Selective laser trabeculoplasty (SLT) is an FDA-approved laser therapy that lowers eye pressure, also called intraocular pressure (IOP). It works by improving how aqueous fluid (aqueous humor) drains from the eye. SLT is used to treat primary open-angle glaucoma and ocular hypertension.

Unlike older laser techniques such as argon laser trabeculoplasty, SLT targets only the pigmented cells in the eye’s drainage channels, called the trabecular meshwork. The surrounding tissue stays completely intact. This precision allows SLT to gently reduce eye pressure with minimal side effects and no incisions.

At Assil Gaur Eye Institute, our glaucoma specialists and ophthalmologists have performed SLT for patients throughout Beverly Hills and the greater Los Angeles area. They deliver excellent outcomes using advanced technology and the precision our patients trust.

Why selective laser trabeculoplasty is now a first-line treatment

For decades, eye drops were the default starting point for glaucoma management. That changed in 2019, when the landmark LiGHT Trial, a large randomized clinical study, found that SLT was more effective than eye drops as an initial treatment for most patients with open-angle glaucoma.

Patients who received SLT first were more likely to reach their target eye pressure. They were also less likely to need additional eye drop medications, and they had a lower rate of disease progression and vision loss over six years.

Despite this evidence, most newly diagnosed glaucoma patients are still started on daily eye drops. Many are never told that SLT is an option. At AGEI, we believe every patient deserves to know about every treatment available.

How the selective laser trabeculoplasty procedure works

We perform SLT right in our office, and it typically takes less than five minutes per eye. Here is what to expect:

• Preparation: We apply numbing eye drops, so you feel no discomfort. We may also place a special contact lens on your eye to help the laser focus.

• Laser application: A specially designed laser delivers short, low-energy pulses of light to the trabecular meshwork, your eye’s natural drainage tissue. The laser targets only pigmented cells, without damaging nearby structures.

• Biological response: Over the next four to eight weeks, your body’s natural healing response improves fluid drainage from the eye, which lowers eye pressure and prevents a future pressure spike

• Recovery: Most patients return to normal activities the same day. You may notice mild inflammation, light sensitivity, or temporary blurred vision, but these typically resolve within 24 hours. We may prescribe anti-inflammatory eye drops for a short time.

Because SLT is non-incisional and preserves eye tissue, you can safely repeat it if your eye pressure rises again over time. This is a significant advantage over ALT and many other laser or surgical alternatives.

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Who is a candidate for selective laser trabeculoplasty?

SLT is appropriate for a wide range of glaucoma patients and those with related eye diseases and conditions, including:

• Newly diagnosed patients with open-angle glaucoma or ocular hypertension who want to avoid or delay daily eye drops.
• Patients already on glaucoma medications who are not achieving adequate IOP control.
• Patients who struggle with eye drop compliance due to side effects, cost, or lifestyle.
• Patients seeking a long-term, low-maintenance glaucoma management strategy.

SLT is generally not recommended for patients with angle-closure glaucoma (closed-angle glaucoma), certain secondary glaucomas, or very advanced disease. However, it can often be performed alongside cataract surgery. During your complimentary evaluation at AGEI, our specialists will review your optic nerve health, drainage angle anatomy, and full eye history to determine whether SLT is right for you.

Selective laser trabeculoplasty vs. eye drops: what patients should know

Many patients are surprised to learn how SLT compares to daily glaucoma drops:

Freedom from a daily drop regimen is one of the most valued benefits our patients report after SLT. This is especially true for patients with active lifestyles or travel schedules that make consistent medication use difficult.

What results can you expect?

Clinical studies show that SLT successfully lowers eye pressure in approximately 75 to 85 percent of patients. On average, patients experience a 20 to 30 percent reduction in pressure. Results typically appear within four to eight weeks of the procedure. They can last anywhere from one to five years, and many patients maintain pressure control well beyond that window.

At Assil Gaur Eye Institute (AGEI), our approach to SLT is grounded in precision diagnostics. Patient Julie H. described how her AGEI doctor compared high-tech scans taken six months apart to determine her exact needs. Our glaucoma team monitors your response to treatment with that same meticulous, data-driven standard of care.

Why choose Assil Gaur Eye Institute for selective laser trabeculoplasty?

Patients throughout Los Angeles and beyond trust AGEI for world-class glaucoma care. When you choose our institute for SLT, you benefit from:

• Elite glaucoma specialists with advanced fellowship training in laser therapy and surgical procedures for glaucoma management.
• Advanced diagnostic technology, including optical coherence tomography (OCT) and visual field analysis, to precisely stage your glaucoma before and after SLT.
• A patient-first philosophy. As patient Hariyanto J. noted, “Dr. patiently answered my questions with clear, descriptive, and convincing explanations.”
• Comprehensive glaucoma care, from SLT and medical management to advanced minimally invasive glaucoma surgery (MIGS) when needed.

Your SLT procedure will be performed by Dr. Avneet K. Sodhi Gaur, a board-certified, fellowship-trained cataract, refractive, and glaucoma specialist at AGEI. She graduated Magna Cum Laude from The George Washington University, earned her medical degree from The George Washington University School of Medicine and Health Sciences, and has been voted a top Los Angeles ophthalmologist numerous times, including this year by LA Magazine.

Dr. Sodhi Gaur has performed thousands of cataract, glaucoma, and refractive surgeries.

Her glaucoma practice includes selective laser trabeculoplasty, laser peripheral iridotomy, minimally invasive glaucoma surgery (including iStent, iStent inject, Hydrus, ECP, OMNI 360, and iTrack canaloplasty), and traditional surgical procedures such as trabeculectomy and drainage implants.

Our patients consistently say they are receiving the best care available. That's because they are.

If you have been diagnosed with glaucoma or ocular hypertension, or if you simply want to understand your options, we invite you to schedule a complimentary evaluation at Assil Gaur Eye Institute. Our specialists will assess whether SLT is right for you and walk you through every step of the process with the clarity and confidence you deserve.