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

Caution: Federal (US) law restricts Lumenis devices to sale by or on the order of a licensed practitioner.