SLT: Optometrists Versus Ophthalmologists
Multicenter BMJ Open Ophthalmology study compares selective laser trabeculoplasty operations performed by ophthalmologists and optometrists
The Ophthalmologist | | 3 min read | News
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A recent UK-based multicenter observational study has evaluated the outcomes of selective laser trabeculoplasty (SLT) performed by optometrists and ophthalmologists for patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). As SLT becomes increasingly adopted as a first-line treatment for these conditions, the study offers particularly significant evidence relating to non-ophthalmologist professionals delivering the procedure – a practice that is becoming more common and more common in the UK’s National Health Service (NHS).
The study, conducted at three hospital eye units (Aintree, Manchester, and Macclesfield in the UK), involved 207 eyes from 131 patients, with 84 eyes treated by optometrists and 123 by ophthalmologists. All data was collected retrospectively, with several key outcomes, including intraocular pressure (IOP) reduction, visual acuity (VA), and the use of glaucoma medications over a 24-month period, being assessed by the researchers.
The main findings? There were no statistically significant differences in the reduction of IOP, changes in VA, or medication burden between the two groups at various time points throughout the 24 months post-treatment. Although ophthalmologist-treated eyes demonstrated slightly better IOP reduction at 24 months, the difference (1.8 mm Hg) was not statistically significant.
It was noted that, though optometrist-treated eyes had a higher rate of glaucoma surgery (13 percent) compared with ophthalmologist-treated eyes (9 percent), ophthalmologist-treated eyes tended to require more aggressive eye-drop treatments to maintain IOP control.
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The study also highlighted that the majority of optometrists performing SLT had undergone extensive training and were supervised by glaucoma specialists, operating in a shared-care model alongside ophthalmologists.
The authors conclude that SLT performed by trained optometrists can be viewed as a safe and effective alternative, delivering comparable outcomes to those achieved by ophthalmologists.
But what do you think about the evolving role of optometrists in glaucoma care – especially with increased demand for treatment and a workforce shortages in ophthalmology? Let us know.
