Selective Laser Trabeculoplasty (SLT)
Glaucoma occurs when there is an increase of fluid production or a decrease in fluid drainage within the front part of the eye. Over time, as the pressure within the eye remains elevated or peaks at different times of the day, the optic nerve fibers are destroyed and peripheral (side) vision is lost. If not treated adequately, an elevated pressure can also cause irreversible loss of central vision.
Aqueous humor flows out of the eye through the Trabecular Meshwork near the outer edge of the iris. Over time, in certain individuals with glaucoma, that trabecular meshwork becomes blocked and the pressure within the eye increases. Treatment of open angle glaucoma is aimed at lowering the pressure within the eye by either decreasing the production of aqueous humor or helping it escape from the eye. There are medications to help with this process as well as surgical treatments.
Selective Laser Trabeculoplasty-SLT does not rely on medicines. Instead, it uses an advanced laser system to target specific melanin containing cells within the Trabecular Meshwork. As a result of SLT, your body’s own healing response helps lower the pressure within your eye.
Laser surgery has become an increasingly popular treatment to control eye pressure prior to consideration of glaucoma filtration surgery or prior to adding several medications to control the intraocular pressure. Selective Laser Trabeculoplasty (SLT) is an advanced form of laser treatment for open-angle glaucoma. SLT uses short pulses of low energy laser light to target melanin-containing cells in a network of tiny drainage channels, within the Trabecular Meshwork. The objective of the surgery is to increase fluid draining out of the eye, reducing the intra-ocular pressure that can cause damage to the optic nerve and loss of vision.
The selective technique is much less traumatic to the eye than the older method called Argon Laser Trabeculoplasty (ALT), which had been the standard laser procedure in the past. ALT can cause tissue destruction and scarring of healthy cells in the Trabecular Meshwork structure. SLT reduces intra-ocular pressure without this risk. SLT can be used to effectively treat some patients who could not benefit from ALT. This includes patients who have already been treated with ALT. More importantly, this procedure may be used instead of, or in addition to glaucoma medications as a means to control the intraocular eye pressure in many individuals.
SLT is for those:
- Who have been diagnosed with open angle glaucoma.
- Whose doctor has determined that SLT is appropriate for controlling their intra-ocular pressure.
- Who would rather not have to use any (or additional) medications to control their eye pressure.
- Safe – SLT is not associated with the side-effects of some medications.
- Selective – SLT treats only the specific melanin containing cells in your eye.
- Smart – SLT stimulates the body’s natural mechanisms to enhance outflow in the eye.
- Sensible – SLT is reimbursed by Medicare and other insurance companies to reduce the costs of medications over time.
What to expect on procedure day:
Your treatment will be performed in your doctor’s office in an examination room equipped with a laser attached to a special microscope, similar to the one used for your eye examinations. SLT does not require a surgery center. Once you have been checked in and settled comfortably, eye drops will be used to numb your eye; no injections or needles are used.
Your doctor will hold up a special lens to your eye which allows him to focus the laser onto the meshwork drain inside your eye. You may see flashes of bright green or red light. The laser selectively targets melanin-containing cells, resulting in increased fluid outflow. You will not feel any pain during the procedure. The entire procedure takes only a few minutes. Your eye pressure will be checked again one to two weeks after your procedure. If there is any soreness, you may use an eye drop for comfort. The full pressure-lowering effect of this procedure may take up to 8 weeks; however, your doctor can oftentimes tell at two weeks if you are a good responder. Usually, there are no activity restrictions following this procedure and you may resume your normal activities immediately.
The effect of the surgery may wear off over several years; however, it may be repeated without ill effects. Serious complications with SLT are extremely rare, but like any surgical procedure, there may be some risks. Going to a specialist experienced in SLT can help minimize the risks and increase the chances of success. Here at Peninsula Laser Eye Medical Group, we specialize in lasers for treating conditions within the eye.
If you and your doctor decide that SLT is an option for you, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all 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.