Glaucoma - laser trabeculoplasty
Discussion
I’ve had high intraocular eye pressures for a while and have been using drops (bimatoprost) daily for years. After falling out of the screening system for a long time (Covid 
) I’m now being seen again by the medical establishment.
Thankfully no sign of damage to my vision, but my pressures are high in spite of the drops. I’ve now been offered “selective laser trabeculoplasty” as a treatment.
Anyone had experience of this? Did it work? Any issues or side effects? I’m not worried about putting drops in my eyes, but I’m not yet 50 and so I’d like to retain my vision..!
Thanks all.
) I’m now being seen again by the medical establishment. Thankfully no sign of damage to my vision, but my pressures are high in spite of the drops. I’ve now been offered “selective laser trabeculoplasty” as a treatment.
Anyone had experience of this? Did it work? Any issues or side effects? I’m not worried about putting drops in my eyes, but I’m not yet 50 and so I’d like to retain my vision..!
Thanks all.
SLT is now the 1st tier treatment for glaucoma and works very well - equivalent to the 1st line PGA drops like xalatan - you can get a 30-40% drop in pressure from a one off treatment.
It is very safe - I have never heard of any issues, and doesn't take long to do - certainly a lot more convenient than putting drops in every day. It doesn't work for everyone and the IOP can rise again over time but it can be repeated with good results and used in conjunction with drops so you need less drops.
Drops themselves can have side effects with long term use - mostly allergy - so SLT would certainly be my 1st choice recommendation if offered.
It is very safe - I have never heard of any issues, and doesn't take long to do - certainly a lot more convenient than putting drops in every day. It doesn't work for everyone and the IOP can rise again over time but it can be repeated with good results and used in conjunction with drops so you need less drops.
Drops themselves can have side effects with long term use - mostly allergy - so SLT would certainly be my 1st choice recommendation if offered.
That’s a simple and clear response. Thanks very much..! 
(My caution is because a sports injury 20 years ago means I can only read easily with one eye - scarred macula in the injured one - so I’m cautious. Sounds like a (low) risk worth taking given the alternative long term downsides of not doing it).
(My caution is because a sports injury 20 years ago means I can only read easily with one eye - scarred macula in the injured one - so I’m cautious. Sounds like a (low) risk worth taking given the alternative long term downsides of not doing it).
Very low risk and much better than developing glaucoma which can be brutal and difficult to treat once it gets going. Conventional SLT uses a single laser and and mirrored contact lens to laser a single spot on the trabecular meshwork , so they have to move round the clock to do it all which takes a bit of time. However I recently saw a new Belkin laser that can do the whole procedure less than a second!
https://www.eyenews.uk.com/reviews/tech-reviews/po...
I doubt it is available on the NHS unfortunately, I was in a private hospital when I saw it.
https://www.eyenews.uk.com/reviews/tech-reviews/po...
I doubt it is available on the NHS unfortunately, I was in a private hospital when I saw it.
I had it done on one eye. As a procedure it's not too inconvenient although the contact lens that protects your eye during the treatment is very difficult to keep in position and, in my case, needed replacing several times. The first treatment didn't work. I had it done again with a different laser operator and it seems to have worked. I was told the drain holes can block causing the intra-ocular pressure to rise and further treatment to be needed. Good luck with it.
Had both eyes done about 8/9 years ago.
Been on Latanaprost since and pressures all good and stable.
My SLT was NHS , and not quite as bad as I expected .
You see a red line flashing , and I was vaguely aware of some small pressure against my eyeball.
For me , it was unpleasant , but not at dentistry levels of unpleasantness.
Been on Latanaprost since and pressures all good and stable.
My SLT was NHS , and not quite as bad as I expected .
You see a red line flashing , and I was vaguely aware of some small pressure against my eyeball.
For me , it was unpleasant , but not at dentistry levels of unpleasantness.
I was diagnosed with glaucoma 13 years ago & prescribed Travoprost eye drops, Had a couple of severe bleeds over the last few years resulting in 14 laser sessions, 8 on the left eye & 6 on the right eye.
On my last visit to the eye clinic last November I was told I was being referred to the the glaucoma clinic.
My appointment came through last week which has only taken six months or so.
On my last visit to the eye clinic last November I was told I was being referred to the the glaucoma clinic.
My appointment came through last week which has only taken six months or so.
I had this done about 6 months ago. My pressures were at 30 (which had got high). And after the surgery they went down to 16. The surgeon said it was a great result. The operation itself is easy, but doesn't feel like someone is trying to prick the back of your eye with a pin and you aren't meant to move which is difficult.
As promised, reporting back. Had the SLT treatment yesterday at a nearby hospital eye clinic.
The whole appointment lasted 90 minutes from arrival to departure and the procedure took around 3 minutes per eye. The anaesthetic drops meant I felt nothing and not much of a headache either. Vision was good enough to drive again a few hours later.
Pressures were tested before and after - left eye didn’t seem to have changed (21) but the right eye had dropped (21 to 16). Let’s see what the follow up tests say in three months. Hopefully it has done the job for now.
The whole appointment lasted 90 minutes from arrival to departure and the procedure took around 3 minutes per eye. The anaesthetic drops meant I felt nothing and not much of a headache either. Vision was good enough to drive again a few hours later.
Pressures were tested before and after - left eye didn’t seem to have changed (21) but the right eye had dropped (21 to 16). Let’s see what the follow up tests say in three months. Hopefully it has done the job for now.
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