Selective Laser Trabeculoplasty (SLT) is a laser procedure used for people with open-angle glaucoma. The laser is used to alter the drain mechanism inside the eye. It is hoped the treatment will allow the drain to open wider and help relieve the build-up of pressure inside the eye. The treatment is effective in a large percentage of patients but not in all patients. If the first treatment is not effective, it can usually be repeated at least one more time a few weeks later. The laser is not expected to improve your vision. It is intended to help lower your eye pressure.
When you arrive at the laser center, you will be given an eye drop called Pilocarpine, which will make your pupil smaller. This drop can cause a mild brow ache that lasts an hour or two. This brow ache is usually relieved by Tylenol. You may want to take Tylenol shortly before coming to the laser center so that the brow ache will be less noticeable later. You can also take it as soon as you get home. Please do not use aspirin or other aspirin like pain-relievers like Advil or Motrin before the procedure because they slightly increase the risk of bleeding. You may take these or any other pain reliever after the procedure.
The laser machine looks similar to the examination microscope that the doctor uses at each office visit to look at your eyes. The laser itself makes little noise and flashes a light about as bright as a flash on a camera. It takes about twenty to thirty minutes for the drops to work and about five minutes to do the procedure. During the procedure, the eye will be numbed with an anesthetic drop and a special contact lens will be applied to the eye. The contact lens is coated with an ointment before applying it to the eye and you may find that this ointment runs down your cheek a bit during the procedure. The ointment is rinsed or wiped away right after the procedure. There is almost no discomfort during the procedure. Some patients describe feeling a “tingle” in the eye when the laser light is applied.
The vision will probably be blurred for a few hours after the procedure both from the effects of the laser light and from whatever ointment remains after rinsing the eye. You will be given a drop after your laser treatment to prevent a rise in pressure in the eye. There are no restrictions on your activities after the procedure and no new drops to take. If you are on drops for glaucoma, you should continue taking them in the same way after the procedure. The doctor will notify you if there is any exception to continuing your medications. You may require additional laser surgery or other treatments to lower the pressure if it is not sufficiently lower after the first laser treatment. We will see you in the office the day after your laser, at which time we will be checking your vision and eye pressure. There is a small risk of temporary elevation of eye pressure with this procedure. If your pressure is up on the first day after your laser, you may be given a drop for a few days to reduce the pressure.
Temporary inflammation in the eye, unexpected rise of pressure, and bleeding inside the eye are remote risks of this procedure and can usually be treated effectively. With any eye procedure, it is possible to have a loss of vision as a complication. This is extremely unlikely with SLT. It is impossible to list all of the potential complications that can occur with any medical treatment and while complications can occur, SLT is generally considered to be very safe and effective.