SELECTIVE LASER TRABECULOPLASTY

What is SLT?

Selective Laser Trabeculoplasty (SLT) is a laser treatment that is performed on the drain of the eye (the angle) the lower eye pressure (IOP) to treat glaucoma. It was FDA approved in 2001. It can be used as a first option before starting eye drops OR if eye drops are not lowering the pressure enough or you do not tolerate them. It is a painless in-office procedure that takes less than 5 minutes.

How does SLT work?

Gentle laser energy is applied to the drain of the eye which helps lower the eye pressure. 

It does not cause any scarring or lasting damage to the eyes. 

On average, it takes 4-6 weeks to see a response. In some cases, it may be 2-3 months before a full response can be seen. 

How successful is SLT?

SLT is about 80% effective in lowering eye pressure

This is typically equivalent to one eye drops and may either replace drops or be used in addition to drops you currently use.

The effect will generally last between 1-5 years, and in some cases, even longer.

If it works initially but wears off, the treatment can be repeated. It may not be as effective on repeat treatments.

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Will I still need eye drops?

Depends on each patient.

Some patients can be controlled with laser alone. Other patients require additional treatment including drops to achieve the target pressure. 

Are there side effects?

The procedure is pain-free. 

You may experience a slight pressure sensation immediately after the procedure which can last 1-2 days. A sandy or gritty feeling in the eye is normal as well. Your vision should not get worse (or better).

There are NO restrictions after the laser. You may exercise, shower, and go back to work as soon as you feel comfortable.

What if it doesn't work?

If SLT doesn’t work enough and the pressure is still too high, then other treatments such as eye drops, dissolvable implants, or surgery, will be used to treat glaucoma. The laser does NOT affect the success of these treatments. 

WHAT DOES THE RESEARCH SAY?

SELECTIVE LASER TRABECULOPLASTY (SLT)

FOR 1ST LINE TREATMENT OF OCULAR HYPERTENSION (HIGH EYE PRESSURE) AND OPEN-ANGLE GLAUCOMA (LiGHT): A MULTICENTER RANDOMIZED CONTROLLED TRIAL

– THE LANCET – April 2019 –

  • Patients were treated with EITHER laser only OR glaucoma eye drops.

  • After three years, 74% of patients who received SLT as their first treatment did not require drops..

  • 93% of patients in the laser group had better IOP control  compared to 91% in the eye drop group.

  • Glaucoma surgery in the operating room was required to control eye pressure for 11 patients in the eye drop group vs ZERO patients in the laser group.

CONCLUSION: “Selective laser trabeculoplasty should be offered as a first-line treatment for glaucoma and ocular hypertension.”