At the 2025 meeting of the American Academy of Optometry, Komal Patel, OD, presented on laser procedures for glaucoma. Here she discusses key takeaways.
Transcription:
Hello, my name is Komal Patel. I am an optometrist and assistant professor at the Oklahoma College of Optometry. I recently presented my lecture, "Laser Interventions in Open and Closed Angle Glaucoma," at the American Academy of Optometry meeting in Boston.
The first half of this lecture focused on SLT—Selective Laser Trabeculoplasty. Attendees were encouraged to begin considering SLT as a first-line therapy for open-angle glaucoma. Both the 3-year and 6-year LiGHT trial studies have shown that SLT should be considered a first-line treatment for open-angle glaucoma and ocular hypertension because it is a safe procedure that may provide better long-term disease control.
We also discussed annual low-energy SLT and direct SLT techniques. It will be very interesting to see the results of those studies as they are published.
The second part of the lecture focused on the management of closed-angle glaucoma, including the use of Laser Peripheral Iridotomy (LPI). The most common reasons we perform LPI are for acute primary angle closure, chronic angle closure, or as prophylaxis for narrow angles.
LPI is a laser procedure that is performed less frequently than SLT. Studies such as the ZAP trial and the EAGLE study have shown that widespread prophylactic LPIs for primary angle closure suspects are not recommended, especially since phacoemulsification lens extraction has emerged as a beneficial alternative. However, LPI still has a place in clinical practice. Having open conversations with patients about all their treatment options is key to helping them be active participants in their care and management.
During the lecture, we also discussed procedural techniques, pre-op and post-op assessments, laser settings, clinical pearls, and possible risks for both SLT and LPI. These are both in-office procedures that more and more optometric physicians across the country are being permitted to perform. This trend will only continue to improve access to care and enhance quality of life for our patients.
Thank you very much. OM