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Selective laser trabeculoplasty (SLT)

We share why you might need this glaucoma treatment, what the procedure involves and what to expect from your recovery

Glaucoma is the end point of several conditions and is usually caused by high eye pressure.  

The eye has its drainage system, but sometimes it does not work well enough, causing an increase in pressure. This can in turn damage the optic nerve and cause blindness. Treatment is to reduce the pressure inside the eye and stop the damage. This is often executed with drugs applied via eye drops, but this does not always work.  

Selective laser trabeculoplasty, or SLT, is a laser treatment that enhances the eye's drainage system, reducing intraocular pressure. It is often more effective than drug regimens.  

At BMI Healthcare, our specialist Consultants offer fast diagnosis of glaucoma and will create a bespoke treatment plan based on your individual needs. 

Untreated glaucoma is serious and often leads to problems with vision, ending in blindness. Treatment of the condition is therefore necessary. A usual treatment is to lower the intraocular pressure with eye drops. This often does work, but there can be side effects from the drugs – usually prostaglandins – themselves.  

SLT, or selective laser trabeculoplasty, is a procedure to improve the drainage from your eye without the use of such drugs. It can be combined, if needed, with drug treatment. SLT can therefore be thought of as an addition to drug treatment for glaucoma or as a replacement for it.  

It also usually provides relief from pressure for several years, unlike drug treatments which must be continuous. SLT does not interfere with the ability to have other mechanical treatments for glaucoma, like iStent Inject, if that is also desired at a later stage.  

It is normal for opticians to test for pressure within your eye during a normal sight test. If glaucoma is suspected, then you will be referred to an ophthalmologist who will investigate. If there is glaucoma, then they will discuss treatment options, including SLT.   

The area of the eye which drains the internal pressure – called the trabecular meshwork – is rich in melanin. It is possible to tune a laser to the precise frequency which will affect this melanin. This is what is done during SLT.  

Immediately before the laser treatment, eye drops are added to the eye to maximise the laser's access. Other eye drops are also given before the treatment to prevent the pressure in the eye rising during the treatment.  

Anaesthetic eye drops are added to prevent pain, and a small lens is placed at the front of the eye. The laser is then shone into the eye for 5 minutes or so per eye.  

The laser acts on the melanin, leaving the other eye tissue alone. The effect of this is that the white blood cells clear up the melanin and this clears any blockages in the drainage system itself. SLT stimulates the eye to improve its own performance.  

You will probably experience blurred vision for the next day and some discomfort, but the physical recovery after SLT is quick.  

The recovery time from SLT in the sense of the treatment taking full effect is several months. The average outcome is a reduction in intraocular pressure by around 30 percent, which happens in about 80 percent of treatments. The treatment can be repeated if necessary after this time. 

Sometimes only half of an eye is done leaving the option of repeating, if necessary, on the other half.  

It is common for there to be inflammation from SLT but this is usually mild. In a small number of cases, the interior eye pressure rises after treatment which is then brought back down with the normal glaucoma eye drops.   

It is possible that SLT will only partially work. Combining SLT with drug treatment to further lower pressure and treat glaucoma is a common reaction at this point.  

SLT is not a cure but a method of management of the condition. It would not be correct to assume that SLT will cure the condition but may help to slow it down significantly. Glaucoma will still be a problem that requires at least monitoring over time, and sometimes repeat treatments are needed. 

Eye drops and drugs often have their own side effects, and SLT will in many cases alleviate the need for such drugs at all. This can mean fewer side effects overall.   

Our 500 trusted eyecare experts offer personalised care at over 40 BMI Healthcare centres across the UK.   

Our experts in affordable eye care offer fast access to treatment in a safe and comfortable environment.   

Your SLT will provide the best possible outcome, along with excellent value for money, to help improve your quality of life.  

What you pay will depend on the exact treatment you need. Your final price will be confirmed in writing following your consultation.

Specialists offering Selective laser trabeculoplasty (SLT)

Ms Sally Ameen

Consultant Ophthalmic Surgeon

MBBS, BSC, FRCOphth

BMI The Clementine Churchill Hospital

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Mr Jamil Hakim

Consultant Ophthalmologist

BSc (Hons), FRCS, FRCOphth, DO

BMI The Blackheath Hospital 1 more BMI The Sloane Hospital

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Mr Amar Alwitry

Consultant Ophthalmologist

BM BS BMedSci MRCS MRCOphth FRCOphth MMedLaw PgD Cataract and Refractive Surgery

BMI The Park Hospital

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