Skip to main content
MJH Life Sciences
  • Login
  • Register
  • Login
  • Register
Home
  • Topics
  • Refractive
  • Cataract
  • Glaucoma
  • Cornea
  • Retina
  • Practice Mgmt.
  • OTE
  • Job Board
MJH Life Sciences

SUBSCRIBE: Print / Digital / eNewsletter

LIGHT Trial focuses on lowering IOP, keeping it there

Repeat-selective laser trabeculoplasty (SLT)
  • Lynda Charters
November 20, 2019
Volume: 
44
Issue: 
19
  • Glaucoma, clinical, Treatments

Abstract / Synopsis: 

Repeat-selective laser trabeculoplasty (SLT) administered during the LIGHT Trial lowered intraocular pressure (IOP) in eyes with IOP increases during 1.5 years after the initial SLT application. The decrease lasted longer than the initial lowering. 

This article was reviewed by Prof Gus Gazzard, FRCOpthMA, MBBCHIR, MD

Repeat-selective laser trabeculoplasty (SLT), a protocol explored in a subset of patients in the SLT Laser in Glaucoma and Ocular Hypertension (LIGHT Trial), successfully lowered the IOP in eyes in which the IOP increased after 1.5 years after the initial SLT application. 

The IOP decrease resulting from repeat-SLT lasted longer than the first round of IOP lowering.

The three-year LIGHT Trial evaluated the initial treatments using SLT laser or medications in patients with glaucoma and ocular hypertension; treatments were increased as required, according to Gus Gazzard, FRCOpthMA, MBBCHIR, MD, professor of ophthalmology at UCL-University College and consultant ophthalmic surgeon, Moorfields Eye Hospital, London.

Related: SLT is a cost-effective, first-line glaucoma approach 

The study included only treatment-naïve patients with newly diagnosed primary open-angle glaucoma (POAG) or ocular hypertension in one or both eyes. Patients with advanced disease who could not be treated with laser or medication were excluded from the trial. 

A total of 718 patients ultimately were randomly selected to either SLT laser or medication at the beginning of the LIGHT Trial. 

At the end of the three years, 91% of patients remained in the study. 

The initial standardized SLT protocol included 360º of treatment in which 100 laser shots were applied using a Latina SLT contact lens. 

The clinical endpoint was that at least 50% of the shots had visible bubble formation without free streams of bubbles. The SLT could be repeated once, Dr. Gazzard explained. 

Related: Looking beyond IOP when managing glaucoma patients 

Repeat-SLT
The criteria for undergoing repeat-SLT were failure within 18 months after the initial SLT and eyes in which retreatment was triggered at a pre-defined criteria using eye-specific, severity-dependent target IOP, and/or disease progression based on a custom-designed clinical decision-support algorithm.

That software also guided the follow-up intervals and time to reintervention.

In selecting the eyes to undergo repeat-SLT, the investigators also considered the degree of IOP lowering at two months; this value at that time point is strongly predictive of the three-year outcome. 

The two-month time point was the first time point at which treatment increases were allowed. 

The investigators also looked at the duration of the effect after the initial and the repeated applications of SLT to determine how long the target IOP remained controlled, Dr. Gazzard explained.

In the initial LIGHT Trial, 611 eyes underwent SLT. Of those, 158 eyes failed during the first 18 months and 115 eyes (90 patients) underwent repeat-SLT. 

The other 43 eyes that were not at the target IOP did not undergo repeat-SLT.

“The total repeat-SLT power used was slightly greater,” Dr. Gazzard reported. 

The initial value was 89.1 mJ versus 100.5 mJ, which was a significant increase (p < 0.001).

Related: Researchers find long-term statin use linked to lower POAG risk 

Pages

  • 1
  • 2
  • next ›
  • last »

Related Articles

Resource Topics rightRail

  • Resource Topics
  • Partner Content
  • Dry Eye Awareness
  • Ocular Surface Disease
  • Wet AMD
  • IOL Advances
  • Therapeutic Cataract & Refractive
Shifting The Paradigm for Retinal Disease Management: The Value of Modern Electroretinography
Video on CATALYS® Laser System presented by Johnson & Johnson
Video on WHITESTAR SIGNATURE® PRO System by Johnson & Johnson
CME Activities
DEXYCU® (dexamethasone intraocular suspension) 9% Case Study Series

Current Issue

Ophthalmology Times: Nov. 15, 2019
Nov 20, 2019 Vol 44 No 19
Digital Edition
Connect with Us
  • Column 1
    • Home
    • About Us
    • Contact Us
  • Column 2
    • Editorial Info
    • Editorial Board
  • Column 3
    • Advertising Info
    • Reprints
    • Advertising Terms
  • Column 4
    • Terms of Use
    • Privacy Policy
Modern Medicine Network
© UBM 2019, All rights reserved.
Reproduction in whole or in part is prohibited.

We've noticed that you're using an ad blocker

Our content is brought to you free of charge because of the support of our advertisers. To continue enjoying our content, please turn off your ad blocker.

It's off now Dismiss How do I disable my ad blocker?
❌

How to disable your ad blocker for our site:

Adblock / Adblock Plus
  • Click on the AdBlock / AdBlock Plus icon on the top right of your browser.
  • Click “Don’t run on pages on this domain.” OR “Enabled on this site.”
  • Close this help box and click "It's off now".
Firefox Tracking Prevention
  • If you are Private Browsing in Firefox, "Tracking Protection" may casue the adblock notice to show. It can be temporarily disabled by clicking the "shield" icon in the address bar.
  • Close this help box and click "It's off now".
Ghostery
  • Click the Ghostery icon on your browser.
  • In Ghostery versions < 6.0 click “Whitelist site.” in version 6.0 click “Trust site.”
  • Close this help box and click "It's off now".
uBlock / uBlock Origin
  • Click the uBlock / uBlock Origin icon on your browser.
  • Click the “power” button in the menu that appears to whitelist the current website
  • Close this help box and click "It's off now".