Objective:

To emphasize the importance of office-based therapies like selective laser trabeculoplasty (SLT) and sustained drug delivery in enhancing glaucoma management and patient outcomes.

Key Findings:

• Office-based procedures like SLT can improve patient compliance and reduce the need for surgical interventions, leading to better long-term outcomes.
• Long-term use of IOP-lowering drops can lead to ocular surface disease and affect surgical outcomes, necessitating a reevaluation of treatment strategies.
• SLT remains underutilized as a first-line therapy despite supporting data from the LiGHT trial, indicating a need for increased awareness among practitioners.

Interpretation:

The shift towards office-based therapies represents a new interventional glaucoma mindset, focusing on early intervention, improved patient quality of life, and a proactive approach to treatment.

Limitations:

• SLT and drug delivery systems may not provide permanent solutions and may require repeated treatments, which can affect long-term patient management.
• Current FDA-approved sustained-release drug delivery systems are limited, with ongoing research needed to expand options.

Conclusion:

Office-based therapies are foundational in glaucoma management, offering a balance between effective IOP control and enhanced patient quality of life, and should be integrated into standard clinical practice.