Selective Laser Trabeculoplasty (SLT)
Understanding SLT
This section explains how SLT works and why it is a trusted option for glaucoma management.
SLT sends quick, cool pulses of light to specific pigmented cells in the eye’s drainage channel. The laser energy wakes up these cells so they can clear blockages and let fluid flow out more easily, which lowers intraocular pressure.
Clinical studies show SLT can reduce eye pressure by about 25 to 30 percent after a full treatment. Because the laser does not damage tissue, the procedure can be safely repeated if pressure rises again in the future.
The LiGHT trial and other large studies found that many patients who start with SLT maintain good pressure control and often avoid daily drops for years. This evidence guides our recommendation of SLT as an early or even first-line therapy.
Candidacy for SLT
Not every patient is suited for SLT. The following points outline who may benefit most and who may need another approach.
Patients with open-angle glaucoma or ocular hypertension often do well with SLT, especially when drops are hard to use or cause side effects.
- Primary open-angle glaucoma
- Ocular hypertension
- Pigmentary, pseudoexfoliative, or steroid-induced glaucoma
- Difficulty remembering or tolerating eye drops
- Need for more pressure control after previous surgery
Certain glaucoma types respond poorly to SLT, and some patient factors can limit success.
- Inflammatory glaucoma
- Iridocorneal endothelial syndrome
- Congenital or neovascular glaucoma
- No response to SLT in the other eye
- Severe anxiety that affects in-office procedures
Post-Procedure Expectations
Most people return to normal activities the same day, but a few temporary effects can occur.
Side effects are usually mild and short-lived.
- Mild redness or irritation that fades quickly
- Brief spike in eye pressure, monitored in the office
- Blurred vision for a few hours that clears on its own
SLT Compared With Other Glaucoma Treatments
SLT is one of several modern options for lowering eye pressure. The comparisons below highlight how it differs from common minimally invasive procedures and implants.
SLT is an in-office laser, while iStent is a tiny implant placed during cataract surgery.
- No incisions for SLT; iStent requires surgery
- SLT has minimal downtime; iStent recovery aligns with cataract healing
Both aim to improve fluid outflow, but the methods differ.
- SLT is non-surgical and repeatable
- XEN is a soft tube implanted in the operating room and may lower pressure more in advanced cases
Durysta releases medicine over time, while SLT relies on laser energy.
- SLT uses no medication
- Durysta slowly dissolves and may need to be repeated
- SLT suits patients who prefer to avoid ongoing drug exposure
Both target the eye’s drainage pathways, but one is laser-based and the other is surgical.
- SLT is done in the office with no incisions
- OMNI opens two drainage channels in an operating room setting
- OMNI can deliver larger pressure drops but carries surgical risks
iDose TR is a tiny implant that delivers medication; SLT is medication-free.
- SLT can be repeated as needed
- iDose TR offers steady drug delivery for months
- Choice depends on preference for laser treatment versus sustained medication
SLT Procedure Details
Knowing what happens before, during, and after SLT can ease anxiety and support good outcomes.
Pressure-lowering and numbing drops are placed in the eye to prevent spikes and ensure comfort.
A special contact lens helps focus the laser on the trabecular meshwork. Short pulses of light treat the full 360-degree angle in minutes without pain.
Anti-inflammatory drops may be prescribed for a few days. A follow-up visit checks eye pressure and healing.
Tips for a Successful SLT Experience
Working closely with your eye doctor before and after the procedure promotes the best results.
SLT often lowers pressure, but individual responses vary and additional treatments may be needed over time.
Using any prescribed drops before the laser session helps reduce short-term pressure spikes.
Ask questions and adjust your seating position so you feel relaxed while the laser is applied.
Regular checks ensure that your eye pressure stays within the target range.
Report unusual symptoms to your doctor right away so adjustments can be made promptly.
Frequently Asked Questions
The answers below address common concerns patients have about SLT.
Yes. Many patients choose SLT before starting daily drops because it often controls pressure well and reduces medication needs.
The laser treatment itself lasts less than five minutes per eye, and most visits are completed within a short office appointment.
Numbing drops prevent pain. Patients may see flashes of light but usually feel no discomfort.
Pressure typically falls over several days to weeks. Follow-up tests track progress and guide any further care.
Temporary redness, mild irritation, a brief pressure spike, or blurry vision can occur but usually resolve quickly with monitoring and drops.
Yes. Because SLT does not harm the drainage tissue, it can be safely repeated if pressure rises again.
Partnering With Our Glaucoma Specialists
Our experienced ophthalmologists are committed to preserving your sight with proven treatments like SLT. We look forward to guiding you through every step of glaucoma care and helping you maintain clear, comfortable vision for years to come.
Dr. Chin is kind, professional, and provides thorough care. I recently had laser surgery for glaucoma and I’m very pleased with the results.
Michele Cucci
Dr. Chin is kind, professional, and provides thorough care. I recently had laser surgery for glaucoma and I’m very pleased with the results.
Michele Cucci
Both my parents’ visits went smoothly! Professionalism and patience in explaining everything were perfect for my elderly parents. Thank you!
Susan Ribaudo
Professional, clean, friendly environment. Dr. Bianchi went above and beyond for my son to ensure he was comfortable. Can’t speak highly enough!
Silvia Gallagher
Dr. Kirszrot and the entire staff from the front desk to the nurses were delightful to deal with. Everyone seemed concerned about my comfort, answered all questions, and gave substantial post-op instructions.
Mary-Ann L.