Glaucoma Treatment Options


Selective Laser Trabeculoplasty (SLT)

What is Selective Laser Trabeculoplasty (SLT)?

Selective Laser Trabeculoplasty (SLT) is a laser treatment used to lower intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. It helps improve drainage of fluid from the eye, reducing pressure and preventing further damage to the optic nerve.


Why is SLT Recommended?

SLT may be recommended if:


How Does SLT Work?

SLT uses a low-energy laser to target specific cells in the eye’s drainage system (the trabecular meshwork). This stimulates natural healing responses, improving fluid outflow and lowering eye pressure. The laser treatment is selective and does not damage surrounding tissues, making it a safe and repeatable procedure.


What to Expect During the Procedure


Benefits of SLT


What is the evidence?

The LIGHT (Laser in Glaucoma and Ocular Hypertension) study was a large clinical trial that compared SLT with traditional eye drop treatments as an initial treatment. The results showed that:

The LIGHT study showed SLT is a safe and effective first-line treatment for glaucoma and ocular hypertension and  SLT is now recommended by the The National Institute for Health and Care Excellence (NICE). 


Possible Side Effects and Risks

SLT is generally safe, but some potential side effects include:


Follow-Up and Aftercare

Trabeculectomy

Trab.pdf

PRESERFLO

What is the PRESERFLO™ MicroShunt?

The PRESERFLO™ MicroShunt is a small, flexible tube measuring approximately 8.5 millimeters in length. It is implanted into the eye to help lower intraocular pressure (IOP) in patients with glaucoma. The device is made from a synthetic material called SIBS (styrene-block-isobutylene-block-styrene), which is biocompatible and designed to remain stable over time. It is non-metallic, so it will not trigger airport scanners and is safe for MRI or CT scans. 

How does it work?

In glaucoma, increased IOP can damage the optic nerve, leading to vision loss. The PRESERFLO™ MicroShunt creates a new drainage pathway for the aqueous humor (the fluid inside the eye), allowing it to flow out of the eye and thereby reducing IOP. This helps prevent further damage to the optic nerve. 

Who is it for?

The PRESERFLO™ MicroShunt is intended for patients with primary open-angle glaucoma where IOP remains uncontrollable despite maximum tolerated medical therapy, or where glaucoma progression warrants surgical intervention. 

Benefits

Risks and Complications

As with any surgical procedure, there are potential risks, including:

Alternatives

Alternative treatments include medications (eye drops), laser therapy, or other surgical procedures like trabeculectomy. 

Before the Procedure

After the Procedure



Hydrus

What is the Hydrus® Microstent?

The Hydrus Microstent is a small, flexible device designed to help reduce eye pressure in patients with mild to moderate open-angle glaucoma. It is made from a biocompatible alloy (nitinol) and is implanted into the eye’s Schlemm’s canal to improve fluid drainage and lower intraocular pressure (IOP).


Who is it for?

The Hydrus Microstent is typically recommended for patients who:


How Does It Work?

Glaucoma is caused by a buildup of fluid in the eye, leading to increased intraocular pressure (IOP). The Hydrus Microstent enhances the eye’s natural drainage system by:


Procedure: What to Expect


Benefits of the Hydrus Microstent

Reduces eye pressure and slows glaucoma progression
Minimally invasive with a quick recovery time
May reduce or eliminate the need for glaucoma eye drops
Implanted during cataract surgery, avoiding additional surgeries


Risks and Possible Side Effects

While the procedure is generally safe, some risks include:

Your doctor will monitor your progress and address any complications if they arise.


Aftercare and Follow-Up


Frequently Asked Questions (FAQs)

1. Will I still need glaucoma medications after the procedure?

2. How long does the stent last?

3. Can the Hydrus Microstent be removed?

4. How soon can I resume normal activities?


iStent

istent.pdf

Elios

Patient-Brochure-English.pdf

Aqueous shunts

An aqueous shunt is a device which drains aqueous humour out of the eye to a small blister (called a bleb) under the surface of the eye (the conjunctiva). It bypasses the normal drainage channels in the eye, and drainage of the aqueous out of the eye is improved, reducing IOP.

Different types of shunt are available. The two most common types are the Ahmed Glaucoma Valve or the Baerveldt Glaucoma Implant. Other common names for this type of device are tube implant, glaucoma drainage implant or glaucoma tube shunts.

The shunt has two parts: a small silicon tube and a plate. The aqueous drains down the tube to the plate, which sits in the conjunctiva.

How will it help with my glaucoma?

By improving the flow of aqueous out of the eye, the IOP will decrease. This reduces pressure on the optic nerve, which means vision loss is less likely. However, any vision already lost to glaucoma can’t be recovered, and the glaucoma is not cured.

This type of treatment is for people with moderate to advanced glaucoma, particularly where eye drops aren’t working very well.

What does the surgery involve?

The surgery is usually done under local anaesthetic, which means you will be awake but the eye will be numb. It usually lasts one to two hours, and you will probably be able to go home the same day or the next day.

What happens after surgery?

The shunt will not normally be permanently visible after surgery. While the eye is healing from the surgery, it will probably be red and swollen.

You will be seen by your ophthalmologist the day after the surgery, and will be given antibiotic and steroid eye drops to improve recovery. You must continue to take all eye drops as directed, including for your other eye if you have glaucoma in both eyes. You’ll be asked to attend several follow-up appointments after the surgery to check the eye is healing well and the device is working. It is very important to attend all these appointments.

It will take your eye several weeks to recover from the surgery, so you’ll need to take some time off work and avoid some types of physical activity.


Tube surgery.pdf