Selective Laser Trabeculoplasty (SLT)

How does SLT work?
Laser energy is applied to the trabecular meshwork, a natural drain for fluid inside the eye. SLT stimulates the trabecular meshwork to drain more fluid from within the eye, which lowers eye pressure. It may take up to 2 months for SLT to reach its full effect.

Who needs SLT?
Patients with ocular hypertension or open-angle glaucoma who need improvement in eye pressure control can benefit. SLT can be used alone or in addition to eye drops.

What are the benefits?
On average, SLT can lower eye pressure by about 20-30%. The laser is effective in lowering eye pressure in about 80% of patients and may reduce the need for eye drops. The laser effect wears off after 1-3 years on average, but the trabecular meshwork can be stimulated again with repeat laser, typically for a total of 3 treatments. SLT does not affect the success rates or the eligibility of receiving other medical or surgical treatments.

What are the risks?
Compared to many other treatments for glaucoma, including eye drops, other laser treatments and surgery, SLT has few side effects. Inflammation after the laser is possible but not common. You may be instructed to use anti-inflammatory drops. There is a small risk of temporary high eye pressures shortly following the laser treatment. Your eye pressure will be checked after the laser and any elevation will be treated with eye drops.

Will SLT cure my glaucoma?
The simple answer is “No.” Glaucoma is a chronic disease that requires constant monitoring and treatment. The SLT procedure will help to lower your eye pressure. However, it will not reverse any loss of vision that has already occurred.

Can I stop my glaucoma drops after SLT?
Sometimes patients are able to reduce the number of drops they are taking. The need for eye drops long-term after SLT varies greatly and depends on your type of glaucoma and the rate at which it is progressing. Even if you need to continue drops, the laser is a success if it helps to lower your eye pressure.

What should I expect during SLT?
The treatment is usually performed in a specially equipped laser room. Eye drops will be used to numb your eye. No sedation, injections or needles will be used.

·       First, you will receive an eye drop which helps prevent a rise in the eye pressure after the procedure. Then a drop of anesthetic will be applied to numb the eye.

·       Gel and a special lens will be placed on your eye to help focus the laser on the trabecular meshwork. This lens also prevents your eye from blinking and keeps the eye still during the treatment.

·       You will place your head in a machine similar to an eye examination machine. Then you will hear a series of clicks and may see flashes of light as the laser treats your eye. You should not have any pain during the laser. You will feel the lens slowly rotating on the surface of the eye as various parts of the trabecular meshwork are treated. The procedure generally takes 5-10 minutes.

What should I expect after SLT?
At the end of the laser treatment, the lens will be removed from the eye. The gel may remain on your eye for up to an hour, leading to blurred vision or a feeling of heaviness. As a safety measure, your eye pressure will be checked approximately 30 minutes to an hour after the procedure.

Will my vision improve after SLT? 
This laser is for lowering the eye pressure and will not improve your vision.

What is the recovery time and what should I expect?
Though everyone heals differently, most people can resume normal activities right after treatment. For the next few days your eyes may be red, a little scratchy and sensitive to light if you develop inflammation in the eye after the procedure.

·       If there is any blurred vision, it usually improves within hours or a day.

·       There are no restrictions in reading, watching TV, using your phone, tablet device, computer, etc. but you may tire more easily during these activities.

·       You may use lubricating eye drops to help reduce any mild irritation, which is usually due to some dryness of the eye surface.

·       If your eye has severe pain or sudden worsening pain or vision after the laser, you should contact your doctor immediately.