Laser Treatment for Glaucoma (SLT)

Selective laser trabeculoplasty (SLT) has emerged in 2019 as a focus of attention as an outstanding first-line treatment option for glaucoma and ocular hypertension and is poised to become a global standard of care to treat these potentially blinding conditions.  SLT has been in existence two decades with a strong proven track record as safe and effective; however, with newer laser technology and enhancements to the procedure, SLT has now catapulted into the spotlight as more safe, more effective, and more economical than the previous “gold standard” of utilizing eye drops to treat glaucoma and ocular hypertension.

Elevated intraocular pressure (IOP) causes permanent damage to the optic nerve with a resultant irreversible loss of vision.  Eye drops have been utilized for decades to treat glaucoma and ocular hypertension by lowering IOP and preserving vision or considerably minimizing the loss of vision.  Newer eye drops, such as Vyzulta and Rocklatan, have been very helpful to accomplish these goals. Unfortunately, as a result of side effects, ocular discomfort, redness, or non-compliance, the use of eye drops has had pitfalls, especially tragic, when loss of vision continues.

A landmark study was performed in the United Kingdom by the National Health Service comparing eye drops to SLT laser as the treatment for glaucoma and ocular hypertension with the compelling findings that SLT proved to be more safe, more effective, and more economical.  Furthermore, patients on eye drops were dramatically more likely to need major, invasive eye surgery in the operating room due to treatment failures.  This study published in the prestigious medical journal Lancet 4/13/19, as well as comparable studies in the US, have had identical results.  Now, in 2019, as a game-changer, experts resoundingly proclaim that “Selective laser trabeculoplasty [SLT] should be offered as a first-line treatment for open-angle glaucoma and ocular hypertension, supporting a change in clinical practice.”  In fact, at a national ophthalmology meeting, November ’19 in NYC, the vast majority of a panel of glaucoma experts indicated that they now recommend SLT preferentially over eye drops for the treatment of glaucoma and ocular hypertension.  SLT has been FDA approved since 2001 and it’s covered by medical insurance due to its outstanding effectiveness in treating glaucoma and ocular hypertension.

SLT is an in-office 10-minute procedure whereby one eye is treated and usually the fellow eye a week or so later.  Normal activities can be resumed immediately after the performance of the laser. SLT treatments usually last several years and can be subsequently repeated to maintain optimal IOP.


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