Medications and eye drops can sometimes cause undesirable side effects or simply fail to control glaucoma, in which case laser therapy may be a better alternative.
With traditional argon laser trabeculoplasty (ALT), tiny, evenly spaced burns are made in the trabecular meshwork with an argon laser. These laser burns facilitate the drainage of aqueous humor. However, scarring of the trabecular meshwork occurs as a result of ALT burns, and may limit its success and the ability to retreat the eye in the future, should the procedure need to be repeated.
Selective Laser Trabeculoplasty (SLT) is an advanced type of laser treatment to manage patients with open angle glaucoma. Instead of burning tissue as in ALT, SLT selectively stimulates or changes only specific pigmented cells to activate increased fluid drainage. Both SLT and ALT produce equivalent drops in IOP, however the more gentle SLT procedure does not have the associated damage to other tissues and adverse scarring effects. For this reason, where ALT is limited to one or two treatments, SLT may potentially be repeated more often. SLT has also been found to be effective when ALT and other forms of medical treatment have failed.
How is SLT Performed?
SLT is usually performed in the office and only takes about 15-20 minutes. Prior to the procedure, eye drops will be given to prepare the eye for treatment. The laser applications are made through a special microscope, similar to the one used for eye examinations. We recommend patients plan to be at the office for approximately two hours and the eye pressure will be checked prior to leaving the facility.
What should be expected after SLT Treatment?
Generally no special post-operative medications are needed and there are no restrictions on physical activities after treatment. Most patients will continue any glaucoma medications that they were taking before the laser, however the physician may treat the eye with anti-inflammatory eye drops that will be continued for 4-7 days following the treatment. Most patients will have to return for follow up visits to re-check the treated eye, as it often takes 4-6 weeks for the pressure to be lowered. Over-the-counter pain medications are fine to use for any discomfort.
Unlike some glaucoma medications, there are no incidences of allergy or systemic side effects with SLT. Complications are minimal but may include inflammation, temporary increase in IOP, conjuctivitis, or eye pain.
Benefits of SLT
- SLT results in a biological response that increases aqueous drainage, and reduces intraocular pressure without burning tissue.
- No adverse reactions from medications.
- No adverse scarring of trabecular meshwork.
- May reduce the need for lifelong use of expensive eye drops and other medications.
Prevention is the Best Medicine
Vision loss from glaucoma is permanent but can usually be prevented with early detection and treatment. Glaucoma management is usually a lifelong process that requires frequent monitoring and constant treatment. Since there is no way to determine if glaucoma is under control based on how a person feels, patients with glaucoma generally should be examined every 3-6 months.
If you have experienced a loss of peripheral vision or are having other difficulties with your vision, schedule a complete eye examination with your primary eye doctor.