Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Malvankar, Monali

2nd Supervisor

Thind, Amardeep

Joint Supervisor

Abstract

Glaucoma is a leading worldwide cause of blindness. There has been a rise in studies published comparing the effectiveness of SLT versus medication for treating open-angle glaucoma. A systematic review and meta-analysis were conducted to compare SLT with medication therapies. At 52 weeks or longer, both the SLT group and the medication group had significant IOP reduction of 1.91 mmHg and 1.70 mmHg, respectively. At 6 months, medication with adjunctive SLT treatment significantly reduced the mean number of medications used by 0.78 where the medication treatment had no significant decrease. Quality of life between participants in the SLT and medication groups were found to be similar. Furthermore, a cost-effectiveness analysis was performed to assess the cost-effectiveness of SLT compared with medication. Using a Markov model, SLT treatment had a lower healthcare system cost of $2,189.74 and better health outcomes of 0.10 quality-adjusted life year per patient compared with medication treatment.

Summary for Lay Audience

Glaucoma is a common eye condition that can lead to vision loss if not managed. Traditionally, it has been treated using eye drop medications, but a laser procedure called Selective Laser Trabeculoplasty (SLT) is becoming an alternative therapy for glaucoma. There have been more recently published studies that compared the effectiveness of SLT versus eye drops for treating open-angle glaucoma, the most common form of the disease.

In this thesis, a systematic review and meta-analysis were conducted to evaluate the intraocular pressure reduction, number of medications, and quality of life comparing SLT with medication therapies. This study analyzed results from 16 clinical trials involving over 2,400 patients. It found that SLT significantly reduces eye pressure over time, which is critical for managing glaucoma. At six months of treatment, patients treated with SLT needed fewer medications, whereas those using eye drops alone showed no significant reduction in their medication use. Quality of life between the two groups was similar.

A cost-effectiveness analysis was conducted to assess the cost-effectiveness of SLT compared with eye drops over a 20-year period in Canada. It found that SLT not only led to better health outcomes but also saved money for the healthcare system. In a statistical model, patients treated with SLT had lower long-term costs and slightly better quality of life than those relying on medications alone.

These findings suggest that SLT is an effective and cost-efficient first-line treatment for glaucoma. By reducing the need for ongoing medication usage and providing better long-term outcomes, SLT could improve patient care and ease the financial burden on healthcare systems.

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Available for download on Monday, November 30, 2026

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