Glaucoma surgery traditionally means opening the eye to create a new drainage path. A different approach uses a femtosecond laser, focused through the clear cornea, to create a small channel in the eye’s drainage tissue without any incision. At a major European eye surgery meeting in London in September 2026, Zoltan Z. Nagy, MD, PhD, chair of ophthalmology at Semmelweis University in Budapest, presented 4-year results.
What the procedure does
The technique is called femtosecond laser image-guided high-precision trabeculotomy, or FLigHT. Guided by imaging, the laser creates a channel about 500 by 200 micrometers in the trabecular meshwork, the tissue through which fluid normally drains. Because the eye is not opened, Dr. Nagy noted there is no bleeding in the front of the eye and no added infection risk from an incision.
What was reported at 48 months
- Average eye pressure fell 27%, from 21.4 to 14.9 mmHg, and stayed stable through 4 years.
- Patients continued glaucoma medicines during follow-up, though some on several medicines were able to drop two of them.
- OCT imaging showed the laser channels stayed open, with no scarring, inflammation, or blockage.
- Two patients had worse vision: one lost two lines of acuity, and one developed a cataract that was later removed, after which vision and pressure returned to their post-laser levels.
What it means
Dr. Nagy contrasted the steady pressure with traditional trabeculectomy, after which pressure can swing very high or very low. He said the system is commercially available in Europe and the UK. The report did not address U.S. availability, and these results come from one center’s prospective group presented at a meeting, not a randomized comparison with other procedures. The report also did not give the number of patients followed.
My advice
- Glaucoma treatment choices now range from drops to laser to several types of surgery; ask which fit your stage of disease.
- Newer procedures can be appealing, but ask how long the results have been followed and in how many patients.
- Whatever is done, keep regular pressure checks and visual field tests.
For more reading on healthy eyes, see foreverfreecontacts.com.
Source: Femtosecond laser trabeculotomy sustains 27% IOP reduction at 48 months in open-angle glaucoma (Ophthalmology Times, 09/14/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.