Selective Laser Trabeculoplasty

As discussed earlier, the goal of glaucoma treatment is to lower the eye pressure. Selective Laser Trabeculoplasty or SLT can accomplish this in a safe and effective manner by helping to drain aqueous humor out of the eye.

This laser procedure is performed in the office setting. The eye is numbed and a lens is placed on the eye to direct the beam of laser to its proper place which is the trabecular meshwork or the drainage system of the eye. It takes only a few minutes to perform the laser so it is a very fast procedure. During the treatment, you will feel no pain. Occasionally some patients may feel a slight discomfort but since the procedure is very quick, it is over in no time. You may see a green flash of light during the treatment process.

The mechanism of action of the laser is the following: The SLT employs a specific wavelength of energy in a very short duration of time 3 nanoseconds to be exact. This burst of energy is absorbed only by melanin-containing or pigmented cells found in the drainage system while the surrounding tissues are unaffected. The body clears these pigmented cells and the overall effect is to open the drain. More fluid is able to drain out of the eye so the overall eye pressure goes down.

The full effect of SLT sometimes takes about a month to kick in and a follow-up visit will determine how effective the SLT was. If glaucoma is present in both eyes, the laser treatment is performed one eye at a time.

One of the main benefits of SLT is that it is not associated with systemic side effects, unlike drops which are absorbed by the eye as well as the body. Compliance with medications or having to remember to take the drops is not an issue with the laser since it works on its own 24 hours a day. This procedure is covered by Medicare and most health insurance.

The laser will generally last for several years and may be repeated in the future if the effect wears off. SLT works in most kinds of glaucoma but not all.