Selective Laser Trabeculoplasty
By Dr. Domenic Turco
In one of our previous blogs, we discussed primary open angle glaucoma and gave a general overview of the disease, the pathology behind the disease, and some of the various treatments available. One of the available treatment options for glaucoma is an in-office laser procedure called Selective Laser Trabeculoplasty (SLT) which is offered by all of the surgeons at Heimer, Fiore, Turco Eye Care and Surgery. SLT is a non-destructive laser procedure that is targeted at the trabecular meshwork—the area of the eye that is responsible for the majority of the drainage of fluid that is produced inside the eye. Resistance of fluid drainage at this area is thought to cause a pressure increase inside the eye leading to optic nerve damage and glaucoma.
SLT is presumed to work by increasing outflow through the trabecular meshwork and thereby lowering the pressure inside the eye. The procedure takes less than 5 minutes and is relatively painless, only requiring an anesthetic eye drop prior to the procedure. In some cases, your physician may have you use a steroid or anti-inflammatory eye drops for up to one week following the procedure. If successful, the procedure may help to lower your eye pressure without the need for additional eye drops or, in patients who have never been on therapy, it may eliminate the need for eye drops for a period of time.
SLT does not provide permanent intraocular pressure lowering but has the potential to last for several years, and since the laser is not destructive it can be repeated multiple times. Unfortunately, just like not everyone responds to certain eye drops for pressure lowering, not everyone responds to SLT. However, about 70-80% of patients achieve the goal of lowering eye pressure by 15-20% from baseline.
Recent studies, including the LiGHT trial, have confirmed that SLT is a very safe and effective means of achieving eye pressure lowering. In fact, the LiGHT trial found that SLT done as a first-line treatment can actually slow progression of visual field loss as compared to eye drops alone. If you have any questions about SLT or glaucoma, please feel free to contact Heimer, Fiore, Turco Eye Care and Surgery at 814-234-1002.