Selective Laser Trabeculoplasty (SLT) can be considered as the first treatment for newly diagnosed patients with ocular hypertension and mild to moderate primary open angle glaucoma

The Science behind the Tip

The LiGHT trial compared two treatment pathways for treatment naïve ocular hypertension and mild to moderate glaucoma. 718 patients were randomised to either primary SLT (100 shots over 360 degrees) and later medications as required or primary medical treatment with no laser. After 3 years, 78% of eyes with SLT treatment were still controlled, achieving predetermined eye-specific Target IOPs without medication and with no sight-threatening complications of laser. Three quarters of these required only a single SLT treatment. Primary SLT was both clinically effective and more cost effective than primary medical therapy.
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Contributor: Gus Gazzard, London

Reference

Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial Gazzard G et al.
https://www.thelancet.com/journals/lancet/issue/vol393no10180/PIIS0140- 6736(19)X0016-1
https://www-sciencedirectcom.libproxy.ucl.ac.uk/search?authors=gazzard&pub=The%20Lancet&cid=271074&show=2 5&sortBy=relevance&years=2019&lastSelectedFacet=years

Tip Reviewer: Roger Hitchings
Tip Editor: John Salmon