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Laser trabeculoplasty uses a very focused
beam of light to treat the
drainage angle of the eye. This surgery makes it
easier for fluid to flow out of the front part of the eye, decreasing pressure
in the eye.
There are two types of laser trabeculoplasty:
SLT uses a lower-power laser than ALT does.
For laser trabeculoplasty:
Some people feel some pressure in the eye during the surgery.
Laser trabeculoplasty can be done
without the person being admitted to the hospital. The person may need to be
checked by the doctor within 2 hours of the surgery. The person will also need
to see the doctor for a follow-up exam as recommended.
Laser trabeculoplasty may be helpful
in treating people whose glaucoma continues to get worse in
spite of medicine treatment. It may also be helpful in treating older adults
who have glaucoma and are not able to use medicines to treat it.
This laser procedure is
usually done before other surgical procedures are tried.
Argon laser trabeculoplasty lowers
the pressure in the eye about 75% of the time in people who haven't had surgery on that eye before.footnote 1
Research comparing ALT and the newer SLT has shown that SLT lowers pressure in
the eye about the same or slightly better than ALT.footnote 2
People usually need to continue taking medicine after laser surgery to keep
down the pressure in their eyes.
over the pressure inside the eye may decrease as time passes. Argon laser
trabeculoplasty is often not effective when repeated. But experts believe that
SLT may be repeated because it uses a lower level of laser and causes less
scarring than ALT. SLT may be used if ALT fails to lower eye pressure. The
results of repeated laser surgeries are less predictable than the results of the first
If excessive scar tissue forms after laser
trabeculoplasty for open-angle glaucoma, other surgery may be needed.
Complications of laser trabeculoplasty are rare. The most common
complication of laser surgery for glaucoma is an increase in the pressure in
the eyes. The pressure may be normal immediately after laser surgery and rise
sharply within 1 to 4 hours after laser surgery. To prevent this problem, the doctor may put medicine in your eyes (such as apraclonidine or brimonidine) before or after laser surgery,
especially in people with high intraocular pressure before laser
Other complications of laser surgery may include:
Decreased vision is usually a temporary problem unless
there is a significant rise in the pressure inside the eye. Very high pressures
inside the eye can lead to permanent vision loss.
Laser trabeculoplasty is less
effective in people who have inflammatory glaucoma, a type of glaucoma caused
by an existing inflammation, and in young people who have developmental
defects. Laser trabeculoplasty is not done for patients who have closed-angle glaucoma.
The drop in pressure in the eye after laser surgery may
not be enough to prevent loss of eyesight in people with very high pressure who
have already lost some of their vision.
If damage to the optic
nerve continues after laser trabeculoplasty, other surgery may be
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
American Academy of Ophthalmology (2010). Primary Open-Angle Glaucoma (Preferred Practice Pattern). San Francisco: American Academy of Ophthalmology. Also available online: http://aao.org/ppp.
Latina MA, et al. (2005). Selective laser trabeculoplasty. Ophthalmology Clinics of North America, 18: 409–419.
Other Works Consulted
Rolim de Moura CR, et al. (2007). Laser trabeculoplasty for open angle glaucoma. Cochrane Database of Systematic Reviews (4).
ByHealthwise StaffPrimary Medical ReviewerAdam Husney, MD - Family MedicineSpecialist Medical ReviewerChristopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
Current as ofMay 23, 2016
Current as of:
May 23, 2016
Adam Husney, MD - Family Medicine
& Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
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