SLT – A safe alternative to glaucoma drops

Mr F Carbonaro / St James Hospital

By Mr F. Carbonaro MD, PhD(Lond), FRCOphth((Lond), CCT(UK) Consultant Ophthalmologist

Selective laser trabeculoplasty (SLT) is a very safe and effective procedure for treating glaucoma and ocular hypertension (OHT). Mr F Carbonaro is a leading ophthalmologist and specialist in the management of glaucoma and ocular hypertension. Learn about why SLT is becoming the first choice for lowering eye pressure worldwide.

What is selective laser trabeculoplasty?

Selective laser trabeculoplasty (SLT) is a safe, first-line option for treating glaucoma and ocular hypertension. The result is that medications are gradually becoming second-line treatments in favour of SLT, a simple and painless procedure that can provide years of control for pressure in the eye.

It’s an outpatient procedure (meaning it’s not an “operation”, you don’t need to go to an operating theatre and you don’t need an overnight stay) and often takes less than five minutes per eye. furthermore, recovery times are quick, often 1-2 days.

Why is SLT a good first-line treatment?

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As a first method of treatment for glaucoma and ocular hypertension, SLT can provide similar results to eye drops but without the need for daily use. By undergoing SLT, patients can have up to 2-4 years without the need to use daily eye drops – the level of reduction of intraocular pressure is at least equivalent to that of one eye drop medication.

For patients already taking eye drop medicines, SLT can be used as a substitute for one or more of them. This can improve quality of life, side effects, sore eyes and the need for repeat prescriptions.

Also, with SLT the need for invasive eye surgery is reduced and the success rate of eye surgery is better if done after SLT, than after many years on drops. The progression rate of the disease is also reduced. Recent research also suggests that SLT seems to reduce the likelihood of developing a cataract.

Are there risks?

While SLT is a very safe procedure, like all medical treatments it is not 100% without risk. However, side effects are either very rare or minimal in terms of severity.

Mild redness and/or ache: It’s possible to have mild redness or ache in the eye following the procedure but this nearly always settles within a few days. Anti-inflammatory eye drops are provided after the procedure to lessen the duration of redness and ache. These can be taken three times per day for up to 7 days if needed. However, many patients don’t require them.

Photophobia (sensitivity to light): Just like redness and ache, sensitivity to light settles quickly thanks to the standard post-procedure anti-inflammatory drops.

A short-term increase in eye pressure: Routine use of preventative eye drops (Apraclonidine) given before and immediately after the SLT procedure and modern laser techniques have reduced this risk to 1 in 800. In the rare scenario that eye pressure rises to an unacceptable level, patients’ are provided with a tablet to bring it back to normal.

Having said this, it’s important to remember that the procedure is very safe. Your eye specialist should talk through these risks when you discuss SLT.

Is SLT suitable for me?

In order to find out if SLT is the best course of action for maintaining your eye health, you’ll need a full and honest discussion with your ophthalmologist who will personalise your treatment plan for your specific case.

This content was supplied by St James Hospital