Selective Laser Trabeculoplasty for Open-Angle Glaucoma - Ophthalmology

More Info

---

Selective Laser Trabeculoplasty (SLT) is a well-established treatment option for open-angle glaucoma, and it has gained popularity due to its effectiveness and safety profile. In the context of your question regarding its use in Taiwan, it is important to clarify a few key points about SLT, its comparison with Argon Laser Trabeculoplasty (ALT), and the general treatment landscape for open-angle glaucoma.


Current Use of SLT in Taiwan
In Taiwan, many hospitals, including major institutions like National Taiwan University Hospital, have adopted SLT as a primary treatment modality for open-angle glaucoma. SLT is favored because it is less invasive and has a lower risk of complications compared to traditional ALT. While some facilities may still use ALT, SLT is generally preferred due to its selective targeting of the trabecular meshwork, which minimizes damage to surrounding tissues.


Differences Between SLT and ALT
1. Mechanism of Action: SLT uses a lower energy level and a different wavelength compared to ALT. SLT selectively targets pigmented cells in the trabecular meshwork, which helps to enhance aqueous outflow without causing significant thermal damage. In contrast, ALT uses higher energy levels that can lead to more extensive tissue damage.

2. Repeatability: One of the significant advantages of SLT is its repeatability. Patients can undergo SLT multiple times if necessary, as it does not cause the same level of scarring as ALT. This is particularly beneficial for patients whose intraocular pressure (IOP) may rise again after the initial treatment.

3. Safety Profile: SLT is associated with fewer complications, such as post-operative inflammation and scarring. While both procedures can lead to transient increases in IOP, SLT generally has a better safety profile.


Effectiveness of SLT
SLT has been shown to effectively lower IOP in many patients with open-angle glaucoma. Studies indicate that SLT can reduce IOP by approximately 20-30% in many cases. The effectiveness can vary based on individual patient factors, including the severity of glaucoma, the presence of other ocular conditions, and the specific characteristics of the trabecular meshwork.


Patient Suitability
SLT is typically suitable for patients with:
- Open-angle glaucoma who are not adequately controlled on topical medications.

- Patients who are intolerant to glaucoma medications or have difficulty adhering to a medication regimen.

- Individuals who may benefit from a minimally invasive procedure before considering more invasive surgical options.


Conclusion
In summary, SLT is a highly effective and safe treatment option for open-angle glaucoma, widely available in Taiwan, including at major hospitals like National Taiwan University Hospital. It offers advantages over traditional ALT, particularly in terms of repeatability and safety. If you are considering laser treatment for glaucoma, it is essential to discuss your specific case with your ophthalmologist, who can provide personalized recommendations based on your condition and treatment history. They will be able to assess whether SLT or another treatment option is the most appropriate for you.