Facilitators and Barriers to Using Selective Laser Trabeculoplasty (SLT) as First-Line Treatment for Glaucoma: Physician and Patient Views Gathered during an Exploratory Descriptive Qualitative Study

ABSTRACT

Purpose

To explore the perception of selective laser trabeculoplasty (SLT) among physicians and patients and the acceptance of using SLT as first-line treatment for glaucoma.

Methods

Exploratory descriptive qualitative study based on semi-structured interviews with glaucoma specialists and patients in two eye hospital of Zhejiang and Guangdong Provinces, China. Data were analyzed using the thematic analysis framework approach.

Results

11 glaucoma specialists and 12 glaucoma patients were interviewed. Four themes were identified in the data: Physicians’ preferences for treatment types, patient views on treatment types, decision-making during the physician-patient encounter and feasibility of SLT as a first-line therapy. Advantages of SLT include safety and repeatability with limited side effects. However, concerns about the durability of the effect of the treatment were often mentioned by both physicians and patients. Some factors such as practice preference, personal motivation and patient characteristics may influence treatment choice. Most patients lack knowledge about SLT and hold high expectations of their treatments. Physicians report insufficient evidence supporting the use of SLT as first line therapy. Physicians report the need for locally relevant, evidence-based guidelines regarding the use of SLT in the treatment of glaucoma.

Conclusions

SLT was suggested as the first-line treatment of glaucoma due to its reliable efficacy and potential advantage. Results from our study offer important insight into barriers of increasing the uptake of SLT, which also provides some guidance for the use of SLT in the future.

KEYWORDS:

• glaucoma
• selective laser trabeculoplasty
• facilitator
• barrier
• exploratory
• qualitative research

Disclosure statement

No potential conflict of interest was reported by the author(s).

Statement that this submission

This work has not been published anywhere previously and that it is not simultaneously being considered for any other publication.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This study was supported by the National Key Research and Development Project of China (2020YFC2008200), the Program for Zhejiang Leading Talent of S&T Innovation (2021R52012), Key Research and Development Projects of Zhejiang Province (2022C03112), the Zhejiang Provincial Program for the Cultivation of Leading Talents in Colleges and Universities (2020099)