Selective Laser Trabeculoplasty (SLT)
Selective Laser Trabeculoplasty, or SLT, is an in-office laser procedure that can lower glaucoma patients' intraocular pressures and possibly decrease or eliminate their need for pressure-lowering eye drops.
SLT is similar to Argon laser trabeculoplasty (ALT) in targeting the trabecular meshwork of the eye. SLT is different from ALT in that it specifically targets the pigment-containing cells of the trabecular meshwork that are clogging the drain and decreasing outflow facility.
The SLT uses a 532 nm frequency doubled Q-switched Nd:YAG laser from Selective II Luminais, Inc., to target the pigmented cells. The laser application is only three nanoseconds, as opposed to 0.1 seconds of ALT. This incredibly short pulse duration does not allow for the conversion of the electromagnetic energy into thermal energy, so there is no collateral destruction of the non-pigmented cells. We are able to clean out the drain without damaging the drain in the process.
SLT was approved by the FDA in 2001, and has been used for years in Europe . We are extrapolating success rates of SLT from our long history with ALT, and thus far, this has been accurate. It has a success rate of 80% and can lower pressure up to 30%!
SLT is useful for patients whose intraocular pressure is not adequately controlled by or have difficulty using topical medications. In some advanced glaucoma patients, it can lower pressures significantly to protect the optic nerve and prevent the need for incisional surgery.
SLT is a procedure that can be performed painlessly in the office. It takes less than 2 minutes to perform a treatment. Its side effects are similar to those of ALT, and include possible pressure elevations and some postoperative inflammation. It has been shown in studies to lower intraocular pressure similar to ALT without damaging the trabecular meshwork. It is proving to be a very useful and safe addition to our current treatment regime for our glaucoma patients.