Mr Velota Sung FRCS(Ed), FRCOphth, MSc(Warwick)

Selective Laser Trabeculoplasty (SLT)

SLT is a laser treatment targeting the pigment containing cells within the trabecular meshwork, the area that aqueous drain away from the eyes. The laser with special wavelength which only stimulate the melanin containing cells in the trabecular meshwork and cause changes that can increase the outflow capacity of the meshwork and hence reducing the eye pressure.

Commonly asked questions:

How SLT is performed?

SLT is performed in the clinic equiped with the laser. The procedure only takes 5-10 minutes to perform. Prior to the procedure, special eye drops to constrict the pupil is instilled about 15 mins before. Then anesthetic eye drops will be given and a special contact lens is placed on the surface of the eye. The doctor will look through the microscope and target the laser beam to the trabecular meshwork. Commonly 360 degrees or about 100 laser shots will be delivered in one treatment session per eye.

How effective is SLT treatment?

Recent major clinical trial showed that SLT is as effective as glaucoma eye drops in lowering eye pressure in patients with open angle glaucoma. On average, 70% of patients achieve successful control of eye pressures but the effects wear off over time, about 50% patients require to use glaucoma drops after 5 years. SLT could be performed at any stage of open angle glaucoma but the effectiveness increases if the treatment is performed at the early stage of the disease even before starting of any glaucoma eye drops. Repeat treatment is less effective than the initial treatment.

What to expect after SLT treatment

You may be given an anti-inflammatory eye drops to use for a few days. You will be given an appointment for review in the clinic usually in 1-2 weeks. You should not drive on the day after the laser as your vision may be blurry for a few hours after the laser because of the bright light and the eye drops. There is no restriction in activity from the next day after the laser treatment. You will need to be reviewed at the clinic

What are the side effects of SLT?

Very few patients experience side effects from SLT treatment. Occasionally patients can experience transient inflammation and increase in eye pressure. Other side effects include transient blurring of vision, red eyes, headache, corneal abrasion, corneal oedema (swelling), eye pain and conjunctivitis.