Selective Laser Trabeculoplasty (SLT) for the treatment of open angle glaucoma has been available for over a generation. Glaucoma is an eye disease that affects about 2% of the population. It is a silent blinding disease of which the exact mechanism of damage is not clearly understood. At some level, the intraocular pressure is too high for a given eye and damage to the optic nerve gradually develops. As nerve damage increases, the visual field of the eye begins to shrink and become more “tunnel-like.”
This can ultimately lead to total blindness.
The flow of fluid in the eye is necessary to provide nutrients to the front portion of the eye. This fluid known as aqueous humor is created by the ciliary body behind the iris and it flows out of the eye in the trabecular meshwork between the cornea and crystalline lens. It is believed that within the trabecular meshwork that the cause of glaucoma originates. If the trabecular meshwork does not allow for the free flow of fluid the pressure in the eye elevates. As the elevation of pressure occurs it may cause damage to the optic nerve by either a direct mechanical effect or an indirect effect on its blood flow.
Many treatments for glaucoma have focused upon the outflow pathway through the trabecular meshwork. Both eye drops and surgical procedure are used to increase the flow of fluid out of the eye and thereby reduce intraocular pressure. SLT in various forms has been used as one of those outflow of fluid enhancers for many years. SLT is believed to work but either mechanically causing the trabecular meshwork to become more open or to incite and inflammatory response the causes the eye’s own
repair mechanisms to allow to meshwork to be more open. Either way, the treatment is highly successful with over 90% of patients experiencing intraocular pressure lowering. The procedure is done in clinic and only takes a few minutes of time. The effect, however, takes several weeks to have a full effect and is repeatable.