LiGHT results - laser trabeculoplasty as first-line glaucoma treatment

Successful trials of laser-based treatment at Moorfields in fight against glaucoma - what could the research mean for you? In March 2019 the results of a pioneering clinical study called LiGHT (Laser in Glaucoma and Ocular Hypertension Trial) were published.   The results of the study by researchers at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology showed that using a laser-based treatment on newly diagnosed cases of glaucoma is more successful and more cost-effective than the current method of using intraocular pressure lowering eye drops. 

What is glaucoma?

Glaucoma is the name given to a group of eye conditions that cause permanent sight loss by damaging your optic nerve. It is one of the leading causes of blindness in the UK and approximately two per cent of the population over 40 have a form of glaucoma. There is no treatment to restore sight loss caused by glaucoma but treatments such as eye drops and selective laser trabeculopolasty (SLT) can help prevent further sight loss from happening.

You can find more information about glaucoma on at:  

Why are these results significant?

This study is the largest ever UK trial looking at ways of treating glaucoma. Currently the main treatment for glaucoma is ongoing use of eye drops which lower intraocular pressure. SLT is currently used as an alternative or alongside these eye drops to try and increase the effectiveness. However, the results from this trial have shown that not only is SLT more effective than using eye drops, but it is also more cost effective. Glaucoma is one of the leading causes of blindness in the UK and the results from this trial could pave the way to improving the vision and day to day life of thousands of people in the UK and across the world.

I’ve been recently diagnosed with glaucoma, where can I find further information or support?

There are a range of organisations and charities where you can find extra information about living with glaucoma. The International Glaucoma Association (IGA) specialises in providing information, literature, and advice to people with glaucoma. The Royal National Institute of Blind People (RNIB) can also give information and support to people with a wide range of conditions including glaucoma. Your consultant or GP will also be able to give you information on where you can find further support or information. Moorfields also has a nurse-led helpline which is staffed by trained eye specialists and is open from 9am to 9pm Monday to Friday and on Saturdays from 9am to 5pm.

How does the selective laser trabeculoplasty (SLT) procedure work?

SLT uses short pulses of relatively low-energy light to target the cells in the drainage channels of the eye. The laser pulses target only the area where fluid drains from the eye and they work by causing the body to release white blood cells in order to rebuild the affected area, reducing intraocular pressure (IOP) in the process. SLT takes approximately 15 minutes, it is performed as an outpatients procedure meaning you will be able to go home on the same day as receiving the procedure. The effects of the procedure might wear off in time but the treatment can be repeated if this happens.

Is the procedure safe?

Yes, the procedure is completely safe. It is fully approved and is already used in the NHS and across the world as a treatment for certain types of glaucoma.

Will I be unconscious for the procedure?

No, the procedure is done under local anaesthetic, sitting at a microscope. This means your eye will be numb and you won’t be able to feel anything around the area, but you will be awake for the procedure.

How can I receive SLT as treatment?

SLT is already available on the NHS as a form of treatment for certain types of glaucoma. However, it is not currently offered as the standard first-line treatment. You would need to speak to your consultant about what your treatment options are and about whether you are suitable for SLT.

Why isn’t SLT used as the main method of treatment already?

This is the largest ever study comparing SLT and IOP eyedrops as a form of treatment and until now there hasn’t been sufficient evidence to strongly support one form of treatment over the other.

Does this procedure cure glaucoma?

No, there is currently no cure for glaucoma or treatment that can restore vision lost due to glaucoma. All glaucoma treatments aim to prevent the condition causing further sight loss. This is why it is so important to diagnose glaucoma from an early stage.

What are the next steps?

There is an ongoing follow up study taking place which will provide more information on the long term effects. This follow up study is due to finish in 2020.