Use of Selective Laser Trabeculoplasty (SLT)
- An in-office procedure and its main use is to reduce eye pressure in patients at risk of glaucoma
- The laser is applied through a special contact lens to the drainage system of the eye where it stimulates a biochemical change that improves the outflow of fluid from the internal eye
- Can be used in combination with drops or as an alternative therapy when drops fail
- A flexible treatment option that can be repeated if necessary
- Approved by NICE guidelines as the first line of treatment to lower eye pressure
How does SLT work?
The trabecular meshwork is around the periphery of the coloured part of the eye, the iris. This is where fluid formed in the eye drains out of the eye. This meshwork is treated directly with the laser to improve drainage through it.
SLT uses short pulses of relatively low energy light to target only the melanin rich cells in the drainage channel of the eye. The laser pulses affect only these melanin containing cells, with the surrounding structure remaining unaffected. This gentle laser treatment induces a response from the body in which white cells are released to clear the affected cells and rebuild the meshwork so that it functions effectively again, reducing the eye pressure.
Benefits
- Lowers raised IOP without the side effects or difficulty of taking eye drops
- Particularly suitable for patients who cannot correctly use or are intolerant to glaucoma drops
- Can also be used alongside medication to enhance the overall eye pressure-lowering effect
- Can lower eye pressure by 20 to 30%. The laser is successful in about 80% of patients
- The treatment effect may last 3 to 5 years and can be repeated more than once
The Procedure
- Anaesthetic drops to numb the front of the eye
- A special lens will is placed against the front surface of your eye. This is not painful, but it might feel a little strange
- May see some flashes of light and hear a clicking sound during the procedure
- Takes about 10 minutes
- Eye pressure check after the procedure
- Appointment for you to come back to the clinic, usually one to two weeks later
- The treatment may take up to eight weeks to work
Potential side effects
- Blurred for a few hours following your laser treatment, but this will settle
- The risk of your vision being permanently affected from SLT is extremely low
- Eye pressure spike immediately after
- Mild inflammation
- In order to prevent this, we put in special drops prior to the procedure
- May also provide steroid drops, and occasionally extra glaucoma drops following the treatment
Rarely, the pressure in the eye rises very high and does not come down. If this happens, you might require surgery to lower the pressure. This is a very unusual and rare occurrence.
