Selective laser trabeculoplasty compared with medical treatment for the initial management of open angle glaucoma or ocular hypertension.

Selective laser trabeculoplasty is a relatively new therapeutic alternative for the management of open angle glaucoma and ocular hypertension. On the other hand, medical treatment has robust data supporting its efficacy and has progressed in last decades with the introduction of prostaglandin analogues. To compare these two therapies, we searched Epistemonikos database, which is maintained by screening 30 databases, and identified four systematic reviews including four randomized and one non-randomized clinical trial. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded that selective laser trabeculoplasty leads to a smaller absolute intraocular pressure reduction than medical treatment. However, it is not clear if there are differences in treatment success rate or need of additional antiglaucomatous interventions, because the quality of the evidence is low.