Selective Laser Trabeculoplasty

The Selective Laser Trabeculoplasty (SLT) has gained in popularity in recent years to the point of replacing Argon Laser Trabeculoplasty (ALT) in for many practitioners. Both these laser techniques are also sometimes referred to as just Laser Trabeculoplasty (LTP.) Although it has not been found that the SLT results in a better pressure reduction compared to the ALT technique, the fact that it is a ‘cold’ laser source compared to the ALT suggests that it is less likely to cause permanent structural damage to the trabecular meshwork as a side effect. Because of this, it is believed that the SLT may be a procedure that can be repeated several times if needed and still be effective each time whereas performing the ALT more than once or twice could make the eye pressure start to rise due to collateral damage to the area being treated.

The goal of either type of trabeculoplasty is to stimulate the eye to release extra amounts of certain enzymes known as matrix metalloproteinases (MMPs) to clean the trabecular meshwork so that the aqueous humour can flow out of the anterior chamber through the angle more easily and thus lower the eye pressure. The effect of this technique usually takes up to 6 weeks from the time of treatment and is less likely to be effective the more a person’s eye has already been treated by other means. Therefore, the SLT has moved itself up higher in the treatment regimen such that it is often tried as initial therapy or after a single medication is no longer effective enough to lower the eye pressure.

Laser trabeculoplasty is an in-office technique at the West Coast Glaucoma Centre. After instilling a drop of topical anaesthetic, a lens is touched to your eye in order to bend the laser light and focus it on the trabecular meshwork surface. The technique takes approximately five minutes per eye. Afterwards, a glaucoma eye drop will also be instilled to reduce the chance of a sudden spike in eye pressure and you will wait in the waiting room for 30-60 minutes so that we can recheck you before you leave. Follow-up will be arranged for 1 week later and 6 weeks later and you will likely take an anti-inflammatory eye drop for several days to make sure you do not have any discomfort.

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Laser Peripheral Iridotomy (LPI)
-> Selective Laser Trabeculoplasty (SLT)
Gonioplasty or Iridoplasty
YAG Capsulotomy