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An in-depth look at the groundbreaking Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial, which recommended selective laser trabeculoplasty (SLT) as a first-line treatment for glaucoma, has revealed that this method slows disease progression by 29% compared to eye drops.
“Selective laser trabeculoplasty should not only be recognised as a safe and effective alternative to medications as an initial treatment for primary open-angle glaucoma but also offers an advantage in reducing the risk of vision loss,” said lead researcher Dr Giovanni Montesano of Moorfields Eye Hospital in London.
The findings were presented on October 20, 2024, during the 128th annual meeting of the American Academy of Ophthalmology (AAO 2024).
Dr Montesano and his team revisited the results of the LiGHT trial, a randomised study originally conducted by Professor Gus Gazzard in 2019 and published in The Lancet. The trial compared SLT to glaucoma eye drops for patients newly diagnosed with open-angle glaucoma (OAG) or ocular hypertension (OHT). SLT works by lowering intraocular pressure through stimulation of the trabecular meshwork.
This trial led to significant changes in international glaucoma treatment guidelines. Organisations in Europe, the United States, and the United Kingdom now recommend SLT as a first-line option alongside medications. A six-year follow-up study in 2023 supported the original findings, showing patients treated with laser therapy had a slower rate of disease progression and were less likely to require glaucoma surgery.
Dr Montesano’s recent analysis used advanced statistical methods to examine visual field outcomes in greater detail. “Since the initial study, we’ve developed an improved statistical approach to measure the progression of mean deviation,” he explained. “With this refined methodology and extended follow-up period, we were able to reanalyse the differences between the SLT-first and medication-first groups in the LiGHT trial.”
The updated analysis showed that patients who received SLT as their first treatment had a 29% slower rate of mean deviation progression over six years. Specifically, 14% of eyes treated with laser showed fast progression (greater than -0.5 dB/year), compared to 25% in the eye drop group, according to a release from the AAO.
The AAO recently published an Ophthalmic Technology Assessment of SLT, which confirmed that this laser treatment is suitable as a primary intervention, a substitute for medication, or a complementary therapy alongside glaucoma medications.
This article has been republished courtesy of Insight News.
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