What is a Selective Laser Trabeculoplasty?

Selective laser trabeculoplasty is a form of laser surgery generally employed in ophthalmology, the study of the eye, to relieve symptoms of high intraocular pressure (IOP) and prevent its complications. It is a safe and highly innovative way of reducing IOP in intraocular hypertension and many types of glaucoma, which does not respond to common medications. Types of glaucoma which can be treated with selective laser trabeculoplasty include primary open angle glaucoma, normal tension glaucoma, and pigmentary and juvenile glaucoma. The procedure is often done in an outpatient setting and does not require the use of anesthesia.

Glaucoma is a condition characterized by the buildup of fluid in the eye resulting in an increased IOP and is one of the leading causes of irreversible blindness in many patients. The eyes produce a small amount of fluid daily. Obstruction in the flow of this fluid can lead to its buildup inside the affected eye. Persistent increase in IOP can cause damage to the retina, the part of the eye that is sensitive to light. It can also compress the optic nerve, the nerve supplying information from the eyes to the brain, which may result in cell injury and even cell death.

Risk factors for the development of glaucoma include old age, diabetes mellitus, history of glaucoma in the family, and heart disease. Patients with glaucoma are often unaware of having the condition until symptoms of visual disturbances and visual loss occur. Other symptoms include blurred vision, difficulty in focusing objects, seeing halos around lights, and eye pain.

Selective laser trabeculoplasty utilizes very low levels of laser frequency selectively aimed at the cells causing obstruction in the fluid drainage of the eye. Prior to the procedure, eye drops are placed in the patient’s eye to decrease the amount of fluid and at the same time prevent an increase in the IOP after surgery. Laser beams are then directed at the target cells to open the spaces and widen the canal, allowing fluid to drain freely. Selective laser trabeculoplasty has no harmful effects on other tissues of the eye during the procedure.

Ophthalmologists, doctors specializing in the treatment of eye disorders, are generally the ones performing selective laser trabeculoplasty. One serious complication is the rise in IOP which frequently occurs two hours after surgery and which may become persistent. Other complications include pain, inflammation, decreased vision, and cloudiness of the cornea, the transparent covering of the eye.

After undergoing selective laser trabeculoplasty, patients are usually allowed to resume with their daily routine. Ophthalmologists often instruct their patients to refrain from certain activities, such as straining, lifting heavy objects and bending, for a minimum of two weeks after selective laser trabeculoplasty. Patients are also expected to return to the clinic for a follow-up eye examination.