Application Notes

In most primary OAG patients, SLT reduces IOP significantly for a few years without any major or permanent side effects or complications. Consequently, the idea of potentially gaining some drug-free years for a newly diagnosed patient by using SLT as the initial therapy is appealing.

Due to the non-thermal laser characteristic of SLT, it does not cause any collateral damage or burn to surrounding tissues and trabecular meshwork structure. This unique clinical effect allows SLT to be potentially repeatable. Clinical trials on the effect of repeated SLT are currently being completed.

The Normal Tension Glaucoma Study Group reported that a 30 percent reduction in IOP can be attained in most NTG eyes with a combination of drugs and ALT. It can therefore be assumed that SLT will achieve similar IOP lowering results in NTG, with the added benefit of potential repeatability and without the side effects associated with ALT.

One of the main theories on the mode of action in SLT is that the laser energy is absorbed in melanin granules in the trabeculum, which triggers a reaction that effectively reduces IOP. If this is indeed the case, the results of the treatment should vary according to the degree of pigmentation of the trabecular meshwork.

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