What to Know About SLT for Glaucoma
Submitted by Atlanta Vision Cataract and Laser Center on May 12, 2021
High intraocular eye pressure (IOP) contributes to glaucoma. IOP may respond to eye drops, but if it does not, selective laser trabeculoplasty (SLT) is a safe alternative. Studies also show that in some cases, SLT may be the more efficient and cost-effective first-line treatment.
The top eye specialists at Atlanta Vision Cataract and Laser Center discuss what you need to know about SLT for glaucoma to keep your eyes healthy.
Selective Laser Trabeculoplasty
SLT is as, if not more, effective in lowering IOP as the prostaglandin analogs, the most powerful form of glaucoma medications. In fact, the LiGHT trial found that SLT was better at lowering IOP than drop therapy — additionally, it was more cost-efficient as a first-line treatment. SLT has a strong track record. It has been used in the U.S. and worldwide for over a quarter-century.
This procedure is called “selective” because the cold laser is absorbed by certain pigmented eye tissue only. Patients experience little or no pain, and relatively little scar tissue is produced using this method.
The laser energy starts a biological change in the eye tissues. In time, IOP is lowered. SLT is a treatment, not a cure, for glaucoma, but that is also true of other medications or surgeries.
Those with open-angle glaucoma, the most common type of the disease, are possible SLT candidates. The drainage angle of the cornea and iris is open but the trabecular network is blocked. That network, located in the tissue around the cornea’s base, drains the aqueous humor from the eye by way of the anterior chamber.
This blockage gradually increases IOP while damaging the optic nerve. SLT lowers this pressure.
Potential Side Effects
SLT is a generally safe procedure with few, if any, side effects. Expect some mild postoperative inflammation, which is easily treated with eye drops or an over-the-counter oral non-steroidal inflammatory drug (NSAID).
There is a slight risk of short-term elevated IOP after laser surgery. Glaucoma drugs can alleviate elevated IOP, which seldom lasts more than a day.
After SLT, many patients no longer need glaucoma medications. Some may need further IOP lowering, so glaucoma medication may prove necessary. Keep in mind that it can take up to three months for complete results.
SLT should lower IOP by at least 30 percent when used as the initial treatment. There is a lesser effect for those already taking glaucoma medications.
Sometimes, SLT does not work. If the effect lasts less than a year, it is considered an unsuccessful therapy. Other medications or surgeries are then used for glaucoma treatment.
After several years, the IOP-lowering effects of SLT wear off. The procedure is then repeated.
If you would like to learn more about SLT and whether you are a candidate for this surgery, contact the dedicated eye care specialists at Atlanta Vision Cataract and Laser Center to schedule a consultation.