Selective Laser Trabeculoplasty (SLT) for Glaucoma by Yishun Health

Selective Laser Trabeculoplasty (SLT) for Glaucoma

What is glaucoma?

Glaucoma is an eye condition that can affect your vision. If glaucoma is not treated, it can cause permanent visual loss. Glaucoma is usually due to build up of pressure with the eye, This pressure is called intraocular pressure (IOP).

This pressure is generated by fluid (called aqueous humour) within the eye. This fluid then drains mainly into a structure called trabecular meshwork. The level of pressure is determined by the balance of fluid entering and leaving the eye. If the fluid flow is blocked, pressure in the eye rises and glaucoma may occur.

How does SLT laser treatment work?

Selective laser trabeculoplasty (SLT) works by using gentle laser energy to treat the trabecular meshwork, thus improving the exit of fluid and in turn, leads to a lowering of the pressure of the eye.

It is not a permanent treatment and may need to be repeated in the future. The procedure does not require admission to hospital and is carried out at KTPH Laser Clinic.

Why is this treatment recommended for me?

SLT is recommended as an option for patients who:

• Have raised eye pressure and are at risk of developing glaucoma

• Have a type of glaucoma called open-angle glaucoma with raised eye pressure

• Cannot tolerate side effects of glaucoma eye drops

• Wish to reduce the number of eye drops used

How successful is the procedure?

Studies show the success rate is about 70-80% in reducing intraocular pressure. While most patients respond well to treatment, some may not respond at all.

We cannot predict how well the laser will work as it depends on the severity and type of glaucoma and the individual characteristics of your eye. If your eye pressure does not decrease enough after the first treatment, you may need a repeat laser treatment or require some additional eyedrops.

The effects of the laser treatment may wear off in time and may be repeated as required.

Are there side-effects from laser treatment?

• The white of your eye may be red for a few hours

• You may experience mild blurring of vision for about a day following your laser procedure

• There may be mild eye inflammation and discomfort after the laser procedure. This is transient and with medication, the inflammation and discomfort will settle

• Occasionally, after the laser procedure, the pressure of the eye may rise. However, this is transient and with medications, the pressure of the eye will normalise again

• Rarely, there may be bleeding inside the eye. This is transient and will settle

Are there any other treatments available for glaucoma?

Other treatments include eyedrops or surgery for glaucoma. Eyedrops that reduce eye pressure are applied once, twice or three times a day to the affected eye. Surgery for glaucoma is usually reserved for eyes in which eyedrops for glaucoma have failed to reduce the pressure of the eye sufficiently.

Will my vision get worse if I do not undergo laser treatment? If you are not on adequate glaucoma treatment, your vision will continue to deteriorate slowly over time.

How do I prepare for the laser?

Before

1. Please continue to apply your usual glaucoma eyedrops as instructed

2. Do not drive as your vision may be blurred for a few hours after treatment

3. Come with a companion so that he/she can take you home safely

4. There is no need to fast, and no need to stop your usual medications

How is the laser carried out?

During

This is a minor laser procedure. It is quick, often taking between 15 to 20 minutes minutes, and it is carried out in the clinic. No injections are required; our nurses will instill eyedrops to protect you from sudden increases in pressure of the eye. After this you will need to sit in front of the laser machine which looks like the slit lamp we use to examine your eyes in clinic. The nurse will apply anaesthetic drops into your eyes to numb the eye.

The doctor will gently apply a contact lens onto your eye. This is not painful but it may feel a little strange and in some cases may cause some temporary redness or irritation. The laser procedure is then carried out. You might see some flashes of light and hear clicking noises. You may experience mild discomfort during the treatment, but this is usually tolerable.

What happens after the laser treatment?

After

After the procedure, we keep our patients under observation for approximately 30 to 45 minutes. After which we will check your eye pressure before your go home.

What do I need to do at home?

Eyedrops may be prescribed for use to soothe any discomfort that may occur. No special after-care is required; you can watch TV or read. Please continue applying your usual glaucoma eyedrops as instructed by your eye doctor. Medical leave can be given for the rest of the day if necessary and work can resume the next day

Follow up

We will make an appointment to see you four to five weeks after your treatment. This is to check your eye pressure and that your eye is settling after the treatment.

Contact information

• Loss of vision

• Your treated eye becomes increasingly red or painful

During office hours (8am to 4pm from Monday to Friday), please call our Contact Center at 6555 8000; or proceed to Acute and Emergency Care at Tower A, Level 1, Khoo Teck Puat Hospital after office hours to see the doctor.

We hope this has helped you and your family understand why you need to undergo SLT laser treatment. Please do not hesitate to ask your eye doctor if you have any other questions related to your eye condition or the laser treatment.

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This brochure was developed together with NHG Eye Institute partners.

Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group in the north of Singapore. It comprises Khoo Teck Puat Hospital, Yishun Community Hospital and community extensions such as Admiralty Medical Centre and Wellness Kampung. Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg

The information is correct at the time of printing and subject to revision without further notice.