A recent study has shown that direct selective laser trabeculoplasty (DSLT), a laser procedure for lowering intraocular pressure in glaucoma patients, has demonstrated a strong safety profile, even at high energy levels. DSLT is a newer, contactless method for lowering intraocular pressure than conventional selective laser trabeculoplasty (SLT), both of which deliver the same laser energy.
Understanding Laser Trabeculoplasty in Glaucoma Treatment
The study, led by Liat Mendel-Veig, MD, and Guy Kleinmann, MD, is titled “Clinical and Histopathological Evaluation of Maximal and Supramaximal Energy Direct Selective Laser Trabeculoplasty (DSLT): A Rabbit Model Safety Study.” The basic science article, published in Lasers in Surgery and Medicine (LSM), the official journal of the American Society for Laser Medicine and Surgery, Inc. (ASLMS), was selected as the October 2026 Editor’s Choice.
The team used DSLT on rabbits to determine how the treatment affected not only the target tissue (trabecular meshwork) but also nearby ocular structures, including the limbus, iris, and sclera. Both maximal and supramaximal energy settings were evaluated and compared with conventional SLT and sham treatment.
“The goal of the study was to evaluate the safety of double-energy laser application and inadvertent laser shots to tissue adjacent to the trabecular meshwork,” the authors stated. “This study is important because it provides evidence supporting the safety of a novel laser modality for the treatment of glaucoma.”
After testing DSLT on the different eye structures, no significant clinical or histopathological damage was observed, even with high-energy or double-density exposures. These findings provide important evidence supporting the safety of DSLT, even in the event of extreme technical failure.
Dr. Mendel-Veig, MD, is a glaucoma specialist and ophthalmologist based in Israel, with clinical and research interests in all types of glaucoma procedures, phacoemulsification, and surgical outcomes research. She completed a glaucoma fellowship at Moorfields Eye Hospital.
Guy Kleinmann, MD, is Chairman of the Goldschleger Eye Institute at Sheba Medical Center, Ramat Gan, Israel, and Associate Professor of Ophthalmology at the School of Medicine, Tel Aviv University .
Prof. Kleinmann specializes in cataract, refractive, and corneal surgery, with particular expertise in complex anterior segment surgery and challenging reconstructive cases. His clinical and research interests include cataract surgery and its complications, intraocular lens (IOL) complications, premium IOLs, IOL injector and delivery systems, ocular surface disease, corneal surgery, and refractive surgery. He also leads an active ophthalmic research laboratory.