SLT AS A FIRST-LINE TREATMENT FOR GLAUCOMA

One of the most pivotal studies supporting SLT as a first-line therapy is the LiGHT study (Laser in Glaucoma and Ocular Hypertension), led by Dr. Gus Gazzard and published in The Lancet. The initial findings, published in 2019, reported outcomes at 3 years, demonstrating the clinical and cost-effectiveness of SLT compared to eye drops. A subsequent publication in February 2023 presented the 6-year results, confirming sustained benefits of SLT, including better long-term disease control and reduced need for glaucoma and cataract surgeries.

A LiGHT Study summarized overview of both publications is available for quick reference.

This landmark study has influenced treatment protocols worldwide and led to updated recommendations positioning SLT as a first-line option in appropriate patients.

Effective IOP Reduction

SLT can reduce IOP by 20–30% from baseline after a single session. The therapeutic effect is similar to that of prostaglandin analogues and beta-blockers.

Repeatability Without Tissue Damage

Because SLT procedure avoids thermal coagulation, the trabecular meshwork structure is preserved, allowing for safe repeat procedures if IOP rises again over time.

Reduced Dependence on Medication

Selective Laser Trabeculoplasty minimizes or even eliminates the need for eye drops, addressing common issues like non-compliance, side effects, cost, and ocular surface toxicity.

Quick and Painless Procedure

This laser treatment is performed in-office, with minimal patient discomfort. Most of them resume normal activities within a few hours after the procedure.

Favorable Safety Profile

SLT has a low incidence of inflammation, IOP spikes, and post-op complications, making it suitable even for elderly people or those with systemic contraindications to drugs.

Here is the indications:

• Primary open-angle glaucoma (POAG)
• Ocular hypertension (OHT)
• Pigmentary or pseudoexfoliative glaucoma
• Patients intolerant or noncompliant with medication
• Patients unable to use eye drops due to dexterity, allergies, or lifestyle

Patients with glaucoma who are newly diagnosed or at early stages can particularly benefit from first-line SLT treatment, reducing the lifetime burden of pharmacotherapy.

Procedure step-by-step:

1. Topical anesthetic drops are applied to the eye.
2. A gonioscopy lens is used to visualize the angle.
3. 50–100 laser applications are delivered over 180°–360° of the trabecular meshwork.
4. Post-operative monitoring ensures IOP stability. Anti-inflammatory drops may be prescribed short-term.

The laser treatment takes approximately 5 minutes per eye and does not require sedation. Follow-up visits typically occur within the first week.

While both techniques aim to improve aqueous flow, SLT procedure offers several modern advantages over ALT (Argon Laser Trabeculoplasty):

Selective action that spares adjacent tissue:

• Repeatable with consistent results
• Minimal inflammation
• Greater patient comfort
• Better long-term IOP control

ALT is no longer considered a first-choice option due to its destructive mechanism and poor repeatability.

Implementing Selective Laser Trabeculoplasty in your practice offers:

• Rapid procedures with high throughput
• Minimal equipment footprint
• Immediate return to activities
• Reduced need for chronic medication follow-up
• Clear treatment results and effects visible within days to weeks

Doctors can easily train to perform SLT, and practices see improved efficiency with minimal discomfort to the patient.

At Lumibird Medical, we deliver cutting-edge laser systems under 3 brands - Ellex, Quantel Medical and Optotek - tailored to the needs of ophthalmologists and glaucoma specialists. Our devices are engineered to:

• Deliver precise laser energy
• Minimize treatment time
• Maximize patient comfort
• Enable full control and customization
• Provide a long lifecycle with low maintenance

Key Features:

• Adjustable pulse energy for custom treatment
• Real-time IOP tracking compatibility
• Easy integration into EMR systems
• Compact, ergonomic design
• Optimized for use with multiple laser procedures

Is SLT safe?

Yes. SLT is clinically proven to be safe, with a low rate of complications and minimal side effects.

Can SLT be repeated?

Yes. Unlike ALT, SLT does not cause tissue damage, allowing repeat treatments over time.

How long does SLT last?

Results can last 3–5 years or more. Some patients may need a repeat laser treatment depending on progression.

Does SLT replace medication?

In many cases, yes. According to the LiGHT study, 74% of people treated were drug-free three years following the laser procedure.