What is selective laser trabeculoplasty?

Selective laser trabeculoplasty is a common laser procedure used to treat glaucoma. Glaucoma is an eye disease in which the optic nerve is damaged, usually by high pressure inside the eye. Eye pressure can become too high if you have a problem with the drainage of fluid from your eye. Damage to the optic nerve can cause a loss of vision.

In this procedure, Dr Hillson uses a laser to create microscopic bursts of energy in the drainage pathways (the trabecular meshwork) in your eye. The burns open the drainage holes in the meshwork and allows fluid to drain better through them. The procedure can lower the pressure in your eye and help prevent more damage to the optic nerve and loss of vision.

Dr Hillson may recommend this procedure after you have tried treating high pressure in your eye with eye drops or pills. These medicines may not be reducing your eye pressure enough, or they may be causing side effects. As the laser is very selective in its application of energy, sometimes Dr Hillson may even recommend it before starting glaucoma drops.

What happens during the procedure?

This procedure is performed in Dr Hillson’s office. Dr Hillson uses eye drops to numb your eye and other drops are used to make the pupil small. A special contact lens is put on your eye to help direct the laser’s high-energy beam of light at the trabecular meshwork in your eye. The laser makes about 50 evenly spaced burns over 180 degrees of the eye. You will see a few brief flashes of light and feel little, if any, discomfort. The procedure usually takes less than 10 minutes. You will be able to go home soon after it is done. Dr. Hillson will ask you to return to the office two hours after your laser treatment to check the eye pressure. You will also have a further appointment in approximately two weeks to have the other 180 degrees lasered.

What happens after the procedure?

Your vision will probably be blurred for a few hours, but then it should clear. You will not need to wear an eye patch. Dr Hillson will ask you to use Voltaren eye drops four times a day for five days. If your vision does not clear within a day or if you feel any pain or discomfort, call Dr Hillson. If it is the evening or the weekend and you are having problems, you should go to emergency to be assessed.

This procedure is usually successful. Several days or weeks after the procedure, the flow of fluid from your eye should improve. Improved flow usually reduces the pressure inside the eye. It can take 2 to 4 weeks, and sometimes longer, to learn the results. Most people do still need to take glaucoma drops after the procedure. The effects of this treatment may not last. In 50% of people it stops working in about 5 years. It can be repeated at that point.

What are the risks?

Although there are some risks with the laser treatment such as inflammation, bleeding inside the eye, and raised pressure in the eye, the risks are fewer risks than with other types of surgery. Problems may occur that could threaten your vision, but they are rare. If you have any questions about the risks of selective laser trabeculoplasty, ask Dr Hillson.