Selective Laser Trabeculoplasty: A gentler, non-invasive laser treatment for Glaucoma

What is primary open angle glaucoma

Glaucoma is a very general term for a group of conditions that affect the optic nerve at the back of the eye.

The eye has a pump that generates clear fluid and a drain to remove it. The pump and drain should work in balance to keep the pressure inside the eye level. In primary open angle glaucoma, there is a mismatch between these functions, which causes the pressure in the eye to increase. Over time this raised pressure damages the optic nerve, leading to severe visual loss and even blindness.

Treating open angle glaucoma

Until recently, lifelong daily eye drops were the first line of defence against this form of glaucoma. An older laser treatment, Argon Laser Trabeculoplasty (ALT), was available if eye drops failed, but ALT could cause more damage to the eye’s trabecular meshwork and success rates declined over time. Surgical interventions such as Trabeculectomy or tube shunts were available when intraocular pressure could not be managed with medications or laser.

Selective Laser Trabeculoplasty

In the early 2000s a gentler and more effective laser treatment became available to treat open angle glaucoma. Selective Laser Trabeculoplasty (SLT) uses a low-energy, frequency-doubled laser to target pigmented cells in the trabecular meshwork—the eye’s natural drainage system. Unlike older laser techniques, SLT causes minimal thermal damage and inflammation, allowing for safer repeat treatments.

How SLT Has Improved Patient Outcomes

Reduces intra ocular pressure

This gentler form of laser treatment can lower intra ocular pressure by nearly a third in many patients, which is comparable to medical treatments. Reducing IOP is critical to slowing the glaucoma and preserving vision.

Less medication

Many patients who have SLT can delay or avoid long-term use of eye drops, which often have side effects such as irritation and absorption by the body.

This improves quality of life and increases the likelihood of treatment compliance.

Repeatable and minimally invasive

Unlike earlier laser treatments, SLT doesn’t scar the trabecular meshwork, meaning it can be safely repeated if a patient’s intra ocular pressure rises again.

Safe and well-tolerated

SLT is an outpatient procedure with minimal discomfort and rapid recovery. SLT has a low risk of complications and is especially useful in elderly or medically complex patients who may not tolerate medications or surgery well.

Cost-Effective

Over time, SLT can be more cost-effective than long-term use of glaucoma medications, particularly in healthcare systems with limited resources.

The content relating to Selective Laser Trabeculoplasty (SLT)  for treating open angle glaucoma was written by Dr Jonathan Lai and is for information purposes only. Consult a medical professional for advice.