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WHAT'S NEW IN GLAUCOMA CARE?
 Selective
Laser Trabeculoplasty (SLT)
Selective laser trabeculoplasty (SLT)
is one of greatest advances in the surgical treatment of intraocular
pressure (IOP) in patients with open-angle glaucoma. Prior to its
introduction, medications and argon laser trabeculoplasty (ALT) were
the ophthalmologist's primary tools.
SLT works by using a specific wavelength to irradiate and target
only the melanin-containing cells in the trabecular meshwork, without
incurring collateral thermal damage to adjacent non-pigmented trabecular
meshwork cells and underlying trabecular beams. When treated with
SLT, a primarily biologic response is induced in the trabecular
meshwork which involves the release of cytokines that trigger macrophage
recruitment and other changes leading to IOP reduction.
The laser beam bypasses surrounding tissue leaving it undamaged
by light. This is why, unlike ALT, SLT is repeatable several times.
While ALT patients can receive two treatments in a lifetime, SLT
patients can receive two treatments a year.
SLT requires a specially designed laser:
- A short pulse to allow for thermal relaxation
- Precise wavelength for optimal melanin absorption
- Sufficient energy to heat melanin to the point that it releases cytokines
- Sufficient spot size to ensure full coverage at the trabecular meshwork
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