What is laser trabeculoplasty, and might I require it?

Written by: Mr Francesco Stringa
Published: | Updated: 13/04/2023
Edited by: Conor Lynch

Top Doctors recently had the pleasure of speaking with award-winning, Southampton-based consultant ophthalmologist, Mr Francisco Stringa, who, here, in our latest article, provides us with a comprehensive explanation of what laser trabeculoplasty is, when it might be required, and what the most common side effects of the surgery typically are. 

What is laser trabeculoplasty?

Selective Laser Trabeculoplasty (SLT) is a type of laser eye surgery which is used to reduce the intraocular pressure in people with glaucoma or ocular hypertension. SLT works by making the cells in the trabecular meshwork (the drainage system of the eye) pump fluid out of the eye more efficiently. The trabecular meshwork is located inside the front part of our eyeball, where the white part joins the coloured part.

 

Why might someone require laser trabeculoplasty?

It is typically performed when eye drop medications are not lowering the eye pressure enough or are causing side effects. It can also be used as initial treatment in glaucoma or in people that cannot cope with or do not want glaucoma eye drops.

 

Is laser trabeculoplasty painful?

It is usually not painful. Most patients do not experience any significant discomfort, although some may feel a little pressure inside the eye or a slight headache during or after the SLT procedure. Many people say that the whole experience is very similar to having a normal eye check-up in the clinic.

 

What is involved in the laser trabeculoplasty procedure? How long does it take to recover?

The SLT procedure typically takes between three and five minutes for each eye. A special contact lens is applied during the laser, in order to keep the eyelids open, and anaesthetic eye drops are applied to ensure that your eye is comfortable with the lens on your eye. The laser machine looks very similar to the microscope used during a normal examination (the slit lamp).

 

No aftercare or precautions are needed following the surgery, and people are generally free to return to their normal activities from the following day onwards. The vision may be a little blurry for a few hours or indeed days afterwards, and the eye may be slightly achy and slightly sensitive to light. If these symptoms are worrying, or if they are getting worse, it is advised to contact your ophthalmologist for a further check-up.

 

The lowering pressure effect is not instantaneous. It will take up to three to five weeks for the eye pressure to reduce after the laser, which is when an eye check-up is recommended. If anti-glaucoma eye drops are used before SLT, these should be continued until the first check-up after the laser.

 

What are the possible side effects of laser trabeculoplasty?

SLT is a safe procedure, and the risk of adverse effects is minimal. There is a small risk of increased eye pressure for a short period of time after the laser treatment. To prevent this, additional eye drops before and/or after the procedure might be required. Eye discomfort, redness, blurry vision, and/or sensitivity to light might be experienced too.

 

There have been very few reports of serious problems after SLT. The reported cases were bleeding of the iris, swelling of the retina (back of the eye) and swelling or distortion of the cornea (front transparent window of the eye). Most peoples’ eyes settle down without any further problems, and it is extremely rare for the SLT laser to cause permanent worsening of vision.

 

To schedule an appointment with Mr Francesco Stringa, simply visit his Top Doctors profile today.

By Mr Francesco Stringa
Ophthalmology

Mr Francesco Stringa is an award-winning consultant ophthalmic surgeon based in Southampton, who specialises in treatment for glaucoma and cataract. His expertise is focused in glaucoma surgery,  glaucoma laser surgery (selective laser trabeculoplasty and laser iridotomy) and minimally invasive glaucoma surgery (MIGS), as well as, standard and advanced cataract surgery and general ophthalmology. He privately practises at Spire Southampton Hospital, while his NHS base is University Hospital Southampton NHS Foundation Trust, where he is the Clinical Lead for Eye theatres.

Mr Stringa is a leading name in the UK and Europe for different types of glaucoma treatment. He has performed over 2,000 surgeries to date, and he works continuously to audit and improve his treatment outcomes. His specialisms include conventional glaucoma surgery, such as trabeculectomy and glaucoma drainage devices, along with new techniques in minimally invasive glaucoma surgery. He performs laser surgery for the treatment of both open angle and closed angle glaucoma.

Mr Stringa is involved in the management of the glaucoma service at the Eye Unit in Southampton, providing high quality care for a population of nearly 2 million people, in one of the busiest tertiary referral centres in the UK. He also has spearheaded various quality improvement projects at Southampton General Hospital, including the introduction of new lasers for the treatment of refractory glaucoma and new minimally invasive glaucoma devices

Mr Stringa is also a cataract surgery expert with outcomes that are higher than the national average, undertaking over 4,000 procedures in both NHS and private practice. He offers a wide range of intra-ocular options for different vision requirements and expectations. He prides himself in his good communication skills, where he is able to empathise with patients as well as providing the highest quality of care while keeping in mind their individual needs.

He is highly qualified, with an MBBS from the University of Pavia in Italy and a Scholarship at the prestigious Almo Collegio Borromeo, which is classified as a ´highly qualified Cultural Institute` by the Ministry of Education, Universities and Research and is the oldest such institution remaining in operation in Italy. He is a member of the Royal College of Ophthalmologists (MRCOphth) and he achieved the Fellowship from the European Board of Ophthalmology in the Subspecialty of Glaucoma (FEBOS-GL). Mr Stringa completed his initial training in ophthalmology at Manchester Royal Eye Hospital, subsequently he underwent two fellowships in Nottingham University Hospital and St Thomas’ Hospital respectively to further specialise in glaucoma

Mr Stringa is an expert in the evaluation of glaucoma surgery outcomes and is actively involved in the improvement of the glaucoma service at his NHS trust. As a result of this, he is regularly invited to talk on such topics at national and international conferences. Furthermore, he is a mentor and teacher of fellows and trainees, and his clinical research frequently features in highly impacted peer-reviewed journals.

Mr Stringa is member of the UK and EIRE Glaucoma Association (UKEGS), the General Medical Council (GMC) and the European Glaucoma Society (EGS), where is part of the Next Generation Partnership. He has won various awards for his clinical practise and research. He won the Runner Up Research Team prize at the Greater Manchester Clinical Research Awards, the Best Abstract Presentation Award from the UKEGS and the Healthcare Leadership Foundations prize at the NHS Leadership Academy Awards. 

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