Selective laser trabeculoplasty (SLT) was associated with slower structural glaucoma progression on optical coherence tomography (OCT) after treatment, according to a retrospective study presented at the 2026 Association for Research in Vision and Ophthalmology (ARVO) annual meeting in Denver.
“Selective laser trabeculoplasty is widely used to lower intraocular pressure (IOP) in patients with open-angle glaucoma, and following the LiGHT trial demonstrating that SLT is an effective first-line treatment, its use has expanded significantly,” said Raeesah Ahsan, BA, a research fellow in the glaucoma service at Wills Eye Hospital in Philadelphia. “However, the impact of SLT on structural disease progression remains less well defined.”
Ms. Ahsan noted that because optical coherence tomography (OCT)-derived structural measurements are a standard component of glaucoma management and are routinely used to monitor progression, understanding the structural effects of SLT is clinically important. “We conducted this study to evaluate whether SLT not only lowers IOP but also slows structural glaucomatous progression as measured by longitudinal OCT changes.”
Results
The study included 25 eyes (21 subjects). At baseline, mean age (SD) was 63.0±7.7 years and retinal nerve fiber layer (RNFL) thickness was 73.3±14.1 µm.
“The study showed that prior to SLT, several structural parameters, particularly average, superior, and inferior RNFL thickness, showed significant progressive thinning over time,” said Ms. Ahsan. “However, after SLT, rates of change for all evaluated OCT parameters were no longer significantly different from zero; progression slowed significantly after SLT compared to before for average RNFL thickness, superior RNFL, and cup-to-disc ratio.”
Ms. Ahsan added that these structural findings were accompanied by a modest but statistically significant reduction in mean IOP following SLT. “Together, these results suggest that SLT may help slow progression of glaucomatous damage over time,” she noted.
Why This Study Is Important
Ms. Ahsan explained that these findings provide clinically relevant evidence that SLT may do more than lower IOP—it may also slow structural progression as measured by OCT.
“OCT is routinely used in glaucoma management and demonstrated slowing of RNFL thinning after SLT supports this,” concluded Ms. Ahsan. “This is particularly important when considering earlier use of SLT, counseling patients about expected outcomes, and evaluating treatment success beyond IOP alone. For ophthalmologists, these results reinforce SLT as a meaningful therapeutic option that may help preserve the optic nerve.” OM