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 Scorecard: Things You Didn’t Know About SLT

At a Glance

Category	Detail
Condition	Glaucoma
Key Mechanisms	Selective laser trabeculoplasty (SLT) reduces intraocular pressure (IOP) and improves ocular surface health.
Target Population	Patients with glaucoma, particularly those with primary open-angle glaucoma (POAG) and ocular hypertension (OHTN).
Care Setting	Ophthalmology clinics and surgical centers.

Key Highlights

SLT is effective as a first-line therapy compared to topical medications.
It can serve as a rescue therapy for ocular surface health.
Patient counseling is crucial for acceptance of SLT.
SLT can be beneficial in uveitic eyes with elevated IOP.
The recent FDA approval of the Voyager DSLT system expands treatment options.

Guideline-Based Recommendations

Diagnosis

Perform gonioscopy to confirm angle openness before SLT.

Management

Consider SLT as a primary strategy for medication reduction.
Use topical NSAIDs after SLT in POAG and topical steroids in uveitic eyes.

Monitoring & Follow-up

Assess IOP and ocular surface health post-SLT.

Risks

Potential for elevated IOP post-SLT requiring additional procedures.

Patient & Prescribing Data

Patients with glaucoma, especially treatment-naïve individuals.

SLT can achieve significant IOP reduction, often exceeding 50% in treatment-naïve eyes.

Clinical Best Practices

Explain SLT as 'light energy treatment' to improve patient receptiveness.
Shift patient discussions from pressure reduction to quality of life improvement.
Utilize SLT early in the treatment paradigm for better outcomes.

PentaVision

Glaucoma Physician