Abstract Selective laser trabeculoplasty (SLT) is experiencing a renaissance as a frontline therapy for open-angle glaucoma and ocular hypertension, supported by evidence from randomized trials and long-term studies. Landmark results from the LiGHT trial demonstrated that primary SLT provides effective and durable intraocular pressure (IOP) reduction, reduces reliance on topical medications, and offers a cost-effective alternative to initial pharmacotherapy. Subsequent long-term follow-up and cohort studies confirm its safety and sustained benefit in diverse patient populations. Meta analysis further establish its efficacy across treatment protocols and suggest comparable outcomes to medical therapy, with the additional advantage of circumventing adherence challenges. Beyond initial treatment, it has shown utility in repeat procedures, adjunctive use, and application across glaucoma subtypes, although variability in response underscores the need for individualized patient selection. Important questions remain regarding durability, optimal retreatment strategies, and its comparative effectiveness against emerging laser technologies. This review synthesizes current evidence on SLT’s clinical utility, risks, and limitations, aiming to guide ophthalmologists in optimizing therapeutic protocols and integrating it into modern glaucoma management.
Priya et al. (Thu,) studied this question.