Pioneering study identifies more effective laser treatment for glaucoma

Mr Gus Gazzard, consultant ophthalmologist and glaucoma service director at Moorfields Eye Hospital:

“In this study, we have shown that a simple, safe, pain-free laser treatment not only works better than eye-drops at preventing glaucoma from deteriorating but also costs the NHS less."

Gus Gazzard at Moorefields Eye Hospital
Gus Gazzard at Moorefields Eye Hospital

What was the aim of the research?
A study part-funded by Fight for Sight has successfully analysed the effectiveness of a laser-based treatment on newly diagnosed cases of glaucoma compared with the current method of using intraocular pressure-lowering eye drops.

What method did researchers use?
The three-year trial – known as The LiGHT trial (Laser in Glaucoma and Ocular Hypertension Trial) - saw 718 patients newly-diagnosed with glaucoma or ocular hypertension (an increase in pressure in the eye without causing damage to the optic nerve) assigned one of two treatment pathways.

One pathway was the current standard treatment of administering eye drops designed to lower intraocular pressure. The other involved a treatment called selective laser trabeculoplasty (SLT), an extremely quick procedure which lowers intraocular pressure by using lasers to make it easier for fluid to leave the eye.

The results, published in the peer-reviewed journal The Lancet in April 2019 showed that patients who received SLT were more regularly at the target intraocular pressure. There was less need for treatment to be escalated and there was a reduced need for both glaucoma surgery and cataract extractions compared to patients who received the eye drops.

What will the impact be?
The results could potentially improve the way glaucoma is treated across the world and could save the NHS up to £1.5million per year in direct treatment costs for newly-diagnosed patients.
An ongoing follow up study, also funded by Fight for Sight, the NIHR HTA, Moorfields Eye Charity and the International Glaucoma Association, will provide more information on the long-term effects. This follow-up study is due to conclude in 2020.

What will this mean for people with glaucoma and optic nerve damage?
Selective Laser Trabeculoplasty potentially has far reaching benefits for patients with glaucoma and is safe, more effective and pain free. The results of this study could change the way that glaucoma patients are treated worldwide.

Guy Staniforth, 61, was referred to Moorfields in 2013 following diagnosis of glaucoma in both eyes. He volunteered for the trial and received SLT treatment throughout.
He says: “In the three years since the procedure I’ve not had to use eye drops and my eye pressures have remained stable. I’m certain that the treatment I have received from Moorfields Eye Hospital, combined with the rapidly advancing medical techniques, have helped me continue my work and earn a living, which is essential as I have a relatively young family growing up.’’

The trial, which was funded by Fight for Sight, the National Institute for Health Research Health and Technology Assessment Programme (NIHR HTA), was held across the NIHR Biomedical Research Facility (BRC) at Moorfields and UCL and with the support of the PRIMENT clinical trials unit at UCL.

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