Laser Trabeculoplasty

In chronic open-angle glaucoma, the intraocular pressure increases due to insufficient drainage of the intraocular fluid and this causes damage to the nerve fibers in the eye over time, thus restricting the visiual field and causing loss of vision.

Figure 1. Selective laser trabeculoplasty (SLT) application for glaucoma.

Under normal circumstances, the intraocular fluid is absorbed in a certain pattern from spongy tissue between the iris and cornea called the trabecular  network and then leaves the eye. However, a deceleration occurs in the fluid drainage for unexplained reasons. In order to treat this condition, different glaucoma medications are used in the form of eye drops. When these medications cannot reach the desired intraocular pressure, laser treatments are used. This is an ambulatory treatment easy to apply within 15-20 minutes. The patient does not feel any pain.

Laser trabeculoplasty is based on the principle of creating small burns in the trabecular network area to reduce intraocular pressure and thus increase the absorption of intraocular fluid. Argon-type laser is used for this purpose and this treatment is called Argon Laser Trabeculoplasty (ALT).

The intraocular pressure of 75% of treated patients can decrease, although it has been observed that it increases again within 5 years. In this case, ALT treatment is required again. This treatment has the risk of causing an intraocular tissue adhesiveness called synechia and uveitis. Another method called Selective Laser Trabeculoplasty (SLT) is also administered, which resembles Argon Laser Trabeculoplasty in terms of application but differs in terms of targeted cell groups in the trabecular area,. An effect is created here on the pigmented cells and it is attempted to create drainage with less damage.