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Selective Laser Trabeculoplasty (SLT) is a relatively new laser treatment for open-angle glaucoma. SLT uses short pulses of low energy laser light to target melanin-containing cells in a network of tiny channels, called the trabecular meshwork. The objective of the surgery is to help fluids drain out of the eye, reducing intra-ocular pressure that can cause damage to the optic nerve and loss of vision.

The selective technique is much less traumatic to the eye than an older laser procedure called Argon Laser Trabeculoplasty (ALT). ALT can cause tissue destruction and scarring of healthy cells in the trabecular meshwork structure. SLT reduces intra-ocular pressure without this risk. SLT can be used to effectively treat some patients who could not benefit from ALT. This includes patients who have already been treated with ALT.

SLT has a very low risk and is highly effective, more and more patients are electing to have SLT performed as initial treatment for open angle glaucoma. Reasons for deciding to proceed with SLT include the side effects, inconvenience, and expense which can be associated with medications (eye drops). However, some patients may still require glaucoma drops after surgery.

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Laser surgery can reduce the need for daily medication
SLT is for those:
  • who have been diagnosed with glaucoma
  • whose doctor has determined that SLT is appropriate for controlling their intra-ocular pressure
  • patients with side effects or allergies due to glaucoma medications
  • patients with glaucoma which is unable to be controlled with medications
  • patients with a history of poor compliance with glaucoma medications
  • patients with disorders making daily instillation of eye drops difficult or impractical (for example, patients with rheumatoid arthritis or a history of stroke)
  • patients for which the expense of life long eye drops are a financial distress
What to expect on procedure day:

Your treatment will be performed in a standard exam room at Karlik Ophthalmology. It does not require a surgery center. Once you have been checked in and settled comfortably, drops will be used to numb your eye; no injections or needles are used. When your eye is completely numb, a contact lens with be placed on your eye to keep you from blinking and assist with the focusing of the SLT laser. You may see flashes of bright green or red light. Most patients do not feel any pain during the procedure. It takes less than 5 minutes.

Anti-inflammatory drops may be prescribed to alleviate any soreness or swelling inside the eye. You should relax for the rest of the day. Most patients can drive home following the procedure. Follow-up visits are necessary to monitor your eye pressure. While it may take a few weeks to see the full pressure-lowering effect of this procedure, many patients are eventually able to discontinue some or all of their medications. Most patients resume activities within a few days.

Realistic expectations:

The effect of the SLT surgery may wear off over time. However, SLT can be repeated safely when necessary. Serious complications with SLT are extremely rare, but like any surgical procedure, it does have some risks.

If you and your doctor decide that SLT is an option for you, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.