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SLT versus Drops for Glaucoma?


As ophthalmologists, we see countless patients who have early-stage glaucoma. Glaucoma is a disease that damages the optic nerve fibers resulting in small blind spots and eventual blindness when the entire nerve is affected. As one can imagine, this can be very emotionally difficult for patients to digest this diagnosis. Often, they are reminded of their parents who had glaucoma and were on life-long drops or had numerous surgeries, and eventually significant vision loss.

Thankfully, we have come a long way in understanding and treating glaucoma. There are newer treatment modalities ranging from lasers, drug-eluting implants, and minimally invasive glaucoma surgeries. One powerful medical therapy for early glaucoma is selective laser trabeculoplasty (SLT).

What is SLT?

SLT is a simple, yet highly effective laser procedure performed by your ophthalmologist that reduces intraocular pressure. It is painless and typically takes no more than five minutes.

How does it work?

Laser energy is applied to the trabecular meshwork. The trabecular meshwork is located in the front of the eye and is the natural drain for fluid. The laser stimulates the trabecular meshwork to increase the amount of fluid drained from within the eye, which lowers eye pressure. It may take up to 6-8 weeks for the laser to fully work.

What happens during the procedure?

First, drops are used to prepare the eye and provide mild anesthesia. Gentle pulses of light are delivered through a special microscope. The entire process takes just a few minutes. Once complete, your doctor may treat your eye with anti-inflammatory eye drops. It is important to keep your follow-up appointments, so your doctor can recheck the treated eye.

What do I have to do after the procedure?

Your ophthalmologist may ask you to use an anti-inflammatory eye drop in the treated eyes for several days. There are no activity limitations after the procedure.

How effective is SLT?

SLT lowers intraocular pressure by an average of 20-30% in 75-85% of patients treated. In select types of glaucoma, studies have shown that patients who received SLT have a slower rate of glaucoma progression than those who were started on eye drops.1 For patients who do not respond, other highly effective forms of treatment are available.

At Georgia Eye, our doctors have performed thousands of glaucoma procedures. Call us today for your evaluation.


Gazzard, Gus, et al. “Laser in glaucoma and ocular hypertension (LiGHT) trial: six-year results of primary selective laser trabeculoplasty versus eye drops for the treatment of glaucoma and ocular hypertension.” Ophthalmology 130.2 (2023): 139-151.