Clinical Report: Reevaluating SLT: Updated Evidence and Clinical Pearls

Overview

Selective laser trabeculoplasty (SLT) is increasingly recommended as a first-line treatment for primary open-angle glaucoma and ocular hypertension, demonstrating extended efficacy and safety for repeat procedures. Recent studies, including the LiGHT trial, support its early use and potential for long-lasting effects.

Background

The management of glaucoma is critical to prevent vision loss, and the introduction of SLT as a treatment option has shifted clinical practice. With evidence supporting its effectiveness and safety, particularly in early-stage glaucoma, understanding SLT's role is essential for optimizing patient outcomes. The recent findings from the LiGHT trial further emphasize the need for updated clinical guidelines regarding SLT usage.

Data Highlights

No numerical data available in the provided material.

Key Findings

• SLT should be considered as first-line therapy for newly diagnosed primary open-angle glaucoma and ocular hypertension.
• The median duration before needing to repeat SLT is greater than 6 years, contrary to previous beliefs of 2-5 years.
• SLT can be safely repeated, with effective outcomes noted upon re-treatment.
• The COAST trial aims to explore the optimal timing and frequency for SLT repeat procedures.
• Recent guidelines from the European Glaucoma Society and the American Academy of Ophthalmology endorse SLT as an early treatment option.

Clinical Implications

Clinicians should consider initiating SLT in patients with early glaucoma to leverage its long-lasting effects and reduce reliance on medications. Additionally, understanding the repeatability of SLT can aid in patient counseling and treatment planning.

Conclusion

The evolving evidence surrounding SLT underscores its importance as a first-line treatment in glaucoma management, with implications for both clinical practice and patient care strategies.

References

1. Glaucoma Physician, 2026 -- Things You Didn’t Know About SLT
2. Ophthalmology Management, 2013 -- ALT vs. SLT: Is One Better Than the Other?
3. European Glaucoma Society, 2026 -- Advancing glaucoma care: What's new in the 6th edition of the European Glaucoma Society guidelines
4. glaucoma physician — Things You Didn’t Know About SLT
5. glaucoma physician — Which Patients Benefit Most From Repeat SLT?
6. European Glaucoma Society
7. Advancing glaucoma care: What's new in the 6th edition of the European Glaucoma Society guidelines - Marta Pazos, Carlo E Traverso, Ananth Viswanathan, Augusto Azuara-Blanco, Luis Abegão Pinto, Ingeborg Stalmans, 2026
8. Selective Laser Trabeculoplasty Compared to Medication for Open‐Angle Glaucoma Patients: A Systematic Review and Meta‐Analysis - PMC