Last updated: October 2, 2026
Direct selective laser trabeculoplasty, or DSLT, is a non-incisional method of performing selective laser trabeculoplasty. The Voyager DSLT device directs laser treatment through the limbus toward the trabecular meshwork without using a gonioscopy lens in the same way as conventional SLT. Current United States product information indicates the device for use in selective laser trabeculoplasty.
DSLT is a pressure-lowering option for selected patients, not a cure for glaucoma. It cannot restore vision already lost to optic-nerve damage, and it does not guarantee a particular pressure or eliminate the future need for medication, repeat monitoring, or another procedure. Fichte, Endl & Elmer Eyecare may discuss DSLT, conventional SLT, medication, or surgery according to diagnosis, angle anatomy, pressure target, prior treatment, and current device availability.
How DSLT Works
The device uses imaging and treatment planning to deliver a sequence of laser spots to the drainage angle from outside the eye. Like conventional SLT, the treatment is intended to improve function of the trabecular outflow pathway and lower intraocular pressure. No implant is left in the eye.
Who May Be Evaluated
Evaluation may include confirmation of an open drainage angle, pressure measurements, optic-nerve and visual-field assessment, corneal and limbal examination, pupil response, prior laser or implant history, and the amount of pressure reduction needed. A clinician determines whether DSLT, conventional SLT, medication, or another procedure is more appropriate.
Contraindications and Limitations
Current product information lists inability to maintain appropriate head or eye fixation and a pupil that cannot constrict to 4 millimeters or less among the contraindications. Caution is advised in active uveitis or neovascularization involving the angle. Current labeling also notes that retreatment was not studied in the pivotal clinical study and is not recommended, and that use is not recommended in eyes with a glaucoma implant in the drainage angle when the device cannot avoid the implant area.
Potential Risks and Follow-Up
Possible effects after laser trabeculoplasty include temporary inflammation, discomfort, blurred vision, pressure elevation, or insufficient pressure lowering. Glaucoma monitoring continues after treatment because pressure response can vary and can change over time.
DSLT Compared With Conventional SLT
Both treatments use selective laser energy to target the trabecular drainage pathway. Conventional SLT typically uses a contact lens and direct angle visualization. DSLT uses an automated non-contact delivery approach. The clinical decision should consider the patient’s anatomy, prior procedures, ability to cooperate with treatment, current equipment availability, and the clinician’s judgment.
Compare glaucoma drops, laser, MIGS, and surgery.
Questions to Ask the Clinician
- Is my drainage angle suitable for laser trabeculoplasty?
- Why is DSLT or conventional SLT being recommended?
- What pressure reduction is a reasonable goal?
- Will I continue glaucoma drops?
- How soon will pressure be checked?
- What happens if the response is insufficient?
Schedule a Glaucoma Evaluation
Call 1-800-309-2020 or request an appointment. Confirm current DSLT availability when scheduling.
Product and Patient Education Sources
This page provides general education and summarizes selected product information. Current device labeling and an individual examination control treatment decisions.
