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PentaVision

Glaucoma Physician

Article

One Year After DSLT Launch

Early users of Alcon’s Voyager share real-world experiences, discuss workflow strategies, and offer tips for efficiency and patient comfort.

By: Jim Gallagher, senior managing editor
Glaucoma Physician January 1, 2026 Page(s): 10-13

Clinical Scorecard: One Year After DSLT Launch

At a Glance

CategoryDetail
ConditionGlaucoma
Key MechanismsDirect Selective Laser Trabeculoplasty (DSLT) offers fully automated, 360° treatment without the need for gonioscopy.
Target PopulationPatients with mild to moderate glaucoma, particularly those seeking to reduce drop burden.
Care SettingOphthalmology practices integrating DSLT into their workflow.

Key Highlights

  • DSLT streamlines treatment and improves accessibility as a first-line therapy for glaucoma.
  • The device allows treatment of challenging cases with limited visualization.
  • Bilateral treatment is preferred to reduce drop burden and enhance efficiency.
  • Anesthesia techniques have evolved to improve patient comfort during treatment.
  • Workflow strategies include preloading patient data and preparing instruments in advance.

Guideline-Based Recommendations

Diagnosis

  • Indications for DSLT are similar to manual SLT in primary open-angle glaucoma (POAG).

Management

  • Use of tetracaine and lidocaine gel for anesthesia to enhance patient comfort.

Monitoring & Follow-up

  • Monitor patient response and adjust anesthesia based on individual sensitivity.

Risks

  • Potential for increased sensation during treatment due to higher energy levels.

Patient & Prescribing Data

Patients with mild glaucoma or those on 1-2 drops seeking to reduce medication burden.

DSLT is effective for patients with dense TM pigmentation or other visualization challenges.

Clinical Best Practices

  • Organize workflow to minimize delays and ensure readiness for each patient.
  • Counsel patients about potential discomfort and the brief duration of laser application.
  • Perform DSLT bilaterally to enhance treatment efficiency.

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