Selective laser trabeculoplasty, or SLT, is an FDA-approved laser procedure for the treatment of open-angle glaucoma. SLT is an advanced treatment option that lowers eye pressure and increases fluid drainage. It is minimally-invasive and uses low levels of energy to selectively pinpoint the areas of the trabecular meshwork, relieving the symptoms of glaucoma. If needed, the procedure can be repeated several times without causing damage to surrounding tissue.
What is selective laser trabeculoplasty?
Selective laser trabeculoplasty (SLT) has replaced argon laser trabeculoplasty for many patient situations. That’s because, in selective laser trabeculoplasty, our Southside Eye Care ophthalmologists use a laser that works at much lower levels. It treats specific cells “selectively,” leaving untreated portions of the trabecular meshwork intact. This allows SLT to be repeated later, if necessary.
Who is a candidate for selective laser trabeculoplasty?
Patients who have primary or secondary open-angle glaucoma (the drainage system in the front part of the eye is open) and are in need of lowering their intraocular pressure are good candidates for this laser procedure. This procedure isn’t right for all patients, but Dr. Keverline or Dr. Uber will discuss your candidacy with you during your consultation.
Advantages of SLT for Glaucoma
Performed as an in-office procedure, SLT takes just a few minutes yet provides long-term results. Other advantages of the SLT procedure include:
- Selective targeting of areas within the trabecular meshwork
- Minimal damage to surrounding tissue
- Reduction of intraocular pressure (IOP) by about 30 percent
- Minimal side effects
- Procedure can be repeated
SLT controls glaucoma symptoms for up to 5 years with no need for additional medication, and relieves symptoms by promoting the body's natural healing response. There are no major risks or complications associated with SLT and the procedure is covered by most major insurance companies.
How is selective laser trabeculoplasty performed?
For SLT procedures, Dr. Keverline or Dr. Uber first numbs the eye with topical eye drops, ensuring you won’t feel anything. The laser energy is then applied to the drain of the eye, which has been clogged and has caused intraocular pressure to rise. This creates openings in the trabecular meshwork, opening exits for fluid and lowering the pressure inside the eye.
These FDA-approved treatments only take a few minutes and we perform them in our offices on Churchland Boulevard.
What can I expect after having selective laser trabeculoplasty?
Selective laser trabeculoplasty lowers the eye pressure in about three-quarters of patients, and this lowers their risk of vision loss from glaucoma. Although the results are not typically permanent, the procedure can be repeated in the future if the pressure begins to build again. Recovery is minimal after SLT, and any future use of eye drops will be less than before the SLT was performed.
What are the risks involved with SLT surgery?
Complications with these laser surgeries are rare. The most common complication is an increase in the pressure in the eyes after this surgery. This rise usually occurs within 1 to 4 hours after the trabeculoplasty. To protect against this possibility, Dr. Keverline or Dr. Uber will place medicine in the patient’s eyes before or after the laser trabeculoplasty.
These are other possible complications of selective laser trabeculoplasty:
- A brief period of inflammation of the iris
- Cloudiness of the cornea, which usually quickly resolves
- Blockage of the drainage angle when the cornea and the iris stick together
- Decreased vision, which is usually temporary
How effective is selective laser trabeculoplasty? How long will my results last?
When used as the initial treatment for glaucoma, SLT lowers the patient’s intraocular pressure by about 30 percent. This is comparable to the use of the most powerful and commonly used class of glaucoma medication (prostaglandin analogs). This lowering of eye pressure lasts from 1-5 years in most patients, but it can last longer. At that point, if the pressure begins to increase again, SLT can be repeated. Sometimes, half of the meshwork may be treated in a first selective laser trabeculoplasty, with the other half treated in a second SLT.
Will I still need glaucoma eye drops after having SLT surgery?
Most patients still need to continue using glaucoma eye drops to keep their intraocular pressure down, but these laser procedures are likely to lessen the amount needed.
Is there recovery after selective laser trabeculoplasty?
As mentioned above, we perform these minor surgeries as outpatient procedures right in our offices. They don’t dictate much of a recovery. You’ll need someone to drive you home after the procedure. In general, patients can resume normal activities the next day after laser trabeculoplasty. Your eyes may be a bit irritated and your vision slightly blurry immediately after the procedure, but this resolves within a few hours.