Micropulse laser trabeculoplasty (MLT) is a newer form of glaucoma laser that delivers energy in short pulses with intervening cooling periods. It targets the trabecular meshwork like ALT or SLT but aims to reduce thermal damage.
Technique
Using a contact lens at the slit lamp, the laser applies a sequence of micropulses to the drainage angle. The duty cycle limits heat build‑up, potentially improving safety and repeatability.
- Usually performed under topical anaesthetic as an outpatient
- Post-procedure discomfort and inflammation are typically mild
- Eyes may continue or adjust pressure-lowering drops afterwards
- Evidence suggests pressure reduction comparable to other trabeculoplasty methods in many patients
Place in Treatment
MLT can be considered for open‑angle glaucoma or ocular hypertension, especially when non‑destructive, repeatable therapy is desired. Long-term comparative data are still evolving.
- Pressure response is monitored over subsequent weeks
- MLT may be repeated if effect diminishes
- Not all patients respond, so ongoing monitoring and alternative options are essential
- It does not replace the need for regular glaucoma follow-up
