Retrospective review links higher TAPE score to better SLT outcomes in glaucoma

Photo by Enzo Tommasi / Unsplash

medRxiv Published April 29, 2026 Medically reviewed April 29, 2026 Study authors: Koval, L. DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider TAPE scoring as a potential predictor of SLT success, but recognize these findings are hypothesis-generating.

This retrospective review analyzed 62 eyes with glaucoma that underwent lower-energy selective laser trabeculoplasty (SLT) using a titrated energy-pigmentation (TAPE) construct. The study examined associations between TAPE scores and intraocular pressure (IOP) outcomes at 2 months and longer follow-up up to 3 years.

Higher TAPE scores (≥70) were associated with lower 2-month IOP (p<0.01) and a greater likelihood of achieving ≥20% IOP reduction. Additionally, higher scores correlated with fewer treatment escalation events and improved survival free of additional therapy. At 3 years, 85% of eyes in the high-TAPE group remained drop-free.

Safety data showed that low-grade anterior chamber inflammation was common but transient and self-limited. No clinically significant IOP spikes or sight-threatening adverse events were observed.

The authors note these findings are hypothesis-generating. The study is limited by its retrospective design, small sample size, and lack of a comparator group. Prospective studies are needed to confirm these associations before clinical application.

Study Details

EvidenceLevel 5

PublishedApr 2026

View Original Abstract ↓

Abstract Objective: To evaluate outcomes of lower-energy selective laser trabeculoplasty (SLT) using a titrated energy-pigmentation (TAPE) construct. Methods: This retrospective study analyzed de-identified clinical data of 62 eyes undergoing lower-energy SLT as part of routine care. Laser energy was titrated relative to trabecular meshwork (TM) pigmentation grade and quantified as the product of the two (TAPE score). For example, grade 2 pigmentation x 40mj total energy yields a TAPE score of 80. The primary outcome was intraocular pressure (IOP) at 2 months, with adjustment for baseline maximum IOP (Tmax) using analysis of covariance (ANCOVA). Durability was assessed using Kaplan--Meier survival analysis and Cox proportional hazards modeling. Results: After adjustment for baseline Tmax, higher TAPE scores ([≥]70) were associated with lower 2-month IOP (p<0.01) and greater likelihood of achieving [≥]20 percent IOP reduction. Over longer follow-up, higher TAPE scores were associated with fewer treatment escalation events and improved survival free of additional therapy. Low-grade anterior chamber inflammation was common, transient and self-limited. At 3 years, 85 percent of eyes in the high-TAPE group remained drop-free, accounting for retreatment where applicable. No clinically significant IOP spikes or sight threatening adverse events were observed. Conclusions: Higher energy-pigmentation (TAPE) scores were associated with improved short-term IOP reduction and greater durability following lower-energy SLT. These findings are hypothesis-generating and suggest that TM pigmentation-adjusted energy delivery may enhance biologic engagement of the trabecular outflow pathway and support prospective evaluation of individualized SLT dosing strategies.