IN SHORT: A low-energy form of the procedure, selective laser trabeculoplasty, has helped to address safety concerns associated with the argon form
Prostaglandin-based topical therapy has been the ‘go-to treatment’ for open-angle glaucoma for decades. In contrast, laser trabeculoplasty has conventionally remained reserved for patients unresponsive or unable to adhere to medication-based therapy.
Recent years, however, have brought the level of technologic advancement needed to move laser trabeculoplasty into the limelight as an effective open-angle glaucoma treatment.
However, with argon laser trabeculoplasty (ALT)—the original laser therapy for glaucoma—requiring a hot, high-energy laser that carries a noteable risk of collateral damage to surrounding tissue, safety concerns are a key disadvantage of this treatment modality.
Fortunately, the subsequent development of a cool, low-energy form of the procedure, called selective laser trabeculoplasty (SLT), has helped to ameliorate safety concerns.
By using a low-energy, Q-switched, frequency-doubled Nd:YAG laser with a short exposure time of up to 5 ns, the SLT laser is primed to specifically target pigmented trabecular meshwork cells without damaging surrounding tissue.1 And studies show that SLT is just as effective as ALT at lowering IOP in glaucoma patients.1, 2
Spurred by encouraging reports about the efficacy of SLT laser systems, I have spent recent months using the OptoYAG and SLT laser system (Optotek d.o.o, Slovenia) in my clinic in Ivano-Frankovsk, Ukraine. While doing so, I have been pleasantly surprised at how easy it has been to integrate an advanced piece on technology within my practice, and I have also become more aware of the realities of using laser technology to treat a condition that is classically managed with eye drops.