Treating Glaucoma with SLT

Selective Laser Trabeculoplasty (SLT) is the newest form of laser treatment to manage open angle glaucoma. SLT is a simple and quick laser out-patient procedure done in the clinic. A special ndYAG laser is used to stimulate cells in the trabecular meshwork to increase the drainage of the aqueous humor. This results in reducing the intra-ocular pressure which will help control the glaucoma.

SLT is an option for some patients who prefer not to use eyedrops to control their glaucoma. It has been found to lower the eye pressure to a similar extent to some glaucoma eyedrops.

Like ALT or surgical glaucoma treatment, SLT efficacy will not last indefinitely. Normal clinical experience has shown that generally SLT is effective for 2 to 3 years, after which re-treatment is possible. One study from Hong Kong has shown that after 5 years, only 30% of the eyes needed re-treatment.

The success rate of SLT is approximately 70% in reducing the eye pressure by an average of 25%. SLT can be used solely as the primary treatment in open-angle glaucoma or it can be used in conjunction with eye drop medication. SLT has also been found to work with patients who had previously undergone ALT.

The best SLT candidates are those that have recently been diagnosed with open-angle glaucoma and have not been chronically on glaucoma eyedrops. Past experience has shown that those who have been on glaucoma eyedrops for a long-term do not respond as well to SLT treatment.

Therefore SLT is best used in the early stages of open-angle glaucoma.

Side effects and risks - though rare, there is the possibility of the eye pressure increasing instead of decreasing. Some other rare side effects possible are - iritis, inflammation, corneal oedema and hyphema.

Overall, SLT is considered a "safe" laser procedure to treat glaucoma with possibility of re-treatment when needed. If it works, it will save on the cost on the eye drop medications and the trouble to stick to the daily eye drop regimen. On the lesser chance it does not work, the patient can go back to eye drop medication.

SLT therapy is done in the clinic with the patient sitting upright in chair looking into a slit lamp/microscope that has a ndYAG laser system linked to it. The treatment only takes a few minutes and is done as an outpatient procedure.

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