Selective Laser Trabeculoplasty

What Is SLT?

Glaucoma management can consist of:

• Medications (eye drops or tablets)
• Laser
• Surgery
• Any of the above combinations

Selective Laser Trabeculoplasty (SLT) is simply another method of managing intraocular pressure, but by using Laser.

The critical element determining whether you are suitable for SLT is whether your trabecular meshwork (internal drains of the eye found at the drainage angle) can be adequately seen by the doctor using specialised lenses.

The trabecular meshwork is a sieve-like structure found inside eyeball, at the junction between the peripheral cornea (clear glassy window at the front of the eye) and the iris (coloured part of the eye). This structure drains the aqueous fluid from within the eye. Note: Aqueous fluid is very different from tears that are produced to coat and wash the outside surface of the eye.

In glaucoma, the trabecular meshwork doesn’t drain efficiently.

Post Laser Management

You must continue ALL your current anti-glaucoma eye drops as usual after the SLT treatment until your next appointment. At that next clinic review, your medication regime will be reviewed and optimised.

Some patients notice a dull headache or a bruised sensation after the laser procedure. This is often associated with the preparatory eye drops (called pilocarpine) used before the laser surgery.

Pilocarpine has the action of (1) opening the drainage angle for safe laser application and (2) lowering the intraocular pressure to prevent the post-laser pressure rise. It is acceptable to take additional paracetamol / aspirin as directed by your treating doctor.

If the pain does not significantly resolve following the paracetamol / aspirin, contact your eye doctor for further advice.