Selective laser trabeculoplasty

Selective Laser Trabeculoplasty (SLT) is the latest technique in glaucoma treatment. It is effective, fast, and painless.

What is SLT?

SLT, or selective laser trabeculoplasty, is a simple but effective laser procedure, which reduces intraocular pressure and is indicated for glaucoma. This treatment can be performed as an outpatient procedure and takes less than 5 minutes.

SLT principle

SLT employs short, low-energy laser pulses directed only at the drainage zone tissue, followed by an improvement in the intraocular fluid outflow and a decrease in intraocular pressure. The eye structure is not affected by SLT.

CAUSE OF GLAUCOMA: Intraocular fluid is constantly secreted in the eye and circulates between the lens and cornea, flowing out of the eye through a drainage system through a peculiar network called the trabeculae. When this network is blocked, the fluid outflow is disturbed, and the intraocular pressure rises. Thus, open-angle glaucoma (the most common form of the disease) may develop.

Is the SLT procedure painful?

No, SLT is painless. Moreover, there are no side effects to worry about.

What happens during the SLT procedure?

Before the procedure, local anesthesia is dropped into the eye. Using a special microscope, pulses of laser radiation are delivered to the right points in the drainage area of the eye with extreme precision.

The entire process takes several minutes and is hardly felt by the patient. After the procedure, your physician will recommend anti-inflammatory eye drops. Four to six weeks after the procedure, your intraocular pressure should decrease significantly.

How often can SLT be repeated?

SLT is an attenuated, non-invasive procedure, allowing it to be repeated if necessary. In comparison, it was almost impossible to repeat laser procedures that were used previously (when SLT was not available).

Who is eligible for SLT?

If you fit into one of the following categories, you may be eligible for SLT:

• If you have open-angle, pseudoexfoliative, or pigmentary glaucoma (your ophthalmologist can explain what form of glaucoma you have);
• If you are intolerant to the eye drops or you cannot apply them as intended;
• If the eye drops do not reduce your intraocular pressure enough, you can have SLT and then continue the hypotensive drops;
• If you have difficulty being monitored and treated for glaucoma for any reason (the eye drops are too expensive for you, you have difficulty seeing an ophthalmologist regularly, etc.);
• If you have had other laser surgery before (e.g., argon laser trabeculoplasty), but your intraocular pressure is rising again.

What if SLT fails?

On average, SLT reduces intraocular pressure by 25% in 75% to 85% of patients. For those who don’t, there are other therapies, including surgery and traditional medications.

Why is it crucial to monitor intraocular pressure?

Intraocular fluid is continuously secreted in the eye and circulates between the lens and cornea, draining out of the eye through a peculiar network called the trabecular meshwork. When this network becomes blocked, the fluid outflow is disturbed and the intraocular pressure increases. This is how open-angle glaucoma (the most common form of glaucoma) may develop. A recess in the optic disk (glaucomatous excavation) is circled in green, which expands due to the increased intraocular pressure, and characterizes the disease progression.

What other glaucoma treatments are available?

• The most common treatment for glaucoma is local medication, but it can have side effects. Additionally, drug therapy is not always effective enough. Furthermore, it is equally essential to put drops in every day at the same time, as well as carry the drops with you at all times;
• If the intraocular pressure cannot be lowered, artificial ways of intraocular fluid outflow are created surgically. In such cases, we implant an Ex-Press fluid filtration device;
• Previously, argon laser trabeculoplasty was widely used in glaucoma treatment. But it involved many complications, the main one being irreversible damage to the eye tissue due to scarring;