19 Mar 2019
Selective Laser Trabeculoplasty More Effective Than Pharmaceuticals In First-line Glaucoma Treatment
The Laser in Glaucoma and Ocular HyperTension (LiGHT), a large multi-centre, randomised controlled trial of selective laser trabeculoplasty (SLT) versus eye drops for newly diagnosed, first-line treatment of ocular hypertension and glaucoma, demonstrated across 718 participants that SLT is safe and effective as a first-line treatment for open angle glaucoma and ocular hypertension. SLT provided superior intraocular pressure stability to drops, at a lower cost and, importantly, it allowed almost three quarters of patients (74%) to be successfully controlled without drops for at least 3 years after starting treatment. The study authors interpretation of the results were “Selective laser trabeculoplasty should be offered as a first-line treatment for open angle glaucoma and ocular hypertension, supporting a change in clinical practice.”
The trial was conducted across six collaborating centres in the UK between 2012-2014. Of 718 patients enrolled, 356 were randomised to the selective laser trabeculoplasty and 362 to the eye drops group. The primary outcome measure was health-related quality of life measured using the EuroQol EQ-5D 5 Levels (EQ-5D-5L) utility scores at 36 months.
LiGHT was the first clinical trial showing a direct comparison between selective laser trabeculoplasty and intraocular pressure-lowering drops in terms of health-related quality of life, clinical, and cost-effectiveness outcomes in a pragmatic hospital setting, guided by a robust treatment escalation protocol to capture realistic clinical management while minimising risk of bias.
Mr. Tom Spurling, CEO of Ellex, commented: “We are delighted by the findings of LiGHT, which validates the benefits of SLT as a first-line treatment option for untreated, newly diagnosed patients with ocular hypertension and glaucoma across a large randomised controlled trial. Not only did patients who received SLT exhibit better control of their disease at three years, none of the SLT patients’ disease progressed to a stage that required surgical intervention and overall the procedure was more cost effective than eye drops. This is a significant benefit versus eye drops, and when coupled with compliance, toxicity issues and the increased rate of cataract surgery versus SLT observed in the LiGHT trial, is expected to materially enhance clinician interest for SLT in markets such as the UK where eye drops are recommended as a first-line therapy.”
Mr Spurling continued: “Ellex has long contended that it has the best two treatments available for glaucoma, with our laser-based interventions to treat early-stage disease and Ellex iTrack™ for patients with more intermediate to advanced forms of glaucoma.”
Ellex supplies SLT for the treatment of ocular hypertension and glaucoma with its Tango™ and Tango Reflex™ lasers.