Mechanisms of selective laser trabeculoplasty: a review

Selective laser trabeculoplasty is a safe and effective treatment for glaucoma, with greater cost effectiveness than its pharmacological and surgical alternatives. Nevertheless, although the basic science literature on selective laser trabeculoplasty continues to grow, there remains uncertainty over the mechanism by which laser trabeculoplasty reduces intraocular pressure. To address this uncertainty, the evidence behind several potential biological and mechanical mechanisms of selective laser trabeculoplasty were reviewed. In particular, cytokine secretion, matrix metalloproteinase induction, increased cell division, repopulation of burn sites and macrophage recruitment were discussed. Refining our understanding of these mechanisms is essential both to understanding the pathophysiology of ocular hypertension and developing improved therapies to treat the condition.