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Article

Things You Didn’t Know About SLT

Experienced surgeons dispel myths about selective laser trabeculoplasty and provide pearls and practice insights.

By: Syril K. Dorairaj, MD, and, Ariana Levin, MD, Tony Realini, MD, MPH, Constance O. Okeke, MD, MSCE, Steven R. Sarkisian, Jr., MD, Christine Funke, MD, Lorraine M. Provencher, MD, Marlene R. Moster, MD, Shivani S. Kamat, MD, Sahar Bedrood, MD, PhD, Douglas J. Rhee, MD, Jacob W. Brubaker, MD, Kateki Vinod, MD, Lauren S. Blieden, MD, Mary Qiu, MD,, Samantha Goldburg, MD, John Berdahl, MD

Glaucoma Physician March 1, 2026 Page(s): 9-12

Clinical Report: Things You Didn’t Know About SLT

Overview

Revise to emphasize SLT's role in ocular surface health and as a rescue therapy.

Background

SLT has shifted earlier in the glaucoma treatment paradigm, supported by evidence from the LiGHT trial and other studies. This change is crucial as it offers a cost-effective alternative to traditional topical medications, potentially improving patient outcomes. Understanding SLT's applications and addressing common misconceptions can enhance its utilization in clinical practice.

Data Highlights

No numerical data provided in the article.

Key Findings

SLT is effective as a first-line therapy for glaucoma, offering better long-term disease control compared to medications.
It can serve as a rescue therapy for patients with ocular surface issues due to medications.
Patient counseling is critical; framing SLT as a primary option can improve acceptance.
SLT can be utilized in uveitic eyes with careful management and collaboration with uveitis specialists.
Topical NSAIDs are generally prescribed post-SLT for primary open-angle glaucoma, while steroids are recommended for uveitic eyes.

Clinical Implications

Clinicians should consider SLT as a primary treatment option for glaucoma, particularly for patients struggling with medication side effects. Effective communication about the benefits of SLT can enhance patient acceptance and adherence to treatment.

Conclusion

Reiterate the need for ongoing education and suggest areas for further training.

Related Resources & Content

Syril K. Dorairaj

Specialties: Ophthalmology

Bio: Syril K. Dorairaj, MD, is an ophthalmology author who has written on anterior segment optical coherence tomography and its clinical applications in evaluating corneal disease and anterior segment structures. His work in Ophthalmology Management has addressed the use of AS-OCT for micron-level assessment of corneal thickness, anterior chamber angle, anterior chamber depth, iris, lens, and related pathology.

Ariana Levin, MD

Specialties: Ophthalmology

Bio: Ariana Levin, MD, is a physician contributor to Glaucoma Physician. Her published article contribution focuses on selective laser trabeculoplasty and practical clinical insights in glaucoma care.

Tony Realini

Specialties: Ophthalmology

Bio: Tony Realini, MD, MPH, writes on glaucoma management, including evolving first-line approaches to therapy. His article in Glaucoma Physician discusses selective laser trabeculoplasty, sustained-release drug delivery, minimally invasive glaucoma surgery, and the limitations of topical medical therapy in primary open-angle glaucoma.

Contributions:

https://glaucomaphysician.net/issues/2025/november/laser-first-rethinking-glaucoma-therapy

Constance O. Okeke

Specialties: Ophthalmology

Bio: Constance O. Okeke, MD, MSCE, is an ophthalmology author writing in Glaucoma Physician on topical medication delivery in glaucoma care. Her article discusses the clinical implications of ophthalmic drop size, including microvolume delivery approaches intended to reduce excess dosing, overflow, local irritation, and systemic absorption.

Contributions:

https://www.glaucomaphysician.net/issues/2024/november/optimizing-drop-size/

https://ophthalmologymanagement.com/issues/2020/march/guest-editorial/

Christine Funke

Affiliations: Barnet Dulaney Perkins

Specialties: Ophthalmology

Bio: Christine Funke, MD, is affiliated with Barnet Dulaney Perkins in Phoenix, Arizona, and focuses on glaucoma care. In a Glaucoma Physician discussion from the 2026 American Society of Cataract and Refractive Surgeons meeting, she addressed interventional glaucoma and the shift toward earlier procedural treatment.

Contributions:

https://www.glaucomaphysician.net/issues/2026/march/ascrs18

Lorraine M. Provencher

Specialties: Ophthalmology

Bio: Lorraine M. Provencher, MD, is an ophthalmologist focused on glaucoma. In Glaucoma Physician, she has contributed commentary on glaucoma training programs and the importance of exposing trainees to modern minimally invasive glaucoma surgery techniques.

Marlene R. Moster, MD

Specialties: Ophthalmology

Bio: Marlene R. Moster, MD, is a glaucoma surgeon and ophthalmologist who contributed clinical insights on selective laser trabeculoplasty for Glaucoma Physician.

Shivani S. Kamat

Specialties: Ophthalmology

Bio: Shivani S. Kamat, MD, is a glaucoma surgeon who contributed practical clinical guidance on selective laser trabeculoplasty for Glaucoma Physician.

Sahar Bedrood

Specialties: Ophthalmology

Bio: Sahar Bedrood, MD, PhD, writes on glaucoma surgery and postoperative bleb management. In Glaucoma Physician, she has discussed bleb needling techniques used to lyse conjunctival and Tenon’s scarring, improve aqueous outflow, reduce intraocular pressure, and help prevent additional glaucoma surgery.

Contributions:

https://ophthalmologymanagement.com/issues/2022/march/guest-editorial/

https://glaucomaphysician.net/issues/2022/march/tips-and-tricks-for-bleb-needling/

Douglas J. Rhee, MD

Specialties: Ophthalmology

Bio: Douglas J. Rhee, MD, is a glaucoma surgeon who contributed practical guidance on selective laser trabeculoplasty for Glaucoma Physician, with a clinical focus on glaucoma care and laser-based treatment strategies.

Jacob W. Brubaker

Specialties: Ophthalmology

Bio: Jacob W. Brubaker, MD, is a glaucoma surgeon who contributed to Glaucoma Physician’s 2026 discussion of selective laser trabeculoplasty (SLT). His contribution is part of a practical, surgeon-focused review addressing patient selection, treatment technique, postprocedure management, repeat treatment, and misconceptions about SLT.

Kateki Vinod

Specialties: Ophthalmology

Bio: Kateki Vinod, MD, writes on glaucoma diagnosis and monitoring, including the interpretation of optical coherence tomography artifacts affecting retinal nerve fiber layer and ganglion cell complex assessment. Her work in Glaucoma Physician focuses on the clinical use and limitations of OCT imaging in distinguishing true glaucoma progression from imaging artifacts and ocular comorbidities.

Lauren S. Blieden, MD

Specialties: Ophthalmology

Bio: Lauren S. Blieden, MD, is an ophthalmologist with a focus on glaucoma. She was listed by Glaucoma Physician among experienced glaucoma surgeons contributing practice insights on selective laser trabeculoplasty, including its role in contemporary glaucoma management.

Mary Qiu

Affiliations: Cleveland Clinic

Specialties: Ophthalmology

Bio: Mary Qiu, MD, is affiliated with Cleveland Clinic and works in the field of glaucoma. In Glaucoma Physician coverage of the 2025 American Academy of Ophthalmology Meeting, she moderated a Glaucoma Group Therapy session focused on challenging surgical cases, including complications in canaloplasty.

Samantha Goldburg

Specialties: Ophthalmology

Bio: Samantha Goldburg, MD, is a physician author in ophthalmology whose work focuses on glaucoma diagnosis and monitoring. She coauthored coverage in Glaucoma Physician on emerging continuous intraocular pressure monitoring technologies, including wearable contact lens–based sensors and implantable telemetric systems for assessing diurnal and nocturnal IOP variability.

John Berdahl

Affiliations: Vance Thompson Vision

Specialties: Ophthalmology

Bio: John Berdahl, MD, is an ophthalmologist at Vance Thompson Vision in Sioux Falls, South Dakota. His clinical writing in Ophthalmology Management focuses on cataract surgery workflow and patient sedation, including IV-free cataract surgery using sublingual conscious-sedation approaches for ocular procedures.

Steven R. Sarkisian, Jr.

Specialties: Ophthalmology

Bio: Steven R. Sarkisian, Jr., MD, writes on glaucoma surgery and interventional glaucoma management. In Ophthalmology Management, he has discussed dual-outflow approaches for glaucoma, including the evolution of minimally invasive glaucoma surgery and emerging strategies to enhance natural aqueous drainage pathways.