Objective:

To evaluate the long-term effectiveness and safety of selective laser trabeculoplasty (SLT) as a first-line treatment for newly diagnosed open-angle glaucoma, highlighting its significance in current treatment practices.

Key Findings:

• Economic analysis favored SLT as the more cost-effective treatment option, suggesting significant implications for healthcare resource allocation.

Interpretation:

SLT may offer additional protective benefits against disease progression beyond IOP reduction, leading to a shift in treatment paradigms in the UK and recommendations in the US, potentially influencing clinical guidelines.

Limitations:

• The study excluded patients with advanced disease, angle-closure glaucoma, childhood glaucoma, or secondary glaucoma, which may limit the applicability of the findings to a broader patient population.

Conclusion:

SLT is a safe and effective first-line treatment for newly diagnosed open-angle glaucoma, with potential benefits in reducing disease progression and surgical interventions, underscoring its role in evolving treatment paradigms.