What Is Selective Laser Trabeculoplasty?
Selective laser trabeculoplasty is a non-surgical laser procedure that treats the eye’s natural drainage channel, known as the trabecular meshwork. In a healthy eye, fluid (aqueous humour) is produced continuously and drains away through this meshwork. When drainage becomes less efficient, pressure inside the eye can rise, which over time may damage the optic nerve, the process underlying glaucoma.
SLT uses very short, low-energy pulses of laser light that are absorbed only by specific pigmented cells within the drainage tissue. This selective action stimulates a biological response that improves fluid outflow, helping to lower eye pressure. Because the energy levels are low, the treatment does not burn or scar the meshwork, which means it can often be repeated in the future if its effect reduces over time.
It is important to understand that SLT is a pressure-lowering treatment rather than a cure. Glaucoma is a long-term condition that requires ongoing monitoring, and laser treatment forms one part of a wider management plan that may also include eye drops, minimally invasive glaucoma surgery (MIGS) or, in some cases, cataract surgery.
Who May Benefit From This Treatment?
Selective laser trabeculoplasty may be suitable for adults who need their eye pressure lowered and whose drainage angle is open on examination. You may be a candidate if you:
- have been newly diagnosed with primary open-angle glaucoma and wish to consider laser treatment before starting long-term drops
- have ocular hypertension (raised eye pressure without detectable nerve damage) that is considered to carry a risk of progression
- find eye drops difficult to instil, uncomfortable, or hard to remember consistently
- experience side effects from glaucoma drops, such as redness, stinging, dry eye or allergy
- have pressure that remains above your individual target despite medication
- have pigmentary or pseudoexfoliative glaucoma, where laser treatment can sometimes work particularly well
Conditions and Problems SLT May Address
- Primary open-angle glaucoma
- Ocular hypertension (raised intraocular pressure)
- Pigmentary glaucoma
- Pseudoexfoliative glaucoma
- Difficulty tolerating or adhering to glaucoma eye drops
- Inadequate pressure control on current medical treatment
Potential Benefits
Outcomes vary between individuals, but for suitable patients selective laser trabeculoplasty may:
- lower intraocular pressure, which is to date the only proven way to slow glaucoma progression
- reduce reliance on daily eye drops, or in some cases avoid starting them
- help protect remaining vision by supporting long-term pressure control
- avoid the ocular surface irritation and preservative-related dryness some drops can cause
- be repeated if the effect diminishes over the years
- be performed without incisions, stitches or a hospital stay
SLT does not restore vision that has already been lost, and not everyone responds. A proportion of patients will need additional treatment to reach their target pressure. The effect also tends to reduce gradually over time, which is why continued monitoring is essential.
Consultation and Assessment
Before any laser treatment is recommended, Ms Diana Urbaneja carries out a detailed glaucoma assessment. This usually includes:
- a discussion of your symptoms, general health, medication and family history
- vision testing and examination of the front and back of the eye
- measurement of intraocular pressure and corneal thickness
- gonioscopy, an examination of the drainage angle, to confirm it is open and suitable for laser
- optic nerve imaging with OCT and a visual field test to assess any existing damage
- a conversation about the realistic benefits, risks and alternatives, including drops, MIGS and other surgical options
You will be given time to ask questions, and a personalised target pressure and treatment plan will be agreed with you before consent is taken.
How Selective Laser Trabeculoplasty Is Performed
SLT is an outpatient procedure, there is no need for a general anaesthetic, an overnight stay, or time in an operating theatre. The typical process is:
- pressure-lowering and anaesthetic eye drops are instilled to numb the surface of the eye
- you sit at a slit-lamp microscope, similar to a standard eye examination
- a special contact lens is gently held against the eye with lubricating gel to allow a clear view of the drainage angle
- brief laser pulses are applied around the meshwork, usually treating the full 360°
- the lens is removed and the eye is rinsed; your pressure may be rechecked shortly afterwards
Treatment usually takes around five to ten minutes per eye. Most people describe small flashes of light and occasional mild tingling or pressure rather than pain. You can normally go home the same day, although vision may be slightly blurred for a short period, so arranging transport is sensible.
Recovery and Aftercare
Recovery from SLT is generally straightforward. You may be prescribed a short course of anti-inflammatory drops, and you will usually be advised to continue your existing glaucoma medication until told otherwise. Mild grittiness, light sensitivity or slight redness for a day or two is common.
Most people return to work, reading, screen use and everyday activities within a day, avoiding swimming and eye rubbing initially. The pressure-lowering effect builds gradually over several weeks, so a follow-up appointment is arranged, commonly within one to three months, to measure your response and decide whether drops can be reduced. Longer-term monitoring of pressure, optic nerve and visual fields continues as part of routine glaucoma care.
You should seek prompt advice if you develop significant eye pain, marked redness, a sudden drop in vision, or persistent haloes after treatment.
01
Consultation
Eye pressure assessment
02
Laser
~10-15 min, in clinic
03
Follow
Pressure check appointment
Guide Price
from £650
Per eye. A quick, drop-free laser that can lower eye pressure without daily eye drops. See the pricing page for all options.
At a glance
Anaesthetic
Topical drops
Procedure time
~10-15 min
Stay
Same day, no admission
Recovery
Same day
Follow-up
Pressure check appointment