Selective Laser Trabeculoplasty (SLT) - Tanner Eyes

Selective Laser Trabeculoplasty, or SLT, is a form of laser surgery that is used to lower intraocular pressure in glaucoma. SelectiveLaserTrabeculoplasty(SLT) SelectiveLaserTrabeculoplasty,orSLT,isaformoflasersurgerythatisusedtolowerintraocularpressureinglaucoma.Itisusedwheneyedropmedicationsarenotloweringtheeyepressureenoughorarecausingsignificantsideeffects.Itcanalsobeusedasinitialtreatmentinglaucoma.SLThasbeeninuseformorethan25yearsbutrecentadvancesinlasertechnologyhaveresultedingreateruseoflasertreatment,oftenavoidingtheneedformoreinvasivesurgeryorextraglaucomadrops.PleaseviewtheSLTvideoatwww.tanner-eyes.co.ukwhichfurtherexplainstheprocedure. TheUltraQReflexandTangoReflexsystemsprovidetreatmentflexibilityandwillensurethatyoucanachievetheresultsyouandyourpatientsarelookingfor—everytime. Selectivelasertrabeculoplasty(SLT) Selectivelasertrabeculoplasty(SLT) CommonlyAskedQuestions EllexSelectiveLaserTrabeculoplasty(SLT)Animation × WhoisagoodcandidateforSLT? Patientswhohaveprimaryorsecondaryopen-angleglaucoma(thedrainagesysteminthefrontpartoftheeyeisopen)andneedtohavelowerintraocularpressure(IOP). Howdoesitwork? Laserenergyisappliedtothedrainagetissueinfrontoftheeye(thetrabecularmeshwork).Thisstartsachemicalandbiologicalchangethatresultsinbetterdrainageoffluidthroughthetrabecularmeshworkandoutoftheeye.Thiseventuallyresultsinloweringofpressure.Itmaytake1-3monthsforthefulltreatmenteffecttoappear.Itisimportanttorememberthatthisprocedureisperformedtosavethesightyoustillhave.Itwillnotrestoreanysightyoumayhavealreadylost,orimproveyoursight.SLTissuccessfulinaboutthreeoutoffour(75%)patients. WhyisitcalledSelective? Thetypeoflaserusedisonlytakenupbyselectedpigmentedtissueintheeye.Sometimesitisreferredtoasa“coldlaser.”Becauseofthis,theprocedureproduceslessscartissueandhasminimalpain.Thisgentlelasertreatmentinduceswhitecellstobereleasedwhichcleanandrebuildthemeshwork.Thisallowsthedrainagemeshworktofunctionmoreeffectively,reducingthepressure. Whataretherisks? SLThasaverygoodsafetyprofile,evenwhencomparedwithglaucomadrops.Post-operativeinflammationiscommonbutgenerallymild,andtreatedwithsteroideyedrops.Thereisanapproximately5%incidenceofpressureelevationafterlaser,managedbyglaucomadropsandusuallyresolvedafter24hours.Rarely,thepressureintheeyerisestoaveryhighpressureanddoesnotcomedown.Ifthishappens,youmightrequiresurgerytolowerthepressure.However,thisisaveryunusualoccurrence. Howeffectiveisitandhowlongdoesitlast? SLTlowerstheIOPbyabout30%whenusedasinitialtherapy.Thisiscomparabletothepressureloweringeffectofthemostpowerfulandcommonlyusedglaucomadrops.Thiseffectmaybereducedifyouarealreadyonglaucomamedications.Theeffectwillgenerallylastbetween1-5yearsorsometimeslonger. Whathappensifitwearsoff? IfSLTiseffectiveatloweringIOPbutthenwearsoffafterseveralyears,theprocedurecanberepeated.Abouthalfofpatientswillrequirerepeattreatmentafter5years.Repeattreatmentsdon’talwayslowerIOPasmuch,andcontinuedrepeatlaserwilleventuallynotbeeffective.Insomepatientswemaydecidetotreathalfofthetissueonthefirsttreatment,thentreatthesecondhalfatalaterdate.IfSLTisnotinitiallysuccessful,repeattreatmentisnotlikelytobeeffective. Howdoesitwork? Laserenergyisappliedtothedrainagetissueinfrontoftheeye(thetrabecularmeshwork).Thisstartsachemicalandbiologicalchangethatresultsinbetterdrainageoffluidthroughthetrabecularmeshworkandoutoftheeye.Thiseventuallyresultsinloweringofpressure.Itmaytake1-3monthsforthefulltreatmenteffecttoappear.Itisimportanttorememberthatthisprocedureisperformedtosavethesightyoustillhave.Itwillnotrestoreanysightyoumayhavealreadylost,orimproveyoursight.SLTissuccessfulinaboutthreeoutoffour(75%)patients. Whathappensifitdoesn’twork? IfSLTfailstolowertheIOP,thentheglaucomaistreatedbyothermeanssuchasmedicationsorsurgery.Thelaserdoesnotaffectthesuccessoftheseothertypesoftreatment. WillIstillneedtouseglaucomamedications? Somepatientscanbecontrolledwithjustlasertreatment.OthersrequireadditionalIOPloweringandmaythereforeneedtouseglaucomamedicationaswell.ThinkofSLTasequivalenttooneglaucomamedication.Justassomepatientswillrequiremorethanoneglaucomamedication,somemayalsorequirelaserplusoneormoreglaucomamedications.ItisimportanttorememberthatSLTisnotacureforglaucoma,justasmedicationandsurgeryarenotcureseither. Whatarethealternativelasertreatments? Othersimilarproceduresareargonlasertrabeculoplasty(ALT)andmicropulselasertrabeculoplasty(MLT).ALTwasthefirstlasertrabeculoplastyprocedure.Itusesathermal(heat)laserandmaycausemorescarringinthedrainageanglethanSLT.MLTwasdesignedtoreducetheamountofenergydeliveredtooculartissuesbypulsingtheenergyinsmallincrements.ItthereforehassimilarpotentialbenefitsasSLTintermsoflowerinflammation,tissuescarringandabilitytorepeat.TheIOPloweringresultsofSLT,ALTandMLTarecomparable. WhatdoIneedtodoafterIgohome? Youreyemayfeelalittlesoreandredaftertheprocedure.Ifyouhavediscomfortwesuggestthatyoutakeyourusualpainrelief.eg:paracetamoloribuprofen. Itisnormaltohavethefollowingsymptomsforafewhoursafterthelasertreatment: –irritableeyes –redeyes –milddiscomfort Whathappensonthedayofsurgery? Youwillneedtovisittheoutpatientdepartmentforapprox.2hours.Wewillcarryoutthetreatmentinthelasertreatmentroom.Anursewillcheckyourvisionandinsertsomeanaestheticdropstogetherwithadroptopreventapostlaserpressurerise.Itisimportantthatyouuseyourregulareyemedicationasnormalonthedayofyourlasertreatment.Wealsousuallyputinadroptomakethepupilsmaller–thismaygiveyouanachearoundtheeyeoraheadache.Pleaseletusknowifyouwouldlikeaparacetamoltohelpeaseanydiscomfort.Youwillthensitatamachinesimilartotheoneusedtoexamineyoureyesattheeyeclinic,butwithaspeciallaserattachedtoit.MrTannerwillputaspecialcontactlensonyoureyebeforeapplyingthelaserbeam.Thislensallowsaclearviewandhelpsapplythelasertothedrainagechannels.Duringthelasertreatment,youmightseesomeflashesoflightandhearclickingnoises.Mostpatientstoleratethelasertreatmentwell,butsomemightfeelslightdiscomfort.Thetreatmentispainlessduetotheanaestheticdropsusedtonumbyoureyebeforehand.Ittakesabout10minutespereyetocomplete. Whathappensafterthetreatment? Youwillreturntothewaitingareaandhaveapressurecheckaboutonehourlater.Yourvisionmaybealittleblurredandyoumaybedazzledbythebrightlightbutthisshouldsettlewithinabout10minutes.Thismayoccasionallybeduetoyourcornea(theclearwindowinthefrontofyoureye)swelling,whichisusuallytemporarybutmayrequiretreatmentwithsteroiddropsforafewextradays.Youwillbeprescribedsteroideyedropstocontrolinflammation.Youmustcontinuetouseyourusualglaucomaeyedropstothetreatedeye.Ifyouareusingglaucomadropstotheuntreatedeye,pleasealsocontinuetousethem.Youshouldbeabletoreturntoworkandyourusualactivitiesbythenextday. PatientInformationLeafletDownload here Disclaimer Theinformationprovidedinthiswebsiteisintendedasausefulaidtogeneralpractitioners,optometristsandpatients.Itisimpossibletodiagnoseandtreatpatientsadequatelywithoutathorougheyeexaminationbyaqualifiedophthalmologist,optometristoryourgeneralpractitioner.Hopefullytheinformationwillbeofusepriortoandfollowingaconsultationwhichitsupplementsanddoesnotreplace. Testimonials ThankstoyouandyourwonderfulteamatKingEdwardVIIHospital,Iwokeupthismorningwithperfecteyesight–forthefirsttimeinyears. Nomoresquintingwhendrivingatnightorreadingsmallprintand,hopefully,nomorebeingdazzledorlostgolfballsasI’llbeabletoseetheminflight. Youmusttakeimmenseprideinthedifferenceyoumaketothequalityoflifeforsomanypeople.Youhavemytotaladmiration.Thankyousomuch. MrTannertooktimetoexplainwhatwasaroutineoperationforhimbutalittlescaryforme.Iwasveryreassuredanddelightedwiththeoutcome,thankyousomuchMrTannerandteam IhavebeenveryimpressedwiththequalityofMrTanner’scare MrTannerwasfriendlyandcourteousthroughout.Ittranspiredhewasatmedicalschoolwithoneofmysons,whichwasabonus.Heisinmyopinionatthepeakofhissurgicalcareer.Veryexperiencedandthereforeverycompetent ThetreatmentfromMrTannerwasexcellent. Heisacourteousandhighlyskilledprofessional. MrTannergaveclearadvice…..TheoperationwentsmoothlyandwasmuchlesstroublethanIimagined.Thevisiontheeyethatwasoperatedonisverygood IwouldhavenohesitationinrecommendingMrTanner.TheresultsofresearchanddiscussionswithBupaandmyGPwereamplyrewardedwiththetreatment…..IhavenowseenMrTannerpre-op,op,andpost-opandcanconfirmthathiscareandtreatmenthasbeenexcellentthroughout TalkingtoMrTannerwaslikediscussingmytreatmentwithafriend Justashortnotetoexpressmydelightatthesubstantialimprovementfollowingthetreatmentonthe28th,muchbetterthanIenvisaged. 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