EFFECT OF SELECTIVE LASER TRABECULOPLASTY SHOT COUNT AND PULSE ENERGY ON INTRAOCULAR PRESSURE REDUCTION IN A REAL-WORLD NATIONAL HEALTH SERVICE (NHS) COHORT.

Abstract

Objective: This study investigates the relationship between selective laser trabeculoplasty (SLT) treatment parameters, specifically shot count and pulse energy, and intraocular pressure (IOP) reduction in a real-world National Health Service (NHS) cohort.

Methods: A retrospective analysis was conducted on 114 eyes with complete baseline and first follow-up IOP data. The total shot count and mean pulse energy were documented, with energy ranges averaged for each eye.

Correlations between shot count, pulse energy, and IOP reduction, both absolute and percentage, were assessed using Pearson’s correlation coefficients.

Results: The mean baseline IOP was 23.1 mmHg, and the mean follow-up IOP was 16.2 mmHg, representing a mean reduction of 6.9 mmHg (22.0%). The mean shot count was 111.0 ± 28.4, and the mean pulse energy was 0.65 ± 0.16 mJ. The correlation between shot count and percentage IOP reduction was minimal (r = 0.03), and the correlation between pulse energy and percentage reduction was also weak (r = −0.08).

Conclusion: In this NHS cohort, variability in SLT shot count and pulse energy did not significantly influence IOP reduction. These findings suggest that biological factors, such as trabecular meshwork responsiveness, may play a more important role in treatment outcomes than adjustments in laser parameters. Once a standard SLT treatment is applied, increasing shot count or pulse energy does not appear to substantially enhance efficacy and may increase discomfort or risk.