Fresh Support for Laser Trabeculoplasty

Coding: CMS proposes to increase physician payment for in-office laser trabeculoplasty.

Glaucoma Physician September 1, 2025 Page(s): 23-24

Clinical Report: Fresh Support for Laser Trabeculoplasty

Overview

Recent findings support the use of laser trabeculoplasty (LTP) as a first-line treatment for primary open-angle glaucoma (POAG) and ocular hypertension (OHT), highlighting its effectiveness in controlling intraocular pressure (IOP) and reducing the need for medications. The proposed increase in physician payment for LTP further underscores its growing relevance in glaucoma management.

Background

The management of POAG and OHT is critical due to the potential for visual impairment and the challenges associated with medication adherence. Recent studies, including the LiGHT trial, have demonstrated that laser treatments can provide effective pressure control while minimizing reliance on patient compliance with topical medications. This shift in treatment paradigms emphasizes the importance of incorporating evidence-based practices in glaucoma care.

Data Highlights

No specific numerical data provided in the source material.

Key Findings

Three-quarters of ophthalmologists prefer topical medications as first-line therapy for POAG, yet most would choose laser trabeculoplasty (LTP) for themselves.
The LiGHT trial showed that selective laser trabeculoplasty (SLT) leads to slower glaucoma progression compared to eye drops.
Current guidelines recommend SLT as a first-line treatment for newly diagnosed OHT with IOP of 24 mmHg or more.
SLT is associated with better long-term disease control and reduced need for incisional surgery compared to medication-first approaches.
CMS plans to increase reimbursement for LTP, reflecting its recognized value in glaucoma treatment.

Clinical Implications

Clinicians should consider SLT as a viable first-line treatment option for patients with POAG and OHT, particularly in light of its effectiveness and the challenges associated with medication adherence. The anticipated increase in reimbursement may also facilitate greater adoption of LTP in clinical practice.

Conclusion

The evolving landscape of glaucoma treatment underscores the importance of laser trabeculoplasty as a first-line option, supported by recent evidence and favorable policy changes. Continued emphasis on patient-centered care and adherence strategies will be essential in optimizing glaucoma management.

PentaVision

Glaucoma Physician