SLT for early glaucoma treatment
What is SLT?
SLT is an advanced, non-thermal, 532-nanometer, nanosecond laser treatment, which can achieve reductions in IOP as effectively as medication, WITHOUT the associated side effects or problems with patient compliance. SLT is ideally suited to glaucoma patients with intolerance to, or who may be frustrated with, the effectiveness of their medications; it can play a role in reducing their associated financial and lifestyle burdens. 1 3
Unlike ALT, which is a deliberately destructive procedure, permanently scarring the trabecular meshwork to provoke a pressure lowering response; the sparse laser energy applied in SLT is targeted and selectively absorbed by melanocyte cells in the Trabecular Meshwork, with no collateral damage to surrounding tissue structures.
SLT works by applying selective photo-thermolysis of the pigmented trabecular meshwork cells. This stimulates the release of proteins and cytokines and the recruitment of macrophages to improve the circulation of aqueous humor through the trabecular meshwork and the inner wall of the Schlemm’s canal.
The selective photo-thermolysis of SLT takes place at a cellular level producing a wound healing effect without causing structural damage to the trabecular meshwork. Collector channels are cleared in the juxtacanalicular tissue improving aqueous outflow and significantly reducing IOP.
Selective Laser Trabeculoplasty uses a 532 nm Q-switched, frequency-doubled Nd:YAG laser, delivering ultra-short pulses of 3-4 nanosecond duration. Using a 400 μm laser-spot-size compared with the 50 μm spot-size used with ALT, SLT irradiates a significantly larger proportion of the trabecular meshwork, (approximately 64 X the surface area of ALT).
Pulse Duration seconds
Always use the appropriately rated safety eyewear when operating a laser. SLT is a relatively simple outpatient procedure performed by a laser, delivered at the slit lamp, using a 1 X magnification indirect, Gonioscopy contact lens. During treatment, approximately 50 confluent laser-spots of 4-nanosecond duration are placed along each hemisphere of the Trabecular meshwork.
Recommended Treatment Guidelines have been prepared in cooperation with Ellex/Quantel Medical’s SLT Clinical Advisory Network and provide general guidance for physicians who are new to the SLT technique. It is the operating physician’s responsibility to familiarize themselves with the latest recommended techniques.
Video courtesy of Prof. Philippe Denis, University Hospitals of Lyon, France.
Glaucoma treatment : SLT Procedure
Selective Laser Trabeculoplasty, (SLT), is a highly effective laser therapy for the treatment of Primary Open Angle Glaucoma, (POAG), and ocular hypertension. It is non-destructive and repeatable, selectively targeting pigmented cells in the Trabecular Meshwork to stimulate a wound healing effect, promoting cellular regeneration WITHOUT structural damage.
SLT is more likely to be cost-effective than medical treatment and provides drop-free IOP control in most patients, for at least 3 years, supporting a change in clinical practice.1 2
SLT can be used as first-line glaucoma therapy or in combination with pharmacotherapy.
SLT lowers IOP by up to 30%, reducing problems with patient compliance, decreasing the overall medication burden.
Light study in figures 2
randomly assigned to SLT (329 patients)
or eye drops (323 patients).
Selective Laser Trabeculoplasty, (SLT), is clinically proven by the light trial to be a safe and effective first-line therapy for the treatment of primary open angle glaucoma or ocular hypertension. Tango Reflex incorporates Ellex’s proprietary SLT technology providing superior energy control, a sharp-edged aiming beam and the industry’s fastest firing rate of four shots per second. 3 With an enhanced view of the trabecular meshwork, you’ll be able to perform SLT procedures faster more accurately.
The role of Selective Laser Trabeculoplasty as a primary and secondary treatment
Selective Laser Trabeculoplasty: A Safe and Effective First-line Therapy for Glaucoma
Let There Be (Laser) Light
Ranking Laser in Glaucoma Treatment
Terminology and Guidelines for Glaucoma
Visual Field Outcomes from the Multicenter, Randomized Controlled Laser in Glaucoma and Ocular Hypertension Trial (LiGHT)
SLT earns a place as first-line therapy
Selective Laser Trabeculoplasty Updates and Tips
Selective Trabeculoplasty in the Management of Open Angle Glaucoma: Retrospective Analysis at 1 Year
Talk about Subthreshold Laser Therapy
1 Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet. 2019, Mar 9;393(10180):1505-16.
2 Ophthalmology. 2020 Apr;127(4):467-476.
3 Katz LJ, Steinmann WC, Kabir A, Molineaux J, Wizov SS, Marcellino G; SLT/Med Study Group. Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma; a prospective, randomized trial. J Glaucoma. 2012,21:460-8