Evidence map›Paper›PMID 30862377›Full record

Trial reportLancet (London, England)2019

Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial.

Gus Gazzard, Evgenia Konstantakopoulou, David Garway-Heath, Anurag Garg, Victoria Vickerstaff, Rachael Hunter, Gareth Ambler, Catey Bunce, Richard Wormald, Neil Nathwani and 4 more

Erratum issued 4 registry-linked trialsOpen access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Lancet (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 4 registered trials, which are not on this map. Cited by 223 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
223citing papers in PubMed, 9 pooled it
59.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05201378 completednot on this mapstarted 2021, after this paper: background citation

Deep Sclerectomy vs Xen in Solo Procedure: Comparative Study, Efficacy and Safety Profile

TypeobservationalSponsorFondation Hôpital Saint-JosephRan2021 to 2022Enrolled282ConditionsGlaucoma
NCT06000280 nacompletednot on this mapstarted 2021, after this paper: background citation

Evaluation of Macular Thickness in Patients With Glaucoma in Use of Topical Prostaglandin Analogue Undergoing Trabeculectomy With Mitomycin C

TypeinterventionalSponsorUniversidade Federal de GoiasRan2021 to 2023Enrolled37ConditionsGlaucomaArmsTrabeculectomy surgery
NCT06865144 phase4active not recruitingnot on this mapstarted 2025, after this paper: background citation

Prospective, Randomized, Double- Masked Study to Evaluate the Effect of Rhopressa Versus Placebo on Intraocular Pressure (IOP) in Patients With Primary Open-Angle Glaucoma or Ocular Hypertension Post-Selective Laser Trabeculoplasty (SLT)

TypeinterventionalSponsorEast Coast Institute for ResearchRan2025 to 2026Enrolled70ConditionsPrimary Open Angle Glaucoma or Ocular HypertensionArmsNetarsudil ophthalmic solution 0.02%, Artificial tears
NCT06933836 recruitingnot on this mapstarted 2025, after this paper: background citation

How Does First Line Treatment With DSLT Perform in Treatment-naïve Patients With Newly Diagnosed Primary Open Angle Glaucoma

TypeobservationalSponsorBarnet Dulaney Perkins Eye CentersRan2025 to 2027Enrolled55ConditionsOpen Angle Glaucoma (OAG)ArmsDSLT enables newly diagnosed patients to remain well controlled and off medications
3 · Its place in the literature

Who cites it

223 citing papers in PubMed, 9 syntheses or guidelines pooled it, 530 citations in OpenAlex.

  1. Minimally invasive trabecular meshwork surgery for open-angle glaucoma.The Cochrane database of systematic reviews · 2026
    Pooled it
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  3. Safety and efficacy of laser trabeculoplasty compared to drug therapy for the management of open-angle glaucoma: systematic review and meta-analysis study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
    Pooled it
  4. Pooled it
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  6. Laser trabeculoplasty for open-angle glaucoma and ocular hypertension.The Cochrane database of systematic reviews · 2022
    Pooled it
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  20. Patterns of Glaucoma Treatment Use in Asian American Patients With Primary Open-Angle Glaucoma.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026
    Article

163 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 3 countries.

Gus GazzardNIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology, University College London, London, UK. Electronic address: gus.gazzard@moorfields.nhs.uk.
Evgenia KonstantakopoulouNIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology, University College London, London, UK.
David Garway-HeathNIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology, University College London, London, UK.
Anurag GargNIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology, University College London, London, UK.
Victoria VickerstaffMarie Curie Palliative Care Research Department, UCL Division of Psychiatry, University College London, London, UK; The Research Department of Primary Care and Population Health, University College London, London, UK.
Rachael HunterThe Research Department of Primary Care and Population Health, University College London, London, UK.
Gareth AmblerDepartment of Statistical Science, University College London, London, UK.
Catey BunceNIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK; School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Richard WormaldNIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology, University College London, London, UK; London School of Hygiene & Tropical Medicine, London, UK.
Neil NathwaniNIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Keith BartonNIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology, University College London, London, UK.
Gary RubinInstitute of Ophthalmology, University College London, London, UK.
Marta BuszewiczThe Research Department of Primary Care and Population Health, University College London, London, UK.
LiGHT Trial Study Group
University College London · GBMoorfields Eye Hospital · GBKing's College London · GBMoorfields Eye Hospital NHS Foundation Trust · GBInstitute of Ophthalmology · MXLondon School of Hygiene & Tropical Medicine · GBPrimary Health Care · QAMarie Curie · GB

Funding

Marie Curie MCCC-FCO-11-U
6 · The paper itself

Abstract

backgroundPrimary open angle glaucoma and ocular hypertension are habitually treated with eye drops that lower intraocular pressure. Selective laser trabeculoplasty is a safe alternative but is rarely used as first-line treatment. We compared the two.

methodsIn this observer-masked, randomised controlled trial treatment-naive patients with open angle glaucoma or ocular hypertension and no ocular comorbidities were recruited between 2012 and 2014 at six UK hospitals. They were randomly allocated (web-based randomisation) to initial selective laser trabeculoplasty or to eye drops. An objective target intraocular pressure was set according to glaucoma severity. The primary outcome was health-related quality of life (HRQoL) at 3 years (assessed by EQ-5D). Secondary outcomes were cost and cost-effectiveness, disease-specific HRQoL, clinical effectiveness, and safety. Analysis was by intention to treat. This study is registered at controlled-trials.com (ISRCTN32038223).

findingsOf 718 patients enrolled, 356 were randomised to the selective laser trabeculoplasty and 362 to the eye drops group. 652 (91%) returned the primary outcome questionnaire at 36 months. Average EQ-5D score was 0·89 (SD 0·18) in the selective laser trabeculoplasty group versus 0·90 (SD 0·16) in the eye drops group, with no significant difference (difference 0·01, 95% CI -0·01 to 0·03; p=0·23). At 36 months, 74·2% (95% CI 69·3-78·6) of patients in the selective laser trabeculoplasty group required no drops to maintain intraocular pressure at target. Eyes of patients in the selective laser trabeculoplasty group were within target intracoluar pressure at more visits (93·0%) than in the eye drops group (91·3%), with glaucoma surgery to lower intraocular pressure required in none versus 11 patients. Over 36 months, from an ophthalmology cost perspective, there was a 97% probability of selective laser trabeculoplasty as first treatment being more cost-effective than eye drops first at a willingness to pay of £20 000 per quality-adjusted life-year gained.

interpretationSelective laser trabeculoplasty should be offered as a first-line treatment for open angle glaucoma and ocular hypertension, supporting a change in clinical practice.

fundingNational Institute for Health Research, Health and Technology Assessment Programme.

Indexed as

Laser TherapyOphthalmic SolutionsAgedAntihypertensive AgentsFemaleGlaucoma, Open-AngleHumansMaleMiddle AgedOcular HypertensionQuality of LifeTrabeculectomyTreatment OutcomeAntihypertensive AgentsOphthalmic Solutions

Identifiers

PMID30862377
PMCPMC6495367
OpenAlexW2921734131

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.