Selective Laser Trabeculoplasty (SLT)

Selective Laser Trabeculoplasty (SLT) has become increasingly popular as a method for treatment of open-angle glaucoma. Commonly, this is performed as an intermediate step between medical therapy and glaucoma surgery. However, some patients may benefit from its use as a primary treatment. The objective of this in-office procedure is to stimulate the "drain" of the eye to allow better outflow of the fluids and reduce intra-ocular pressure that can cause damage to the optic nerve and loss of vision.

How it works:

SLT uses laser light to stimulate the cells of the trabecular meshwork or "drain" of the eye. This treatment will then lead to better outflow of the aqueous humor or "fluid" out through the trabecular meshwork and thereby lower the intra-ocular pressure. Earlier lasers like the Argon Laser Trabeculoplasty, or ALT, use thermal damage or burning of tissue and can cause pain and scar tissue formation. The SLT is more akin to a "cold" laser without the heat. Therefore, the patient experiences virtually no pain throughout the procedure, which is potentially repeatable since there is no scar tissue formation.

SLT is for:

• Patients with open-angle glaucoma
• Patients who have had previously successful ALT
• Patients who are intolerant to glaucoma drops or have difficulty applying drops
• Newly diagnosed patients with ocular hypertension or glaucoma

What to expect on procedure day:

Your procedure will be performed in our specially equipped laser room in the office. You will not be required to go to a surgical center or hospital. After you have been checked in, a technician will perform standard screening measures and review the nature of the procedure. Once that is completed, you will be taken to the laser room where anesthetic drops as well as an anti-glaucoma drop are placed into your eye. No needles or intravenous injections are used.

The doctor will then have you position your head into the device which is much like the microscope used in the examination rooms. A special contact lens is placed in the eye to help hold your eyelids open as well as focus the laser onto the target tissues. You may see occasional flashes of light as well as hear beeps as the procedure commences. Your doctor will place anywhere between 50 to 120 laser "spots". The procedure will take between 5 to 10 minutes per eye. You should not feel any pain throughout the procedure. When the laser is finished, your eye will be cleaned and an additional anti-glaucoma drop will be given.

After the treatment, you will be taken to our recovery area and your eye pressure will be rechecked in approximately one hour. The most worrisome complication that may occur with SLT is a pressure "spike" that rapidly increases the eye pressure. If this happens, you may be required to stay for an additional time period while this pressure spike is treated by the staff. Also, some patients may experience mild eye soreness and blurriness of vision, but these symptoms will resolve within 1 to 2 days. Otherwise you will be free to resume your normal activities. For those patients who currently are using glaucoma medications, you will resume these medications as usual unless otherwise instructed by your doctor.

Follow up visits will be scheduled for you after the procedure. The effects of the SLT may not be seen for several weeks. In general, you will see the doctor approximately one week later, and then one month. Future appointments will be determined by your doctor. If the treatment is successful, your doctor will then discuss with you what to do with your eye drops. In many cases, patients will be able to discontinue one or more drops.

Important facts about SLT:

Although SLT is an exciting technology and an effective tool, it is not a cure for glaucoma. Also, like medication, the effects have a limited life span, and can wear off over time. In general, the pressure-lowering effects of SLT diminish after two to three years, and medications may be restarted. However, SLT can be repeated, and current studies have shown that over half of those retreated see a similar benefit of reduced pressure. It is important to understand that if you have been using glaucoma medications prior to SLT you will be required to continue them after SLT treatment until otherwise instructed by your doctor.

We at California Eye Professionals are pleased to offer this new and groundbreaking technology for our patients. If you have any questions regarding SLT or want to find out if it is right for you, please contact our office at your convenience. An appointment with our doctor will be set up for you and the risks and benefits of SLT will be discussed to allow you to make an informed decision about whether to proceed. Be sure you have all of your questions answered to your satisfaction.
 

If you would like more information about this procedure you can make an appointment or contact the office for additional information.