Challenges and Limitations of Selective Laser Trabeculoplasty in Modern Glaucoma Management: A Narrative Review

Selective laser trabeculoplasty (SLT) has become a mainstay in the management of a variety of glaucoma diseases. SLT provides a safe, minimally invasive, and effective way to lower intraocular pressure. Many studies have discussed its favorable safety profile, and the benefits of SLT being used as a primary and adjunctive therapy in glaucoma. However, while there are many benefits, it is important to note the potential drawbacks that can be seen with this procedure, particularly for non-ideal populations. Common complications include transient episodes of intraocular pressure spikes, hyperemia, blurred vision, and anterior chamber inflammation. Rarer complications such as corneal edema, hyphema, or vision loss have also been reported. This narrative literature review examines the incidence and mechanisms of SLT-related complications, drawing from peer reviewed publications and case reports. The goal is to highlight selective laser trabeculoplasty limitations and complications for physicians to make a more informed decision, counsel patients on possible risks, and implement strategies for optimal outcomes.