Direct SLT: A Revolutionary Advance in Glaucoma Treatment Debuts in Massachusetts

Glaucoma is one of the leading causes of irreversible blindness worldwide, affecting over 3 million Americans and millions more globally. This silent disease gradually damages the optic nerve—often without noticeable symptoms until significant vision is lost. Lowering intraocular pressure (IOP) remains the only proven way to slow or stop its progression—and innovative treatments continue to evolve in the fight to preserve vision.

In a major advancement for glaucoma patients in Massachusetts, Dr. Roger Kaldawy, MD, is offering the state’s first Direct SLT (Selective Laser Trabeculoplasty) using Alcon’s newest, state-of-the-art laser system. This groundbreaking 2-second procedure will take place at Milford Franklin Eye Center’s surgical facility in Milford, MA, marking a new chapter in laser glaucoma care—right here, close to home.

What Is Glaucoma and How Is It Treated?

Glaucoma is a group of eye diseases that damage the optic nerve, usually due to increased intraocular pressure. The most common form, open-angle glaucoma, occurs when the drainage system of the eye becomes less effective over time, allowing fluid to accumulate and pressure to build. Without treatment, this pressure can cause permanent vision loss.

Traditional glaucoma treatment options include:

• Medicated eye drops to reduce fluid production or improve drainage

• Oral medications, often a last resort due to systemic side effects

• Laser treatments, such as conventional SLT or argon laser trabeculoplasty (ALT)

• Minimally Invasive Glaucoma Surgery (MIGS) for moderate disease

• Traditional surgeries, including trabeculectomy or tube shunts, for advanced cases

Each approach has its pros and cons, and treatment is tailored to the patient’s specific needs and stage of disease.

What Is SLT?

Selective Laser Trabeculoplasty (SLT) is a well-established, non-invasive laser treatment that targets the eye’s trabecular meshwork—the tissue responsible for draining fluid from the eye. SLT uses gentle laser pulses to improve outflow and lower IOP, often reducing or eliminating the need for daily eye drops. It’s a quick, painless procedure with minimal downtime, typically performed in an outpatient setting.

At Milford Franklin Eye Center, Dr. Kaldawy was among the first surgeons in the region to offer SLT, performing hundreds of successful treatments over the years. Our facility provides SLT in a state-of-the-art surgical center in Milford, offering expert care without the need to travel to distant hospitals or urban centers.

With this advanced center available in your backyard, there’s no reason to travel hours for glaucoma or eye surgery. If your provider is still recommending you drive long distances for treatment, we welcome second opinions and offer world-class laser glaucoma care, right here in Milford.

Introducing Direct SLT: The Next Generation of Laser Therapy

Alcon’s Direct SLT takes traditional SLT to the next level, combining the trusted benefits of SLT with cutting-edge technology and enhanced precision. This new approach allows the laser to be applied more accurately and consistently to the drainage tissues of the eye, resulting in improved outcomes and a better patient experience.

What Sets Direct SLT Apart from Traditional SLT?

Traditional SLT:

• Requires a goniolens: A specialized lens is placed on the eye to allow the physician to visualize and direct the laser beam at the trabecular meshwork

• More operator-dependent: The accuracy and effectiveness can vary based on the physician’s experience and technique

• Longer procedure: Typically takes a few minutes

• Can involve some discomfort: Some patients may experience discomfort from the goniolens

Direct SLT (DSLT):

• Non-contact: Laser energy is delivered through the limbus, eliminating the need for a goniolens or physical contact with the eye

• Automated and fast: The procedure is automated, takes less than 3 seconds, and can be performed by trained personnel

• Efficient and accessible: DSLT may treat more patients in less time, making care more accessible

• Potentially more comfortable: Non-contact delivery improves patient comfort

Who Should Consider Direct SLT?

Direct SLT is especially beneficial for:

• Patients with early to moderate open-angle glaucoma

• Individuals looking to reduce or avoid glaucoma medications

• Patients with sensitivity or allergies to eye drops

• Those with difficulty maintaining a drop regimen

• Patients with ocular surface disease worsened by medications

Benefits and Risks of Direct SLT

Benefits:

• No incisions and minimal discomfort

• Quick recovery

• May reduce or eliminate the need for daily drops

• Repeatable treatment

• Customized for individual patient needs

Risks:

• Temporary eye irritation or inflammation

• Mild, short-term increase in IOP immediately after treatment

• In rare cases, insufficient pressure reduction

 Why Choose Milford Franklin Eye Center for Your Laser Glaucoma Surgery?

We are proud to be the first center in Massachusetts to offer Direct SLT, and even prouder to provide it in a local, accessible setting that prioritizes patient comfort and convenience. Our facility is equipped with the latest ophthalmic technology, and our team—led by Dr. Kaldawy—delivers compassionate, expert care with excellent outcomes.

Here’s the great news: You don’t need to travel far to receive top-tier glaucoma care. We’re offering excellence in SLT—including the newest Direct SLT—right here in Milford.

If you or someone you love is living with glaucoma or elevated eye pressure, contact us today to learn whether Direct SLT is right for you. We’re honored to bring this breakthrough in glaucoma care to our community—and we’re ready to help you protect your vision for years to come.

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