SLT suitability criteria
You may be a good candidate for selective laser trabeculoplasty (SLT) if:
- You have primary open-angle, pseudoexfoliation, or pigmentary glaucoma. (If you’re not sure, ask your ophthalmologist.)
- You are intolerant of glaucoma medications or have difficulty taking them as prescribed.
- You are currently undergoing glaucoma drug therapy and wish to combine it with SLT.
- It is difficult for you to commit to regular follow-up treatments such as lack of transportation, or other limitations.
- You have a history of unsuccessful ALT (argon laser trabeculoplasty) treatment.
How SLT works
Selective Laser Trabeculoplasty (SLT) is a simple yet effective laser procedure that reduces the intraocular pressure inside the eye.
SLT can be used as the first treatment once glaucoma is diagnosed, avoiding the usual need for daily eye drops. It may be used in patients already on eye drops to allow them to stop or reduce their eye drops if found to be inconvenient or if side effects are a problem. Finally, it can be used in an attempt to avoid the need for glaucoma surgery if eye drops are not controlling the pressure well enough.
SLT uses short pulses of low-energy light to target the melanin, or pigment, in specific cells of the affected eye. In response, the body’s natural healing mechanisms rebuild these cells. This rebuilding process improves drainage and lowers intraocular pressure. The surrounding, non-pigmented cells, as well as the rest of the eye structure, are untouched and undamaged.
How often can I have SLT done?
SLT is gentle and non-invasive, which allows the procedure to be repeated if necessary.
Advantages and Disadvantages
- Effective in lowering your eye pressure
- Quick and painless procedure
- Can avoid or reduce your need for eye drops
- Can be repeated
- No laser procedure is entirely risk free
- The success of the treatment is dependent on other treatment steps being effective
- Inflammation in eye
- Swelling of cornea (window of eye)
- Reduced vision
SLT options and alternatives
For those that do not respond to SLT, other forms of treatment, including eye drops or glaucoma surgery are alternatives.
I perform SLT in the clinic as a day treatment. The entire process takes just 5 to 10 minutes.
Step one: Before treatment, I administer eye drops to prepare and numb the eye.
Step two: I then position a contact lens onto the eye, which helps to target the laser and hold the eyelids out of the way.
Step three: The laser delivers gentle pulses of light through a specially designed microscope.
You will need to have your eye pressure checked six weeks later.
SLT lowers intraocular pressure by an average of 25% in up to 75% of patients treated. It does wear off in some patients, and the success rate at three years is approximately 50%.