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Selective Laser Trabeculoplasty

Selective Laser Trabeculoplasty

Clinically proven as first-line therapy for glaucoma

Selective Laser Trabeculoplasty (SLT) is clinically proven by the LiGHT trial to be a safe and effective first-line therapy for the treatment of primary open angle glaucoma or ocular hypertension1.

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The preferred first-line therapy for glaucoma

Selective Laser Trabeculoplasty (SLT), plays a critically important role in the treatment of glaucoma. Around the world, thousands of physicians are deploying the procedure as a primary therapy tool that stimulates the eye's natural healing response to effectively manage their patients’ IOP without the burn and scar tissue associated with argon laser trabeculoplasty (ALT).

Watch how SLT (Selective Laser Trabeculoplasty), the recommended first-line therapy for glaucoma, gently reduces intraocular pressure.

WATCH THE SLT ANIMATION

Reduce IOP — as effectively as medication

SLT is an advanced, non-thermal nanosecond laser treatment that can achieve reductions in IOP as effectively as medication, without the associated side effects or compliance problems.1 SLT is also ideally suited for glaucoma patients who are frustrated with the effectiveness of their medications; it can play a role in reducing their associated financial and lifestyle burdens.

Published in The Lancet, the pivotal results of the LiGHT trial compared the use of SLT versus eye drops as a first-line treatment for treatment-naïve patients who had open angle glaucoma or ocular hypertension – and recommended SLT as first-line treatment for open angle glaucoma and ocular hypertension, supporting a change in clinical practice.”

1 LiGHT study, The Lancet. 393.10175

LIGHT SLT

The results of the LiGHT Trial support the findings by Katz et al in 2012, in which SLT was demonstrated to achieve the same IOP-lowering effects of medication when used a first-line therapy2.

Equivalent Efficacy to Medication

SLTMEDICATION
Baseline IOP24.5 mm Hg24.7 mm Hg
Post-Treatment IOP18.2 mm Hg17.7 mm Hg


2
. Katz LJ, Steinmann WC, Kabir A, Molineaux J, Wizov SS, Marcellino G; SLT/Med Study Group. Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma; a prospective, randomized trial. J Glaucoma. 2012,21:460-8

A restorative treatment approach

SLT works by applying selective photothermolysis of the pigmented trabecular meshwork cells. This intervention stimulates the release of proteins and cytokines and the recruitment of macrophages to improve the circulation of aqueous humor through the meshwork and the inner wall of the Schlemm’s canal without causing thermal or coagulative damage.

SLT versus ALT

Due to its restorative, non-destructive mechanism, SLT does not cause scarring of the trabecular meshwork and helps to keep Schlemm's canal intact – making it the ideal adjunct procedure to MIGS options that target Schlemm’s canal. Argon Laser Trabeculoplasty (ALT), in contrast, causes scarring of Schlemm’s canal and thereby compromises the success of future MIGS procedures.

Trabecular Meshwork SLT 400 micron spot, 0.8 mJ/pulse
Screen Shot 2019 05 16 at 3 21 05 pm
Trabecular Meshwork ALT 50 micron spot
Screen Shot 2019 05 16 at 3 21 10 pm

A key tool in diagnosis

You can evaluate the result of intervention with SLT to estimate the location of the pathology. If the intervention is successful, the primary region of obstruction may lie within the trabecular meshwork, but if it is ineffective, then the primary obstruction may reside elsewhere. That’s why SLT can play a key role in helping both to understand a patient’s pathology and provide key information on the potential efficacy of future treatments.

Seamless pairing with MIGS

SLT pairs seamlessly with all MIGS procedures, including iTrack™ canal-based glaucoma surgery, as both a preoperative diagnostic aid or as a postoperative adjunct, and can be deployed synergistically to reduce the need for further medication or future filtration surgery.

Proven capability

Ellex’s proprietary SLT technology delivers advanced energy control, a sharp-edged aiming beam and the industry’s fastest firing rate of three shots per second*. It's a capability that's being used every day by thousands of physicians around the world to visualize the trabecular meshwork in greater detail, and to perform procedures faster and with improved accuracy, delivering better patient outcomes - reliably, accurately and safely.

*Based on system performance testing. Data on file. Ellex Medical.

“SLT has the potential to become the go-to glaucoma treatment. Not only can SLT eliminate or at least reduce the need for drops, it can help to preserve vision and delay or even prevent complicated, invasive surgical interventions.”
Teymoorian
“We've known for years that the preservative in the drops actually damages the trabecular meshwork. We're using drops to help a patient's pressure, but at the same time we're damaging the system that naturally relieves the pressure.”
GALLARDO QUOTE
"The safety profile of SLT is so great, I would argue that it's actually a safer first option than many of the medications."
Richardson

SLT SNAPSHOT

  • SLT is a therapy and not a surgical treatment – it is gentle, does not destroy tissue, and can be repeated.
  • SLT can lower IOP as effectively as medication
  • SLT is a highly effective first-line therapy, and is particularly well suited to patients who are known to be noncompliant with medication
  • SLT can be used as a replacement treatment if medication is not well tolerated
  • SLT is a highly effective adjunct treatment in combination with medications
  • SLT is not argon laser trabeculoplasty (ALT), which causes permanent damage to the structure of the TM

Resources

Video

SLT Animation

Watch how SLT (Selective Laser Trabeculoplasty), the recommended first-line therapy for glaucoma, gently reduces intraocular pressure. SLT acts at a cellular level to specifically trigger thermolysis of pigmented trabecular meshwork (TM) cells, the process of which stimulates the release of proteins and cytokines, and recruitment of macrophages. This restorative mechanism results in the improvement of aqueous humour circulation through the TM and the inner walls of Schlemm’s canal, thereby reducing IOP.

Article

SLT: The First-Line Advantages of SLT

This CRST article features an article by Paul I. Singh, MD, which discusses the first-line benefits of SLT in lowering IOP, reduce medication use, and provide key diagnostic information.

Associated websites

SLT Patient Education

A restorative approach, learn how SLT can restore the eye’s natural drainage channel.

Video

The Evolution of SLT

This interview with Dr. Latina, the inventor of SLT, addresses the role of SLT in clinical practice, including its role as a primary therapy – and as an adjunct to MIGS.

Video

ASCRS Glaucoma Roundtable: SLT Misconceptions

Iqbal Ike K. Ahmed, MD, FRCSC, asks this roundtable of surgeons to clarify the misconceptions surrounding selective laser trabeculoplasty (SLT).

Article

Restoration of Outflow Pathways with iTrack

David Lubeck, MD discusses the role of ABiC in conjunction with SLT and MIGS.

Video

SLT Treatment Protocol

SLT works by stimulating a natural healing response in the body to manage the elevated IOP associated with glaucoma, promoting cellular regeneration without the burn and scar tissue associated with other laser procedures.

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Ellex is the manufacturer of the Tango Reflex and Tango for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma. Tango Reflex and Tango have been approved for the indication of Selective Laser Trabeculoplasty (SLT) whereby they may potentially improve patient IOP. Ellex does not accept any responsibility for use of the systems outside of this indication.

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