Laser Trabeculoplasty

If you have open angle glaucoma and your eyesight is getting worse in spite of medication, your doctor may recommend laser trabeculoplasty as an initial surgical option. Laser trabeculoplasty uses a focused beam of light to treat the drainage angle of your eye. The procedure decreases the pressure in your eye by making it easier for fluid to flow out of the front part of the eye.

Selective laser trabeculoplasty (SLT) is an innovative modification of Argon laser trabeculoplasty (ALT). ALT uses heat, whereas SLT uses a low level laser beam and is sometimes referred to as a “cold laser.” SLT protects the trabecular meshwork (the spongy tissue around the cornea of your eye) against heat and clotting because it targets only pigmented cells and protects the surrounding area. Because it is uses a lower beam, SLT can be repeated if necessary. It also has no systemic side effects, and it is a safe outpatient procedure.

Before Surgery

Because SLT is an outpatient procedure, you may go home the same day. In preparation for the procedure, your surgeon will examine your trabecular meshwork and plan the treatment area. On the day of the surgery, eye drops will be placed in your eye both before the surgery, and after, to decrease the amount of fluid in your eye. This will prevent increased pressure in your eye after laser treatment.

During Surgery

You will be given local anesthetic to numb your eye. Your surgeon will use a slit lamp microscope and lens to guide the laser beam to the trabecular meshwork where fluid drains from the eye. The entire process takes only a few moments, and it is painless.

After Surgery

You should be able to resume your normal routine the day after your surgery. You may experience blurred vision, and your eyes may feel irritated after the procedure, but this is normal. Your doctor will prescribe anti-inflammatory eye drops to use for several days after the procedure and will schedule a post-op appointment to evaluate results of your surgery.

Results

Although it might take one to three months for results to appear, SLT has a success rate of over seven percent in lowering the pressure in the eye. SLT usually lowers the intraocular pressure by about three percent when used as an initial therapy. Even after surgery, you will need to continue taking your medication. Because SLT uses a lower beam of laser and causes less scarring, you can have another treatment later if your doctor recommends it. The effect of the surgery will last somewhere between one to five years and sometimes longer. Subsequent treatments may not be as effective or last as long.