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Laser is better than drops for glaucoma - SLT (Selective Laser Trabeculoplasty) is first line treatment in Moorfields study

9/3/2019

SLT induced cellular response within the drainage channels of the eye (trabecular meshwork)

A major new study has shown that SLT, a non invasive, pain-free laser that has been in use for many years, is better at controlling pressure in patients with open angle glaucoma than conventional eye drops.

Dr Gus Gazzard and colleagues at the world famous Moorfields Eye Hospital in London, UK reported the results of the LiGHT Study, which compared SLT to glaucoma eye drops as first-line therapy in a multi centre randomised controlled trial, in The Lancet journal.

KEY POINTS:

STUDY NUMBERS / IOP REDUCTION: 718 patients (1,235 eyes). Intraocular pressure (IOP) reduction was similar for those treated with SLT (356 patients, 613 eyes) and medication (362 patients, 622 eyes) after 36-months follow-up.
EYE DROP USE: 78.2% of SLT patients did not need drops to maintain target IOP at 36-months. Further, patients who received SLT were within IOP target for more visits compared with medicated group (93.0% vs 91.3%).
NO SURGERY REQUIRED: No patients who received SLT required surgery to lower IOP, versus 11 eye drop patients.
ADVERSE EVENTS: There were 5 times less medication-drop related adverse events* with SLT (30) compared to eye drops (150).
COST PER PATIENT: The average cost per patient for all ophthalmology expenses was significantly less in the SLT group compared to eye drops (p<0.001).

Not only was the laser treatment better at reducing eye pressure and therefore controlling glaucoma than eye drops, it was also shown reduce the need for surgery and to be more cost-effective in the long term than eye drops. Patients tolerated the SLT laser treatment well and the decreased and more stable eye pressure that resulted from the treatment freed them from the burden of daily eye drops and their side effects.

As reported in The Guardian

For the full text article of the LiGHT study as reported in The Lancet, clink this link:

As reported in The Lancet

From the Moorfields Eye Hospital website:

From the Moorfields Eye Hospital website

Dr Vincent Lee has performed SLT laser treatment for glaucoma at South West Eye Surgery in Warrnambool for nearly 2 decades now with excellent results. A full eye check is necessary to determine suitability for SLT laser treatment.

To find out more about glaucoma and the use of SLT and other laser treatments in glaucoma, click the link below:

Glaucoma: treatment with SLT and other lasers

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Angle closure can be missed by Van Herick technique

19/11/2018

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While simple to perform and generally fairly accurate, a recent study has shown that the Van Herick technique for estimating anterior chamber angle depth can be unreliable in some circumstances.

This applies to males and myopes (people with short sight). The other risk factors are when this technique is performed on individuals of Asian and black race.

Click the button to read an abstract of the study:

Missed diagnosis with Van Herick technique

As such, it is recommended that when examining people in this demographic, a more reliable test is gonioscopy, especially when performed in a dark room.

One system of grading the anterior chamber angle depth is the Shaffer grading system, as depicted below:

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Laser is better than drops for glaucoma - SLT (Selective Laser Trabeculoplasty) is first line treatment in Moorfields study

Angle closure can be missed by Van Herick technique

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