Direct Selective Laser Trabeculoplasty (DSLT)

DSLT offers a non-contact, automated laser procedure that safely lowers intraocular pressure (IOP) in just seconds—without the need for eye drops or direct contact with the eye’s surface.

What is DSLT?

Direct Selective Laser Trabeculoplasty (DSLT) is the next generation of glaucoma laser therapy, developed by Alcon and powered by the Voyager™ system.
It builds upon the success of Selective Laser Trabeculoplasty (SLT)—a proven, first-line therapy for open-angle glaucoma—but removes the need for a handheld contact lens and manual aiming.

Instead, DSLT uses advanced image-guided automation to deliver a precise ring of laser pulses directly to the trabecular meshwork (the eye’s natural drainage tissue). The treatment is performed without touching the eye, takes about two and a half seconds, and requires no numbing drops or pressure-inducing contact lenses.

Glaucoma Treatments

MIGS: Tiny IncisionDSLT: Contactless LaserSLT: Targeted LaseriDose® TR: Automatic Control

How The DSLT Procedure Works

Glaucoma often develops when the eye’s natural drainage system doesn’t function properly, causing fluid buildup and increased IOP that can damage the optic nerve. DSLT gently stimulates the trabecular meshwork to restore natural fluid outflow, lowering eye pressure and slowing disease progression.

Here’s what makes DSLT unique:

  • Automated precision: Computer-guided imaging identifies the target zone and delivers the laser energy uniformly.
  • Contact-free comfort: There’s no lens touching the eye—improving patient experience and eliminating risk of corneal indentation or infection.
  • Speed and consistency: The entire treatment takes about 2–3 seconds per eye, with results comparable to SLT in lowering IOP.
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DSLT vs. Traditional Treatments

No daily maintenance, fewer side effects, no risk of missed doses.

Faster, non-contact, and equally effective.

Non-invasive and repeatable without risk of scarring or infection.

Glaucoma MIGS evaluation with OD.

The Science Behind DSLT

Recent studies published in the American Journal of Ophthalmology and Investigative Ophthalmology & Visual Science confirm that DSLT:

  • Produces non-inferior pressure reduction compared to conventional SLT.
  • Offers excellent safety, with no corneal burns, pressure spikes, or vision-threatening complications.
  • Delivers consistent results, even among patients with mild to moderate glaucoma or ocular hypertension.
  • Provides repeatability, meaning the treatment can be safely performed again if eye pressure rises in the future.

Insurance for DLST Treatment

Many plans cover laser trabeculoplasty when medically necessary. Because DSLT is a newer, non-contact approach, coverage is plan-dependent. We verify your benefits and obtain any required authorizations first. Insurance policies differ by region and provider; patients in Arizona should verify pre-authorization requirements and out-of-pocket costs with both their ophthalmologist and their insurance company before scheduling surgery.

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Elevation and retina surgery what’s the connection? Senior woman with backpack looking out over a mountain landscape, illustrating safe return to outdoor activities after surgery

Who Is a Candidate for DSLT?

DSLT may be recommended if you:

  • Have open-angle glaucoma or ocular hypertension
  • Prefer to reduce or eliminate daily eye drops
  • Have difficulty with drop adherence or side effects
  • Seek a first-line, non-invasive option before surgical intervention
  • Have previously undergone SLT and require additional pressure lowering

Your Arizona eye specialist will evaluate your eye anatomy, pressure levels, and disease stage to determine whether DSLT is appropriate for you.

What to Expect During Treatment

1

Consultation

Your ophthalmologist reviews your glaucoma history and current eye pressure.

2

Imaging

The DSLT system maps the eye’s drainage angle using 3D imaging.

3

Laser Delivery

The automated system delivers about 100 laser pulses in a 360° ring pattern in just seconds.

4

Post-procedure

You can go home immediately; most patients report no discomfort or downtime.

5

Results

Eye pressure begins to lower within days to weeks, with results lasting 12–24 months for many patients.

Why Early Laser Therapy Matters

According to the Glaucoma Today editorial board, the future of glaucoma care is moving toward “drop-free, first-line laser therapy.”

DSLT supports this evolution by making laser treatment safer, faster, and more accessible than ever. For many patients, it’s the first step toward preserving vision without daily medication.

Even if your glaucoma is well-controlled, early intervention can slow disease progression and reduce future treatment burden—helping protect your sight for years to come.

OCT imaging of the optic nerve during IOP monitoring for glaucoma

Frequently Asked Questions

DSLT means Direct Selective Laser Trabeculoplasty, a non-contact laser procedure for lowering eye pressure in glaucoma patients.

No. Because the laser never touches the eye, patients typically feel no sensation. No anesthesia is required.

The actual laser time is approximately 2–3 seconds per eye, with the whole visit lasting around 5–10 minutes.

Clinical trials have shown that DSLT provides equivalent IOP reduction to SLT at six months, with fewer side effects and greater patient comfort.