Q: What is SLT and why would I need it?
A: Selective laser trabeculoplasty is an outpatient laser procedure that improves fluid drainage through the eye’s natural drainage structure, the trabecular meshwork, to lower intraocular pressure in glaucoma or ocular hypertension. It takes about 5–10 minutes per eye, requires no incision, and most patients return to normal activity the same day.
Q: How much does SLT actually cost?
A: Here’s the full breakdown.
| Cost Component | Price Range | Notes |
|---|---|---|
| Procedure fee (per eye) | $400–$900 | Outpatient, in-office laser |
| Facility fee (if applicable) | $150–$400 | Varies by setting |
| Pre-procedure glaucoma workup | Usually bundled | Included in comprehensive glaucoma exam |
| Follow-up pressure check | $75–$150 | Typically at 1 week, 1 month, 3 months |
| Medicare/insurance copay | $40–$150 | Standard cost-sharing after coverage |
| Repeat SLT (if needed) | $400–$900 | Can typically be repeated after 1–5 years |
Q: Is SLT actually as effective as eye drops?
A: According to results from the LiGHT trial, a large randomized study published in The Lancet in 2019, SLT performed as well as or better than daily eye drops as an initial glaucoma treatment — with the added benefit that patients on SLT needed fewer or no drops at all over the following years. That finding has shifted a meaningful number of ophthalmologists toward offering SLT as a first-line option rather than reserving it for patients who’ve already failed drop therapy.
SLT costs $400–$900 per eye and, unlike older laser treatments, can typically be repeated multiple times over a patient’s life without losing effectiveness. The NEI estimates glaucoma affects more than 3 million Americans, and more than half don’t know they have it — early laser treatment can meaningfully slow vision loss once diagnosed.
Q: Does insurance cover it?
A: Yes, in almost all cases. SLT is billed as a medical procedure to treat a documented diagnosis of glaucoma or ocular hypertension, and Medicare Part B along with most commercial insurance plans cover it with standard coinsurance. Expect a copay in the $40–$150 range per eye rather than the full cash-pay price, assuming you have a documented diagnosis.
Q: How does SLT compare to eye drops over time?
A: Glaucoma eye drops run $30–$150 a month per medication, and many glaucoma patients are on two or more drops simultaneously — meaning $720–$3,600 a year in medication costs alone, plus the ongoing hassle of daily compliance. A single SLT treatment, at $400–$900 per eye, can replace or reduce drop dependence for one to five years, making it a genuine cost-saver for a lot of patients even before factoring in the convenience of not remembering a nightly drop routine.
Q: Why is “selective” in the name?
A: SLT uses a much lower energy laser than its predecessor, argon laser trabeculoplasty (ALT), targeting only pigmented cells in the drainage meshwork while leaving surrounding tissue undamaged. That selectivity is exactly why SLT can be repeated multiple times, whereas ALT caused enough tissue scarring that it typically could only be done once or twice per eye over a lifetime.
Q: What are the risks?
A: SLT has an excellent safety profile — temporary pressure spikes and mild inflammation in the first day or two are the most common side effects, both typically resolved with a short course of anti-inflammatory drops. Serious complications are rare.
SLT lowers pressure gradually over 4–8 weeks — it is not an instant fix, and your ophthalmologist will likely keep you on your current drops until follow-up confirms the pressure has responded. Don’t stop any glaucoma medication on your own before that confirmation; untreated pressure spikes can cause irreversible optic nerve damage.
Bottom Line
At $400–$900 per eye, with most insurance plans covering the bulk of the cost, SLT is one of the more cost-effective tools in glaucoma management — repeatable, low-risk, and increasingly used as a first-line option rather than a last resort. Ask your ophthalmologist whether you’re a candidate before committing to another year of daily eye drops.