Laser treatments offer effective, minimally invasive options for managing glaucoma. These procedures can reduce dependence on eye drops and are performed in an office setting with minimal downtime.
Selective Laser Trabeculoplasty (SLT)
SLT is the most commonly performed glaucoma laser procedure. It uses short pulses of low-energy laser light to stimulate the trabecular meshwork, improving natural drainage. Success rates range from 70-80%, achieving IOP reduction of 20-30%. The procedure takes about 5 minutes, is nearly painless, and can be repeated if the effect diminishes over time. Recent studies (LiGHT trial) support SLT as an effective first-line treatment.
Laser Peripheral Iridotomy (LPI)
LPI is the primary treatment for narrow-angle and angle-closure glaucoma. A small hole is created in the peripheral iris using a YAG laser, allowing fluid to flow freely between the anterior and posterior chambers. This relieves pupillary block and opens the drainage angle. The procedure is quick, performed in the office, and is both a treatment and a preventive measure for the at-risk fellow eye.
Cyclophotocoagulation
This laser procedure targets the ciliary body, the tissue that produces aqueous fluid, to reduce fluid production and lower IOP. Transscleral cyclophotocoagulation (TCP) and endocyclophotocoagulation (ECP) are available options. Micropulse cyclophotocoagulation is a newer, gentler approach with fewer side effects. These procedures are typically reserved for more advanced or refractory cases of glaucoma.
What to Expect After Laser Treatment
Most laser procedures cause minimal discomfort and require no recovery time. Your vision may be slightly blurry for a few hours. Anti-inflammatory drops are typically prescribed for several days afterward. IOP-lowering effects may take a few weeks to fully develop. You will have a follow-up visit to check your pressure and response to treatment. Normal activities can usually be resumed the same day.