50 between men and women. Among the subjects, 78% of eyes had glaucoma, while 22% had OHT; further, 23% of eyes were treatment-naive and the remaining 77% had already used glaucoma medications pre-study.The authors conducted a review of electronic medical records from patients; afterwards, they analyzed outcomes using the Voyager laser system.Patient IOP was then measured before treatment, 30 minutes afterward and again at a two-month follow-up visit. Treatment success was defined by the researchers in the study as either a 20% or greater IOP reduction or a decrease of at least 3mm Hg “without extra therapy.”At two months, 67% of eyes met the study’s success criteria. Mean IOP fell from 19.7mm Hg at baseline to 16.3mm Hg, representing a 15.57% reduction rate. Treatment-naive eyes achieved a greater reduction than previously medicated eyes, with success rates of 78.4% and 63.47%, respectively. Higher baseline IOP was associated with a stronger treatment response, while efficacy was similar across glaucoma subtypes, lens status and medication burden.In total, each eye’s BCVA remained stable throughout follow-up. The most common adverse event was subconjunctival hemorrhage, which occurred in 54.6% of treated eyes; conversely, IOP spikes were the least common, affecting only 1.8% of eyes, and all resolved after treatment with topical medication. The authors noted that, otherwise, “no serious ocular adverse events were reported.” They concluded that “DSLT may be a safe and effective treatment option for patients with OHT and OAG,” adding that the procedure’s design, which is “noncontact, rapid and standardized,” could make it a beneficial alternative to traditional glaucoma therapies.Click here for the journal source. Goldberg M, Shohat N, Garzozi D, et al. Safety and efficacy of direct selective laser trabeculoplasty in patients with ocular hypertension or open angle glaucoma. Journal of Glaucoma. June 1, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.