Laser Treatment for Glaucoma: Procedure, Benefits, Risks, and Outlook

Comprehensive guide to laser treatments for glaucoma, including procedure details, benefits, risks, and future outlook.

By Medha deb

Created on Sep 25, 2025

Comprehensive guide to laser treatments for glaucoma, including procedure details, benefits, risks, and future outlook.

Glaucoma is a progressive eye condition characterized by damage to the optic nerve, often associated with increased intraocular pressure (IOP). Laser treatments, especially selective laser trabeculoplasty (SLT), have become an integral component in the management of glaucoma. This guide provides a comprehensive overview of laser treatment for glaucoma, how it works, who may benefit, and key findings from recent clinical trials.

What is Glaucoma?

Glaucoma refers to a group of eye diseases that damage the optic nerve, potentially leading to vision loss or blindness. The most common type is primary open-angle glaucoma (POAG), where fluid drainage is impaired, raising intraocular pressure. Timely intervention can help preserve vision.

Laser Treatment Options for Glaucoma

Laser procedures for glaucoma are designed to lower eye pressure by improving fluid outflow or reducing fluid production. The main types include:

Selective Laser Trabeculoplasty (SLT): Uses laser energy to stimulate the drainage tissue (trabecular meshwork) in the eye, improving fluid outflow.
Argon Laser Trabeculoplasty (ALT): Similar to SLT, but uses a different type of laser; now less commonly used due to potential scarring and limit on repeatability.
Laser Peripheral Iridotomy (LPI): Used to treat angle-closure glaucoma by creating a small hole in the iris to improve fluid flow.
Cyclophotocoagulation: Reduces fluid production by targeting the ciliary body; typically reserved for advanced glaucoma.

Selecting the Right Procedure

The choice of laser procedure depends on glaucoma type and severity. SLT is most commonly used for open-angle glaucoma and ocular hypertension, while LPI is reserved for angle closure scenarios.

How Does SLT Work?

SLT utilizes low-energy laser pulses targeted at the trabecular meshwork, a region responsible for draining fluid out of the eye. The laser selectively targets pigmented cells, triggering a biological response that enhances fluid drainage without causing permanent damage to surrounding tissue. This selectivity allows the procedure to be repeated if necessary.

Advantages of SLT

Minimally invasive: No incisions necessary.
Repeatable: Can be performed again if needed, since it does not scar tissue.
Reduced need for medications: Many patients manage IOP without daily eye drops after treatment.

Who is a Candidate for Laser Therapy?

Laser treatment for glaucoma is generally suggested for:

Adults with open-angle glaucoma who wish to reduce or eliminate dependence on eye drops.
Individuals with ocular hypertension.
Patients for whom medications are ineffective or not well tolerated.
Those with poor compliance to medical therapy.

Your ophthalmologist may recommend laser treatment based on several factors, including pressure control, disease progression, and individual lifestyle.

What to Expect During SLT

SLT is typically done in an outpatient office setting. The procedure lasts around 5–15 minutes. Here’s a step-by-step outline:

You receive numbing eye drops before the procedure.
A special lens, with gel, is placed on your eye to focus the laser.
The doctor applies laser pulses to the drainage canals. You may hear clicks and see bright flashes.
Minimal discomfort—most patients report only a slight tingling or pressure sensation.
The lens and gel are rinsed off, leaving temporary blurred vision that resolves quickly.
You might be asked to rest briefly after the procedure and avoid strenuous activities for a day.

Most people resume normal activities the following day.

Benefits of Laser Treatment for Glaucoma

Effective IOP reduction: SLT can lower eye pressure for most people, sometimes for 2–3 years or longer.
Medication reduction: SLT reduces or eliminates the need for daily eye drops in a majority of cases (74% in the LiGHT trial had controlled IOP without drops at three years).
Safety: The procedure is minimally invasive, carries a low risk of complications, and is generally well-tolerated.

Risks and Potential Side Effects

Although SLT is generally safe, there are risks and side effects to consider:

Temporary eye discomfort: Mild pain or irritation immediately after procedure.
Increased eye pressure: Rarely, a temporary spike in IOP may occur in the hours following SLT.
Inflammation: Minor, short-lived inflammation (redness or swelling) is common, but usually resolves quickly.
Blurred vision: Temporary; usually subsides within hours.

Serious complications are uncommon. Your doctor will monitor you after the procedure to address any issues promptly.

Comparing SLT with Glaucoma Eye Drops

Aspect	SLT (Laser)	Eye Drops
Effectiveness	Comparable or superior for initial IOP reduction	Effective, but variable compliance
Duration	Can last 2–3 years per treatment	Requires regular, lifelong use
Side Effects	Mild, transient (redness, blurred vision)	Systemic and local side effects (dry eyes, stinging, allergy)
Convenience	One-time, quick procedure	Daily application, routine adherence needed
Cost	$332–$752 per procedure. Often covered by insurance.	Ongoing cost of medication
Repeatability	Can be repeated if needed	N/A

Results from Major Clinical Trials: The LiGHT Study

The LiGHT (Laser in Glaucoma and Ocular Hypertension) Trial is a pivotal study comparing initial SLT therapy with traditional IOP-lowering eye drops for newly diagnosed patients:

Enrolled 718 participants with primary open-angle glaucoma or ocular hypertension.
Randomised to SLT or eye drop treatment.
After three years, 74% in the SLT group maintained target pressure without additional medication.
Both groups had high success rates, but only SLT patients avoided further surgery during study period.
SLT was found to be more cost-effective and at least as safe as eye drops.
Quality of life scores were similar between groups, although avoiding daily drops has practical advantages for many.

How Long Does Laser Treatment Last?

The pressure-lowering effect typically lasts 2–3 years but can persist longer. Repeat treatments may be needed as pressure creeps up over time. The decision to perform repeat SLT depends on individual response and disease progression.

Insurance and Costs

SLT costs range from $332 to $752 per session, with most insurance plans (including Medicare Part B) covering some or all of the procedure. Discuss out-of-pocket expenses with your provider before scheduling.

Limitations and Considerations

Laser therapy is not a cure for glaucoma. Lifelong monitoring is required.
Some patients still need medication or surgery for optimal pressure control.
SLT effectiveness may decline after several treatments; not all eyes respond equally.

Frequently Asked Questions (FAQs)

Q: Is laser treatment painful?

A: SLT is essentially painless for most patients, with only mild discomfort such as a tingling or pressure sensation reported during the procedure.

Q: Can SLT be repeated?

A: Yes, since SLT does not damage tissue, it can often be safely repeated when pressure rises again.

Q: Will I still need eye drops after SLT?

A: Many patients control their IOP without daily drops after SLT, but some may need additional medication or treatment over time.

Q: How soon will I see results?

A: IOP reduction often begins within weeks, with your doctor monitoring pressure at follow-up visits.

Q: Is laser treatment covered by insurance?

A: Most insurance plans, including Medicare, cover SLT for glaucoma treatment.

Q: Are there alternatives to laser therapy?

A: Alternatives include daily eye drops, conventional surgery (trabeculectomy), and minimally invasive glaucoma surgeries. Choice depends on your medical history and disease severity.

Key Takeaways

Laser treatment (especially SLT) is an effective and safe option for lowering eye pressure in glaucoma and ocular hypertension.
SLT is increasingly being offered as a first-line therapy based on clinical trial results.
The procedure is quick, minimally invasive, and can reduce or eliminate the need for glaucoma medications for many patients.
Consult an ophthalmologist to determine if laser treatment is right for your condition.

References

For further information on glaucoma laser treatment, key trials, and patient eligibility, consult professional sources and talk with your eye care specialist.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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