Selective Laser Trabeculoplasty

What is SLT?

Also know as Selective Laser Trabeculoplasty, SLT is a simple, yet highly effective laser prcedure that reduces the intracular pressure associated with glaucoma. It is performed in your opthalmologist's office, and typically takes no more than five minutes.

How does it work?

SLT uses short pulses of low-energy light to target the melanin, of pigment, in specific cells of the affected eye. In response, the body's natural healing mechanisms go to work to rebuild these cells. This rebuilding process improves drainage and lowers intraocular pressure. The surrounding, non-pigmented cells - as well as the rest of the eye structure - are untouched and undamaged.

Does SLT hurt?

No, it is painless. The side effects to expect are a bit of blur immediately afterwards, and some glare for 2-3 days afterwards.

What happens during the procedure?

Prior to treatment, eye drops are administered to prepare the eye and provide mild anesthesia. Then, gentle pulses of light are delivered through a specially designed microscope. The entire process takes just a few minutes. When it's complete, your physician may treat your eye with anti-inflammatory eye drops.

One to three days after the procedure, your intraocular pressure should drop significantly. And of course, your physician will want to re-check the treated eye during periodic follow-up visits.

How often can I have SLT done?

SLT is gentle, non-thermal and non-invasive - which allows the procedure to be repeated, if necessary. In comparison, repeat treatments of previous approaches in laser therapy were either extremely limited or not possible.

Who will benefit from SLT?

If you fit in to any of the following categories, you're a good candidate for SLT:

If you have primary open-angle, pseudoexfoliation, or pigmentary glaucoma. (If you're not sure, ask your ophthalmologist.)
If you are intolerant of glaucoma medications, or have difficulty taking them as prescribed.
If you are currently undergoing glaucoma drug therapy and wish to combine it with SLT.
If it is difficult for you to commit to regular follow-up treatments, due to finances, lack of transportation, or other limitations.
If you have a history of failed ALT (argon laser trabeculoplasty) treatments.

What if SLT doesn't work for me?

SLT lowers intraocular pressure by an average of 25 percent in 75 to 85 percent of patients treated. For those that do not respond, other forms of treatment, including traditional drug therapy, can still be highly effective.

Why is it important to relieve intraocular pressure?

The eye's aqueous fluid constantly produced and drained at a balanced rate to ensure the health and lens of the cornea. When this drainage becomes blocked, intraocular pressure increases and open-angle glaucoma (the most common form of glaucoma) occurs. In order to preserve eyesight, it is critical to decrease and control intraocular pressure.

What are my other treatment options?

Drug therapy is the most common form of treatment for open-angle glaucoma; however, there are side effects, and medications aren't effective for all patients - and you have to remember to take your medicine every day.
If non-surgical methods fail, surgery may be attempted to create a new drainage channel. Unfortunately, this is a highly invasive procedure with a risk of bleeding and infection.
Argon laser trabeculoplasty was formerly the most widely used laser treatment for glaucoma. There are many problems associated with ALT, including irreversible damage to the eye, along with permanent scarring.

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SLT in the treatment paradigm for glaucoma

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SLT can be used first line for open angle or narrow angle forms of glaucoma
SLT can be repeated safely
SLT can be used to augment medical therapy
SLT can be used to augment surgery
SLT is an outpatient procedure with minimal side-effects

SLT - 10 Compelling Reasons:

1.	SLT has been shown to enhance the IOP lowering effect of medication in manyglaucoma patients.
2.	Non-compliance to medications has emerged as the biggest challenge in patient glaucoma management.
3	Non compliant glaucoma patients miss an average of 103.9 days treatment/year.
4.	A recent study found that 25-40% of glaucoma patients who turned in a prescription at a pharmacy never picked up the medication.
5.	42% of glaucoma patients use their medications incorrectly.
6.	At a recent SLT symposium. Canadian clinicians reported that when given the option, 70% of patients elected to try SLT treatment in preference to drugs or surgery.
7.	In a recent study conducted by Dr. Madhu Nagar, researchers achieved a 90% success rate using SLT as a primary therapy.
8.	SLT has a much lower complication rate than ALT - a recent study found the complication rate for SLT to be 4.5, in contras to ALT which has a reported complication rate of 34%.
9.	At least 70% of failed ALT patients respond to SLT, with a 6.8mm Hg average reduction in IOP.
10.	According to international trials, SLT therapy has experienced 80% success in obtaining a mean 23% reduction in IOP, lasting for at least 24 months.