Study Reports Failure Rates of IOP-Lowering Treatment Options

Selective laser trabeculoplasty along with a topical agent can increase the long-term effects of treatment for patients with ocular hypertension and primary open-angle glaucoma. Photo: Nate Lighthizer, OD. Click image to enlarge.  Ocular hypertension can lead to more complications like primary open-angle glaucoma (POAG), but early treatment can reduce the risk of further progression. Different management options available are safe and effective, but there are times in which a method will fail, and patients may need to seek retreatment or another form of therapy. However, the long-term outcomes of particular surgeries and medications are not often reported on, and further investigations are needed to determine their lasting effects.In a recent study, London researchers reported on the effectiveness of intraocular pressure (IOP)-lowering treatments for both ocular hypertension and POAG. They analyzed 4,564 eyes from 2,708 patients who were treated with selective laser trabeculoplasty (SLT) or topical therapeutics at eye care centers in the United Kingdom. A total of 2,013 patients received topical agents, and 140 patients underwent SLT.Over a 10-year observational period, the researchers examined the duration of treatment success by analyzing the time to treatment failure. They discovered that the median time to treatment failure for patients taking solely topical medications was 1.72 years, which was a longer duration compared to the 1.35 years reported in the SLT group.Some patients escalated to two topical agents (n=467), and others escalated to one topical agent along with SLT (n=88). The median time to treatment failure for patients taking two medications was 1.32 years, and the median time for patients taking one medication plus SLT was 1.53 years.“This study reports the real-world treatment outcomes following SLT and medical therapy following initiation of IOP-lowering treatment and intensification from a single topical drop,” concluded the authors in their study’s paper. “A difference in the efficacy between real-world settings and randomized controlled trials is noted, underscoring the importance of real-world studies. Such data provide valuable insights into the effectiveness of treatments in a more varied clinical setting, offering a more accurate reflection of the expected outcomes in routine care.” Click here for the journal source. Fu DJ, Sharma I, Farwana R, et al. Real-world outcomes of selective laser trabeculoplasty and medical treatment in primary open-angle glaucoma and ocular hypertension. BMJ Open Ophthalm 2025;10:e002151.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.