Selective Laser Trabeculoplasty (SLT)
Selective Laser Trabeculoplasty (SLT) is a form of laser treatment that lowers the pressure and helps glaucoma patients by applying laser energy to the eye’s drainage tissue, starting a chemical and biological change in the tissue that can lead to better fluid drainage out of the eye.
This video provides a brief introduction to selective laser trabeculoplasty (SLT) for treating open-angle glaucoma.
It’s called “Selective” because the laser selectively affects the pigmented tissue in the eye without causing collateral damage to other parts of the tissue. This advantage makes SLT repeatable in the proper setting.
Though traditionally used as an alternative or supplement to medication, SLT is quickly becoming more accepted as a first-line treatment. From the Glaucoma Laser Trial in 1995 to the more recent LiGHT clinical trial, large clinical studies have shown initial laser for open-angle glaucoma to be equivalent or even superior to medications.
Selective laser trabeculoplasty (SLT), often a first-line treatment for Open-Angle Glaucoma, can also be effective in patients already on eye drops. SLT uses low levels of laser light to improve drainage of intraocular fluid through the natural drainage pathway out of the eye. For most eyes this improved drainage helps lower eye pressure and a single treatment’s effect lasts 2 to 3 years, and sometimes longer. Since SLT leaves the drainage canals intact, it can be repeated if the initial treatment was effective. Minor self-limited inflammation follows SLT and may aid in the eye pressure lowering effect.
Some patients can have their eye pressure controlled with SLT alone. Others require glaucoma medications also or incisional surgery in the operating room.
What to expect from SLT treatment:
- SLT is performed in an outpatient setting, frequently in the doctor’s office.
- Your doctor will use special eye drops to numb your eye. Then, your doctor will have you sit at the laser and place a special lens with contact lens gel on your eye to help direct the laser light onto the drainage canals in your eye.
- You will hear a series of clicks and see bright lights, like a camera flash, as your doctor performs the procedure. You may feel a slight tingling sensation, but the procedure is nearly painless.
- SLT takes about 5-10 minutes.
- At the end of the treatment, the lens is removed and your vision will be blurry until the thick contact lens gel is rinsed off.
- After the treatment, you should take it easy for a day and then return to your daily routine.
The Light Study for SLT
A 2019 report in “The Lancet” said the laser treatment selective laser trabeculoplasty, or SLT, should be offered as first-line treatment for glaucoma, replacing the prescribing of pressure-lowering eye drops. The study revealed that SLT is not only more effective and safer, but can also save money in health care costs.
Due to its excellent benefit-to-risk profile, Selective Laser Trabeculoplasty, or SLT, is being offered earlier in the treatment of glaucoma, including as primary therapy.
Watch a recorded webinar “SLT and the LiGHT Trial” in which Inder Paul Singh, MD, President of The Eye Centers of Racine & Kenosha, shares his insights about the benefits of Selective Laser Trabeculoplasty (SLT) for glaucoma, and Gus Gazzard, MD, Director of the Glaucoma Service at Moorfields Eye Hospital, discusses results from the “Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial.”
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