CONDITION :
Selective Laser Trabeculoplasty (SLT)
A Gentle, Effective Laser Option to Lower Eye Pressure and Manage Glaucoma
One of the most effective laser therapies for glaucoma is Selective Laser Trabeculoplasty (SLT) - a safe, outpatient procedure that can significantly reduce intraocular pressure (IOP), the primary risk factor for glaucoma-related vision loss. It is now recommended as first-line treatment for new diagnoses of glaucoma by the National Institute of Clinical Excellence (NICE).
What Is SLT?
Selective Laser Trabeculoplasty (SLT) is a non-invasive laser procedure used to treat open-angle glaucoma and ocular hypertension. It uses a low-energy laser to stimulate the eye's natural drainage system (called the trabecular meshwork), enhancing fluid outflow and lowering eye pressure without causing permanent tissue damage. Unlike older laser treatments, SLT is "selective" because it only targets specific pigmented cells within the drainage tissue, leaving surrounding structures untouched. This allows for a gentler, repeatable treatment with minimal risk of scarring.
How SLT works
-
Inside your eye, a clear fluid called aqueous is continuously produced and drained.
-
In glaucoma, the drainage system becomes less efficient, causing a buildup of pressure that can damage the optic nerve and lead to vision loss.
-
SLT uses a targeted laser to stimulate biological changes in the drainage tissue, increasing fluid outflow and reducing intraocular pressure.
By lowering IOP, SLT helps slow or halt the progression of glaucoma, preserving your vision over time.
Benefits of SLT
Frequently asked questions
Who is a Good Candidate for SLT?
SLT may be a suitable option if:
-
You have been diagnosed with open-angle glaucoma or ocular hypertension
-
You're not achieving target eye pressure with medications alone
-
You have difficulty using or tolerating prescription eye drops
-
You're seeking to reduce your dependence on daily medications
-
You're newly diagnosed and prefer a non-pharmacologic first-line treatment
Not all glaucoma types are suitable for SLT - Mr Vig will advise if SLT is a good option for you.
What to Expect During the SLT Procedure
1. Before the procedure
-
The procedure takes place in the outpatient clinic
-
Your eye will be numbed with anaesthetic drops.
-
A special contact lens will be gently placed on your eye to help focus the laser.
2. During the procedure
-
The laser delivers brief pulses of light to the trabecular meshwork
-
You may see bright flashes or feel a slight tapping sensation
-
The procedure typically takes 10-15 minutes
-
Your eye pressure will be checked about 1 hour after the laser
3. After the procedure
-
You may experience mild irritation or blurry vision for a few hours.
-
Anti-inflammatory eye drops may be prescribed for a few days.
-
You will return for a follow-up visit within several weeks to check your eye pressure.
.jpg)
How Effective is SLT?
-
SLT lowers intraocular pressure by 20-30% in most patients, comparable to the effect of daily eye drops.
-
Results are often noticeable within a few days to a few weeks.
-
For some patients, SLT can delay or eliminate the need for glaucoma medications.
-
The effects of SLT typically last 2 to 5 years and can be safely repeated if necessary.
It's important to remember that while SLT helps control eye pressure, it does not cure glaucoma or restore lost vision. Regular monitoring and follow-up care remain essential.
Risks and Side Effects
SLT is a low-risk procedure, but like any medical treatment, it can have side effects. These may include:
-
Mild eye discomfort or redness (usually temporary)
-
A short-term spike in eye pressure (rare and usually controlled)
-
Inflammation inside the eye (easily treated with drops)
-
In around 20% of patients, the treatment may not lower pressure at all
