Laser Trabeculoplasty
Laser trabeculoplasty improves natural aqueous outflow and helps lower eye pressure.
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About the service
Laser treatment lowers eye pressure through different mechanisms. The procedure depends on glaucoma type, anterior chamber angle anatomy and the treatment goal.
Who the service is for
Intraocular pressure
Primary open-angle glaucoma or ocular hypertension when SLT is considered appropriate for IOP reduction.
Eye-drop tolerability
Insufficient effect, intolerance or adherence difficulties with pressure-lowering eye drops.
Anterior chamber and angle
Narrow or closing angle with confirmed pupillary block when laser iridotomy is indicated.
Previous treatment
Need for additional IOP lowering after previous therapy or surgery when ocular anatomy allows laser treatment.
Glaucoma and eye pressure
Complex or refractory glaucoma when micropulse ciliary-body treatment is being considered.
Realistic expectations
Laser is not a cure that reverses glaucoma and it does not restore already lost visual field. Drops or glaucoma surgery may still be needed after SLT or iridotomy. Possible adverse effects include transient IOP rise, inflammation, discomfort and blur; iridotomy can also cause dysphotopsia, iris bleeding or require repeat treatment if the opening is not adequate.
Do not change medicines yourself
The patient is willing to continue follow-up after laser and understands that the procedure does not replace glaucoma monitoring.
Determining the mechanism of glaucoma
Bring your latest glaucoma results: intraocular pressure, gonioscopy, optic nerve/RNFL OCT, visual fields, pachymetry and records of previous operations. Do not stop pressure-lowering drops on your own. Tell the doctor about inflammatory eye disease, injuries, operations, steroid use, pregnancy, medicine allergies and systemic conditions.
Individual treatment choice
The ophthalmologist or laser surgeon determines the exact tests required before laser treatment.
Limitations and safety
Laser is not a cure that reverses glaucoma and it does not restore already lost visual field. Drops or glaucoma surgery may still be needed after SLT or iridotomy. Possible adverse effects include transient IOP rise, inflammation, discomfort and blur; iridotomy can also cause dysphotopsia, iris bleeding or require repeat treatment if the opening is not adequate. Severe pain, marked redness, sudden vision loss, nausea or vomiting require urgent clinical assessment.
Book a consultation
Stages
Stage 1
Confirming diagnosis and treatment goal
Glaucoma type, stage, target pressure and changes in the optic nerve and visual field.
Stage 2
Gonioscopy
An open, narrow or closed angle and the blockage mechanism are confirmed.
Stage 3
Preparation
Pressure measurement and other indicated tests; medicines change only on the doctor's instructions.
Stage 4
Laser stage
Topical anaesthesia and placement of a special gonio/laser lens when required.
Stage 5
Laser treatment
SLT to the trabecular meshwork, peripheral iris iridotomy or another selected method.
Stage 6
Immediate check
The doctor assesses the eye and pressure if needed after treatment.
Stage 7
Postoperative prescriptions
Drops and the regimen are individualised; do not change pressure-lowering therapy yourself.
Stage 8
Assessing effectiveness
Pressure, optic nerve and visual fields are monitored over time; effectiveness is not determined only by pressure on treatment day.
Service benefits
Lower intraocular pressure
Reaching the target pressure helps reduce the risk of further optic nerve damage.
No surgical incision
Laser treatment can be performed without a standard surgical incision into the eyeball.
Targeting the disease mechanism
The laser technique is selected according to drainage angle anatomy and the cause of raised pressure.
An outpatient treatment option
Many laser procedures are performed without hospital admission; the doctor determines the setting and follow-up.
Methods comparison · 1
Criterion
SLT
Conventional laser trabeculoplasty
Laser iridotomy;
Micropulse CPC
Main goal
Improve trabecular outflow
Improve outflow through trabecular meshwork
Relieve pupillary block / create aqueous pathway
Reduce aqueous production
Typical mechanism
Open angle
Open angle
Narrow/closed angle with pupillary block
Selected refractory/complex glaucoma
Effect on drops
May reduce medication burden
Depends on response
Does not replace drops if IOP remains above target
Can complement medical/surgical strategy
Repeatability
Possible in selected patients
Depends on technique and trabecular status
Repeat may be needed if opening is inadequate or closes
Retreatment may be considered when indicated
Main limitation
Requires accessible trabecular angle
Effect may diminish over time
Does not address every mechanism of chronic angle closure
Not a universal first-line laser for all glaucoma
SLT
Main goal
Typical mechanism
Effect on drops
Repeatability
Main limitation
Improve trabecular outflow
Open angle
May reduce medication burden
Possible in selected patients
Requires accessible trabecular angle
Improve outflow through trabecular meshwork
Open angle
Depends on response
Depends on technique and trabecular status
Effect may diminish over time
Relieve pupillary block / create aqueous pathway
Narrow/closed angle with pupillary block
Does not replace drops if IOP remains above target
Repeat may be needed if opening is inadequate or closes
Does not address every mechanism of chronic angle closure
Reduce aqueous production
Selected refractory/complex glaucoma
Can complement medical/surgical strategy
Retreatment may be considered when indicated
Not a universal first-line laser for all glaucoma
Methods comparison · 2
Criterion
Eye drops
SLT
Filtering glaucoma surgery
Invasiveness
No procedure
Incision-free laser
Intraocular surgery
Adherence
Regular daily use required
Daily medication burden may decrease
Follow-up remains essential and drops may still be needed
Treatment adjustment
Medication can be changed relatively quickly
Effect is assessed over time after laser
Requires surgical planning
Best fit
When medical treatment is chosen or laser is unsuitable
Suitable uncomplicated open-angle glaucoma or ocular hypertension
Advanced or insufficiently controlled glaucoma
Main trade-off
Ocular/systemic side effects and adherence
Effect is not guaranteed and may diminish
Greater surgical burden and postoperative care
Eye drops
Invasiveness
Adherence
Treatment adjustment
Best fit
Main trade-off
No procedure
Regular daily use required
Medication can be changed relatively quickly
When medical treatment is chosen or laser is unsuitable
Ocular/systemic side effects and adherence
Incision-free laser
Daily medication burden may decrease
Effect is assessed over time after laser
Suitable uncomplicated open-angle glaucoma or ocular hypertension
Effect is not guaranteed and may diminish
Intraocular surgery
Follow-up remains essential and drops may still be needed
Requires surgical planning
Advanced or insufficiently controlled glaucoma
Greater surgical burden and postoperative care
Book an appointment
Book a consultation for laser glaucoma treatment at KazRIED. The ophthalmologist will assess angle anatomy, target IOP, optic-nerve status and previous treatment before deciding whether SLT, iridotomy or another laser procedure is appropriate.
Procedure prices
Service name
Price
Selective trabeculoplasty, code 221 (per eye)
from 32 500 ₸
Trabeculoplasty, code 207 (per eye)
from 24 500 ₸
Iris perforation, code 209 (per eye)
from 26 000 ₸
Iris plasty, code 206 (per eye)
from 16 500 ₸
Micropulse cyclophotocoagulation (per eye)
from 172 000 ₸
Gonioscopy, code 328 (per eye)
from 3 400 ₸
Non-contact tonometry, code 330 (per eye)
from 900 ₸
Spectralis RNFL, code 376 (per eye)
from 2 600 ₸
Our doctors
A team of experienced doctors across specialties.
Experience: 30 years
Ophthalmologist
Umbetiar Almas Bekimuly
Candidate of Medical Sciences; Highest-category ophthalmologist
Experience: 23 years
Ophthalmologist
Abelkarieva Zhanara Abdrakhmangalievna
Highest-category ophthalmologist
Experience: 49 years
Ophthalmologist, Laser Treatment Unit
Silkin Vasiliy Pavlovich
Highest-category ophthalmologist
Experience: 12 years
Ophthalmologist
Tadzhimetov Murat Mikhaylovich
Highest-category ophthalmologist
Experience: 6 years
Ophthalmologist
Ordabaev Islam Kuanyshkaliuly
Second-category ophthalmologist
Experience: 7 years
Ophthalmologist, Laser Treatment Unit
Shaykenova Asiya Dulatovna
PhD Student
Experience: 5 years
Ophthalmologist, Laser Treatment Unit
Gallamov Diyar Muratkalievich
Laser treatment for glaucoma: methods and procedure selection
Laser treatments for glaucoma work through different mechanisms. The procedure is selected according to the disease mechanism and the eye’s anatomy.
Which methods are used?
- Selective laser trabeculoplasty (SLT) targets the trabecular meshwork to improve aqueous humor outflow when the open-angle anatomy is suitable. Other forms of trabeculoplasty may also be considered.
- Laser iridotomy creates a small opening in the peripheral iris, providing an alternative route for aqueous humor flow in cases involving pupillary block and an angle-closure mechanism.
- Laser iridoplasty may be used in selected narrow-angle configurations.
- Micropulse transscleral cyclophotocoagulation targets the ciliary body and is used in more complex situations when aqueous humor production needs to be reduced.
How is the procedure selected?
The choice depends on gonioscopy findings, glaucoma stage, target intraocular pressure (IOP), optic nerve condition, previous treatment, and the eye’s anatomy.
What is the goal of laser treatment?
Laser treatment does not restore optic nerve fibers that have already been lost. The goal is to lower IOP to an individualized target and reduce the risk of further progression.
Even a good response to laser treatment does not remove the need for continued IOP monitoring, OCT examinations, and visual field testing.
When laser treatment for glaucoma is considered
Laser treatment is selected according to the specific disease mechanism. A simple comparison suggesting that “laser is better than drops” does not reflect all the factors involved in choosing treatment.
For open-angle glaucoma
International guidelines recognize selective laser trabeculoplasty (SLT) as an initial treatment option for suitable patients with uncomplicated chronic open-angle glaucoma or ocular hypertension.
For angle-closure glaucoma
The clinician determines whether pupillary block is present and whether laser iridotomy would provide a pathway for aqueous humor flow.
Diagnosis and follow-up at KazRIED
KazRIED has a specialized Kazakhstan-German Glaucoma Center and a laser department.
This allows the decision about laser treatment to be integrated with a comprehensive glaucoma assessment and subsequent follow-up. The procedure should be accompanied by continued monitoring of the eye.
Related information: Kazakhstan-German Glaucoma Center.
Facts and offers
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Related services
Frequently asked questions
Can laser cure glaucoma completely?
No. Laser treatment can lower intraocular pressure and reduce the risk of further optic-nerve damage, but it does not restore vision already lost from glaucoma and does not remove the need for follow-up.
What is selective laser trabeculoplasty?
SLT is a laser procedure that treats the trabecular meshwork in an open anterior-chamber angle to improve aqueous outflow and lower intraocular pressure.
Can SLT be used instead of eye drops?
In suitable patients with open-angle glaucoma or ocular hypertension, SLT can be used as initial treatment. It may also be used alongside medication. Selection depends on the diagnosis, disease stage, target IOP and other factors.
Will eye drops definitely be stopped after SLT?
No. SLT may reduce medication burden or delay the need for drops, but some patients still require medication to reach target IOP and control the risk of progression.
Can SLT be repeated?
Yes. If an initially successful SLT effect declines over time, repeat treatment may be considered. The decision depends on the previous response and current glaucoma status.
Is SLT suitable for angle-closure glaucoma?
SLT requires accessible trabecular meshwork and cannot be performed through a completely closed angle. After pupillary block has been relieved, for example by iridotomy, SLT may sometimes be considered if enough trabecular meshwork becomes visible.
What is laser peripheral iridotomy?
It is a procedure in which a small opening is created in the peripheral iris, allowing aqueous to pass directly from the posterior to the anterior chamber and relieving or reducing pupillary block.
Does iridotomy lower intraocular pressure permanently?
Not necessarily. Iridotomy relieves pupillary block, but IOP may remain elevated because of peripheral synechiae, chronic trabecular damage, plateau iris or another mechanism. Additional treatment may then be required.
When is laser iridoplasty used?
Peripheral laser iridoplasty may be used when appositional angle closure persists, particularly in plateau iris after a patent iridotomy. Laser treatment contracts the peripheral iris and helps widen the angle.
What is micropulse transscleral cyclophotocoagulation?
It is a laser treatment in which micropulse energy is delivered through the sclera to the ciliary-body region to lower intraocular pressure. It is often used in complex or inadequately controlled glaucoma, although indications are individualized and have been expanding.