Selective Laser Trabeculoplasty-What Do We Know So Far? Review

Selective laser trabeculoplasty (SLT) has been used for lowering intraocular pressure (IOP) in patients with different types of glaucoma. It is a safe and effective procedure as initial or additional therapy when target IOP could not be achieved with medical therapy. SLT could specifically target pigmented cells in trabecular meshwork (TM) leaving nonpigmented cells unaffected, which may allow repeat treatments and thus has lower complication rate. It can be successfully used for IOP reduction in primary open angle glaucoma (POAG), normotensive glaucoma (NTG), pigmentary glaucoma (PG), pseudoexfoliation glaucoma (PXFG), primary angle closure glaucoma (PACG), silicone-oil-induced glaucoma, and high IOP after failed trabeculectomy. SLT could also be used in all stages of open agle glaucoma but failure of SLT in advanced glaucoma patients should go to immediate filtering surgery to avoid postoperative fibrosis. SLT reduces IOP fluctuation. IOP-lowering effect of SLT diminishes over time, but it can be repeated in order to achieve additional or recurrent IOP reduction. Higher baseline IOP up to a certain level is the strongest predictor of success after SLT.