Is There a Role for SLT After MIGS?

A practical framework for patient selection and clinical decision-making when intraocular pressure rises after minimally invasive glaucoma surgery.

By: Shivani S. Kamat, MD

Glaucoma Physician September 1, 2026 Page(s): 8-11

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Minimally invasive glaucoma surgery (MIGS) is preferred for patients with mild to moderate primary open-angle glaucoma (POAG) during cataract extraction.
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Intraocular pressure (IOP) can rise after MIGS due to various factors, necessitating further treatment options like selective laser trabeculoplasty (SLT).
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SLT has been shown to lower IOP effectively and has a favorable safety profile, making it a potential option when MIGS efficacy decreases.
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The effectiveness of SLT after MIGS depends on the preservation of trabecular meshwork (TM) tissue, which varies by MIGS procedure type.
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Retrospective studies indicate that SLT can provide meaningful IOP reduction after MIGS, particularly in cases with preserved TM tissue.

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