SLT Information Sheet - Dr Michelle Baker

Selective Laser Trabeculoplasty overview © Michelle Baker This overview provides general information related to Selective Laser Trabeculoplasty and does not take into account your personal circumstances

SELECTIVE LASER TRABECULOPLASTY INFORMATION INFORMATIONSHEET SHEET FOR LOWERING

INTRAOCULAR PRESSURE

Selective Laser Trabeculoplasty

TABLE OF CONTENTS When is SLT Indicated?

How Does SLT Work?

What To Expect On The Day Of Treatment?

What To Expect After Treatment Are There Any Risks Or Complications?

How Successful Is SLT In Lowering Your Intraocular Pressure?

Frequently Asked Questions Where Can I Get More Information On SLT? Who Can I Contact If I’m Having Problems?

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Selective Laser Trabeculoplasty

WHEN IS SLT LASER INDICATED? How can I get more information on SLT? 1. From Your Ophthalmologist (eye specialist) - Ask Me! 2. Glaucoma Australia SLT Fact Sheet 3. AAO: Primary SLT efficacy, Safety and Predictors of Success 4. SLT and LiGHT Study Results

Selective Laser Trabeculoplasty (SLT) is a safe, quick, simple and non-invasive treatment option for open angle glaucoma and ocular hypertension. It works by reducing the pressure inside the eye known as the intraocular pressure. The procedure does not require admission to hospital and is carried out in the clinic rooms.

HOW DOES SLT WORK? SLT uses laser to target pigmented cells in the trabecular meshwork (drainage channel) of the eye. Generally half of each eye is lasered at a time (180 degrees of the trabecular meshwork) and then a few weeks later the remaining 180 degrees is lasered. Short pulses of low energy light are used to target only those cells that contain melanin, a natural pigment. In response, the cells activity is increased, recruiting immune cells which improves the drainage of aqueous humour out of the eye (fluid in the anterior chamber of the eye). This, in turn, lowers the intraocular pressure.

Some patients can have an early response to SLT but in most cases it can take up to six weeks for the effects of laser to be apparent and for your intraocular pressure to reduce. View Video Here

WHAT TO EXPECT ON THE DAY OF TREATMENT Please continue to use your eye drops/medications for glaucoma as normal before and after your SLT, including on the day of treatment, unless instructed otherwise.

Do not drive yourself to the clinic as you will be unable to drive home. Please allow 1-2 hours for your selective

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Selective Laser Trabeculoplasty

laser trabeculoplasty. At the clinic we will first check your vision and intraocular pressure. It is possible for the intraocular pressure to increase after the treatment.

Special eye drops will be instilled in your eye to make the pupil smaller and decrease the intraocular pressure. These drops are instilled to make the laser easier to perform and to prevent the intraocular pressure rising within your eye after the laser.

Prior to your procedure, I will take your written consent and discuss the benefits and risks with you based you your individual needs and answer any questions. The procedure usually takes about 5 minutes to perform in each eye. Just prior to the laser, anaesthetic drops are instilled which numb the surface of your eye. Once seated in front of the laser machine, which looks similar to the microscope you will have been examined on in clinic, a special lens will be placed against the front surface of your eye for better viewing of your drainage angle, which is being lasered. During the laser treatment you will hear the laser pulses as short clicking sounds and may see bright flashes of light. The laser is generally painless, only a few patients’ experience discomfort, which is usually from pressure from the contact lens. Immediately following the SLT another drop is instilled to keep the intraocular pressure low.

WHAT TO EXPECT AFTER TREATMENT Sometimes you will be asked to wait for approximately one hour after the SLT so that your intraocular pressure can be re-checked. Very occasionally you will be given a prescription for anti-inflammatory eye drops to take home.

There are no activity or work restrictions needed after SLT. You may wish to take pain relieving medication, for example Paracetamol to relieve any additional discomfort. If you are already taking pain relief for a different condition continue to take those, but do not take both.

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Selective Laser Trabeculoplasty

ARE THERE ANY RISKS OR COMPLICATIONS? Although SLT is relatively safe and efficacious, complications do exist but most are temporary/short term effects which include: • Red eye - For a few hours after the SLT you may find that the white of the eye appears red. This is usually due to the lens used on your eye during the treatment and will resolve.

• Blurred vision – Your vision may be blurred for a short time after laser treatment due to the eye drops used and bright light and will resolve usually within six hours. If you are concerned that your vision is not returning to normal please contact the clinic.

• Raised intraocular pressure – Rarely some people’s eyes can have an intraocular pressure rise or spike after the laser treatment. This is the reason your eye pressure is lowered at the time of laser. There is a remote risk that your intraocular pressure may go up significantly which may cause a change or reduction in your vision and require additional treatment.

• Mild inflammation within the eye – Your eye might feel slightly bruised afterwards and sometimes your eye can become inflamed and red. This occurs infrequently and is treated with anti-inflammatory eye drops. Most patients will not experience this.

• SLT-induced corneal oedema and keratitis - changes in the clear window at the front of your eye - a rare risk which could reduce your vision.

• Vision loss - Rarely SLT can cause shifts in refractive error (both myopic and hyperopic). Other remote risks are foveal burns and macular oedema.

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HOW SUCCESSFUL IS SLT IN LOWERING YOUR INTRAOCULAR PRESSURE? SLT is not recommended for all types of glaucoma and does not work for all patients. Its success can vary on an individual basis and I will discuss this with you. Studies have shown on average a 70% success rate.

The effects of the laser may wear off over time. About 50% stop working after two years. As the SLT laser does not damage the trabecular meshwork of the eye, it may be repeated.

The information in this leaflet is intended as a guide only as each patient’s experience will be different.

FREQUENTLY ASKED QUESTIONS How long will I require off work?

You can usually return to work the next day.

Am I able to fly following laser treatment?

In most cases, there are no restrictions to flying, except in very rare circumstances.

Am I able to play sport, exercise, watch TV and read following the procedure?

Yes you can.

When am I able to drive?

Please do not drive yourself to the clinic as you will be unable to drive home. Your vision will be slightly blurred for a few hours following your laser treatment but this will settle.

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WHERE CAN I GET MORE INFORMATION ON SLT? How can I get more information on SLT? 1. From Your Ophthalmologist (eye specialist) - Ask Me! 2. Glaucoma Australia SLT Fact Sheet 3. AAO: Primary SLT efficacy, Safety and Predictors of Success 4. SLT and LiGHT Study Results

WHO CAN I CONTACT IF I’M HAVING PROBLEMS? If you are experiencing pain or visual loss and are unable to contact the clinic staff, please attend the emergency department at the Royal Adelaide Hospital or Flinders Medical Centre as ophthalmic review is available 24 hours every day.

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