Selective Laser Trabeculoplasty (SLT) is a minimally invasive laser procedure used to lower intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. It targets the trabecular meshwork, the drainage system of the eye, to improve the outflow of aqueous humor (fluid inside the eye). By enhancing drainage, SLT helps reduce eye pressure, slowing the progression of glaucoma and preventing vision loss.
How Does SLT Work?
SLT uses a low-energy laser to selectively treat pigmented cells in the trabecular meshwork without damaging Glaucoma surrounding tissues. The procedure stimulates the body’s natural healing response, leading to improved drainage over time.
Unlike Argon Laser Trabeculoplasty (ALT), which causes permanent scarring, SLT is a gentler and repeatable treatment option.
Who is a Candidate for SLT?
Doctors may recommend SLT for patients who:
- Have open-angle glaucoma (the most common form of glaucoma).
- Have ocular hypertension (high eye pressure without glaucoma damage).
- Need additional pressure reduction despite using glaucoma eye drops.
- Have difficulty using or tolerating glaucoma medications due to side effects or cost.
- Prefer a non-surgical, outpatient treatment option before considering more invasive surgeries.
SLT is not suitable for patients with narrow-angle glaucoma or extensive scarring in the trabecular meshwork.
How is SLT Performed?
SLT is an in-office procedure that takes about 5-10 minutes per eye and involves little to no discomfort.
Step-by-Step Process
- Numbing Drops – The doctor applies anesthetic eye drops to prevent discomfort.
- Lens Placement – A special contact lens is used to focus the laser on the trabecular meshwork.
- Laser Treatment – The doctor delivers short pulses of laser energy, treating only select pigment-containing cells while leaving surrounding tissue unharmed.
- Post-Treatment Care – Anti-inflammatory drops may be prescribed to reduce mild irritation.
Patients can resume normal activities the same day, but they should avoid rubbing their eyes and follow post-operative care instructions.
How Effective is SLT?
SLT can lower eye pressure by 20-30%, with effects lasting 3-5 years. However, its effectiveness varies based on:
- The patient’s eye anatomy and glaucoma severity.
- Whether SLT is used as a first-line treatment or after eye drops.
- The presence of pigment in the trabecular meshwork (darker pigment often responds better).
If eye pressure rises again, SLT can be repeated, but repeated treatments may become less effective over time.
Risks and Side Effects
SLT is generally safe, but some patients may experience:
⚠ Temporary eye redness and irritation
⚠ Mild inflammation or discomfort
⚠ A brief spike in eye pressure (rare)
⚠ Blurry vision for a few hours
Most side effects resolve within a few days without complications.
SLT vs. Glaucoma Medications
- SLT may replace or reduce the need for eye drops, offering a cost-effective, long-term solution.
- Unlike eye drops, SLT eliminates the risk of medication side effects such as dry eyes or allergies.
- Some patients still need eye drops or additional treatments after SLT to maintain pressure control.
Selective Laser Trabeculoplasty (SLT) is a safe, effective, and repeatable laser treatment for open-angle glaucoma and ocular hypertension. It provides long-term eye pressure reduction while avoiding medication side effects or invasive surgery. If you have glaucoma and are looking for alternative treatments, consult an ophthalmologist to see if SLT is right for you.