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Laser-based treatment successful and cost-effective for glaucoma


An NIHR-funded study has shown 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.

The three-year trial, by researchers at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, is the largest ever of its kind. It saw 718 patients newly-diagnosed with glaucoma or ocular hypertension (an increase in pressure in the eye without causing damage to the optic nerve) assigned one of two treatment pathways.

One pathway was the current standard treatment of administering eye drops designed to lower intraocular pressure. The other involved a treatment called SLT, an extremely quick procedure which lowers intraocular pressure by using lasers to make it easier for fluid to leave the eye.

The results, published in The Lancet, showed that patients who received SLT were more regularly at the target intraocular pressure. There was less need for treatment to be escalated and there was a reduced need for both glaucoma surgery and cataract extractions compared to patients who received the eye drops. 

The results could potentially improve the way glaucoma is treated across the world and could save the NHS up to £1.5million per year in direct treatment costs for newly diagnosed patients.

The trial, which was predominantly funded by the NIHR Health Technology Assessment programme, was held across the NIHR Biomedical Research Facility (BRC) at Moorfields and UCL and with the support of the PRIMENT clinical trials unit at UCL.

An ongoing follow-up study, also funded by the NIHR HTA alongside Moorfields Eye Charity, Fight for Sight, and the International Glaucoma Association, will provide more information on the long term effects. This follow-up study is due to conclude in 2020.

Mr Gus Gazzard, consultant ophthalmologist and glaucoma service director at Moorfields Eye Hospital, and reader in glaucoma studies at UCL said: “In this study, we have shown that a simple, safe, pain-free laser treatment not only works better than eye-drops at preventing glaucoma from deteriorating but also costs the NHS less.

“These results strongly suggest that laser should be the first treatment for glaucoma in all newly diagnosed patients and will provoke further interest in its use in patients who are already on treatment. In the results so far we’ve already seen eye pressure lowering that has lasted far longer than the older early data had suggested, so we’re excited by the prospect of seeing very long-term pressure control given that glaucoma is a long-term, chronic disease.”

Professor Sir Peng Tee Khaw, director of the NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, said: “This groundbreaking research into eye diseases will lead to significant benefits for many patients in the UK and around the world. Glaucoma is increasing with our ageing population and it has a huge impact on many lives and is increasing the demand for clinical services in the UK. The NIHR supports research that looks at methods of improving treatment and promoting better quality of life and convenience for patients.”

For further information on this study visit the NIHR Journals Library.