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OUTLOOK EYE TREATMENTS

SLT Laser

SLT stands for “Selective Laser Trabeculoplasty”. This is a treatment for glaucoma that is increasingly used around the world.

Principle:

Glaucoma or raised eye pressure occurs when there is an imbalance of fluid produced by the eye and drainage out of the eye. Eye fluid “the aqueous” passes through some tiny filters called the “trabecular meshwork”. In glaucoma, these filters become clogged similar to a pool filter becoming clogged with leaves. The laser works by unclogging these filters, improving drainage and thus reducing eye pressure.

Unlike older forms of glaucoma laser treatment, numerous studies have shown SLT to be gentle, effective, and safe and can be repeated. Its effect on average lasts about 2-3 years although some patients have had benefit for more than 5 years.

Procedure:

This is performed as an outpatient/office procedure.

  1. 15 minutes before treatment, you will be given some drops to constrict your pupil and to reduce chances of a pressure rise. You may also be given some fluid tablets (please inform us if you have a Sulphur allergy).
  2. A contact lens is applied to your eye. This keeps the lids apart, steadies the eye, and allows treatment with the laser. There is very little discomfort and the procedure takes about 5 minutes.
  3. You may be given anti-inflammatory drops to use for a week after the laser.

Follow up:

You will be reviewed in the weeks following the procedure. An improvement in pressure is often present by 2 weeks, and by 6 weeks the final effect is often seen.

Who benefits:

  1. It can be used as additional treatment for glaucoma patients whose pressure are inadequately controlled by drops.
  2. Intolerance or Noncompliance with Glaucoma drops
    Some patients develop side effects to drops and laser can help to achieve control. It can also be used in patients who are non-compliant.
  3. Alternative to Drops.
    Increasingly, the laser is being used as an alternative to drops to achieve pressure control.

Important:

Patients with Glaucoma are not cured of their problem with SLT laser. There is a tendency to think that patients do not have a problem as they are not instilling drops. The effect of SLT laser wears off over time so it is important to have continued follow up. Often the laser treatment can be repeated or alternatively drops may be prescribed.

Helpful Links: Macular Hole, Central Serous Chorioretinopathy, Keratoconus

Frequently Asked Questions

Selective Laser Trabeculoplasty (SLT) is a gentle, safe laser treatment for glaucoma that reduces intraocular pressure by improving the drainage of fluid from the eye through the trabecular meshwork. Unlike older laser treatments, SLT uses selective low-energy pulses that target only pigmented cells, leaving the surrounding tissue undamaged.
The LiGHT trial (the largest randomised controlled trial of SLT versus eye drops) demonstrated that SLT is as effective as eye drops as a first-line treatment for open-angle glaucoma and ocular hypertension, with no local side effects. In that trial, 74% of SLT-treated patients required no additional drops at 3 years.
SLT is a comfortable procedure. A contact lens is placed on the eye to focus the laser. Patients may see brief flashes of light during treatment. Some experience mild discomfort or a dull ache around the eye for a few hours afterward, which responds to over-the-counter pain relief if needed.
The laser treatment itself takes approximately 5–10 minutes per eye. Including preparation and a post-procedure eye pressure check, your total appointment will be approximately 45 minutes.
Eye pressure reduction from SLT typically begins within 4–6 weeks of the procedure. A formal pressure check is usually scheduled 6 weeks after treatment to assess the response. Maximum pressure reduction is usually achieved by 3–6 months.
The pressure-lowering effect of SLT lasts an average of 2–5 years. When the effect diminishes over time, SLT can be safely repeated in most patients. This is one of the key advantages of SLT over older laser treatments that could only be performed once.
For some patients, SLT can reduce or eliminate the need for daily eye drops. However, the response varies between individuals. Your ophthalmologist will review your pressure response 6 weeks after the procedure and advise whether your drops can be reduced or ceased. Drops should never be stopped without medical advice.
SLT is most effective for open-angle glaucoma and ocular hypertension. It is an excellent option for patients who have difficulty tolerating or remembering eye drops, those seeking an alternative to long-term drop therapy, and patients with open-angle glaucoma as first-line treatment. Patients with narrow-angle or closed-angle glaucoma require a different type of laser treatment.
SLT has an excellent safety profile. A temporary rise in eye pressure can occur in the hours after treatment and is monitored and managed at the post-procedure check. Mild inflammation is common and treated with anti-inflammatory drops. Serious complications are extremely rare.
Yes. SLT laser is eligible for a Medicare rebate when performed by a specialist ophthalmologist with a valid referral. Our team will provide a cost estimate at your consultation.