Selective Laser Trabeculoplasty

What is Laser Trabeculoplasty?
There are different ways in which laser therapy can be used to treat patients with glaucoma. Laser trabeculoplasty is a treatment for patients who have open angle glaucoma. The trabecular meshwork is around the periphery of the iris and is where fluid made in the eye drains out of the eye. This meshwork is treated directly with the laser to improve drainage through it. Selective laser trabeculoplasty is a newer form of a long established treatment that has the advantage of not causing any damage to the tissue treated.

What happens on the day of treatment?
The treatment takes place in the outpatient department. You will be asked to attend the clinic in advance of the treatment time. The nurse will check your vision and put some drops in to your eye to prevent the pressure rising within your eye. The drops take up to one hour to work. I will take your written consent and explain further if you have any questions. You will also have anaesthetic drops put in to numb the front of the eye.

Once seated in front of the laser machine, which is similar to the microscope you will have been examined on in clinic, a special lens will be placed against the front surface of your eye. This is not painful, but it may feel a little strange. During the laser treatment, you may see some flashes of light and hear clicking noises. The laser treatment is generally painless, although some patients feel a slight pain lasting a second or less.

After the laser treatment, you will have further drops put in your eyes to help reduce any rise in pressure caused by the laser. The pressure in your eye will be checked about an hour after the treatment, before you go home. You will then receive a prescription for drops to take at home for 2 days only if the eye is red or sore. We will then make an appointment to come back to the clinic, usually 1 to 2 weeks afterwards.

Are there any risks or side effects of this treatment?
Your vision may be slightly blurred for a few hours following your laser treatment. This will settle. If you are concerned that your vision is not returning to normal please contact me or the hospital on the numbers below. It is advisable that you do not drive yourself to the hospital, as you will be unable to drive home.

Your eye may feel slightly bruised afterwards and some times become inflamed but if so the drops you have been given to use will control any inflammation and help to relieve discomfort, although nearly everyone finds they do not need to use the drops.

You may wish to take a mild painkiller, for example Paracetamol, to relieve this discomfort. If you are already taking painkillers for a different condition continue with these, but do not take both.

It is possible for the pressure in your eye to increase immediately after the treatment. In order to prevent this we put in some special drops before and immediately after the treatment.

How successful is it in lowering the pressure?
It does not work in all patients. Studies show a 70% success. It is usually necessary to continue with some eye drops to lower the pressure after laser trabeculoplasty. It may take days or weeks after the laser treatment for the pressure to be reduced.

The effects of the laser may wear off in time, about 50% stop working after 5 years for the previous form of laser trabeculoplasty.

The information in this leaflet is intended as a guide only, as each patients experience will be different.

Consultants who undertake private cataract surgery:

Leon Au