Broadening Access to Glaucoma Care
5 minute read
Broadening Glaucoma Care: What Led Dr. Wiley to Embrace Voyager DSLT
Dr. William Wiley is the Medical Director for the Cleveland Eye Clinic, one of the most recognized eye care practices in the Northeast Ohio area. His practice has always been known for its comprehensive approach to treatments for conditions ranging from cataracts, refractive errors and glaucoma. While Dr. Wiley is known for his willingness to adopt technology that’s not yet widely available, Voyager™ Direct Selective Laser Trabeculoplasty (DSLT) was not initially on his radar. In our conversation with him, we discussed his voyage to enthusiastically adopt DSLT as a first-line laser therapy.
Laser Sharp Results
Following the Laser in Glaucoma and Ocular Hypertension (LiGHT) study, the Selective Laser Trabeculoplasty (SLT) procedure became more widely known as a as an early intervention for glaucoma therapy to help delay the need for more burdensome treatments.1-4 The LiGHT study confirmed SLT is an efficacious primary procedure for the treatment of OAG and OHT.5
However, in the years since the data came out, the SLT treatment has faced limitations in its widespread use, including required specialized training and patient ergonomics. The manual SLT drawbacks can restrict accessibility for patients who could benefit from a laser-based approach.6
For Dr. Wiley, these downsides made him relatively reluctant to perform the SLT procedure. As he describes it, the treatment was not ideal for many of his patients, especially those who cannot tolerate a gonio lens on their eye for an extended period. Further, some patients’ co-morbidities cause them to struggle to sit still for multiple minutes while manual SLT is applied.
“In general, I found SLT to be cumbersome and physically uncomfortable for both myself and my patients from start to finish,” said Dr. Wiley. “If there was a patient who would benefit from the procedure, in many instances, I would refer these patients to one of my partners.”
“So, when Voyager DSLT was presented to me as a treatment option, I thought, why me?” said Dr. Wiley. “As a low-volume SLT surgeon, DSLT wasn’t on my radar as a new technology to be excited about. But, after the first day of using it, my eyes were opened to a whole new world of possibilities.”
Unlocking First Line Therapy
With the recent launch of Voyager DSLT, physicians can provide their patients with a convenient and comfortable alternative to glaucoma management, helping to unlock first-line glaucoma care.6,7
By streamlining first-line therapy, DSLT expands accessibility while addressing SLT’s limitations.1-3,6
Since the device is controlled through an intuitive touchscreen, this takes the slit lamp and manual gonio lens aiming out of the equation, reducing the need for specialized training required with manual SLT.7
DSLT features SureTrac™ technology, which tracks the patient’s eye movement and includes built-in safety checks before each laser shot to confirm laser energy delivery to the target location.7 Additionally, DSLT is designed for an exceptional patient and physician experience and it's user-friendly interface enables a fully automated treatment, reducing complexity and time for ECPs with a safety profile comparable to SLT.6,7,†
Dr. Wiley attests to these benefits and has even received positive feedback from his patients and staff on the efficiencies and ergonomics.
For busy practices with high patient volumes, like Dr. Wiley's, DSLT enables efficient treatment designed to optimize workflows.1-3,6,**
“DSLT’s speed has allowed us to schedule other procedures, like cataract or MIGS surgeries, between our DSLT sessions, allowing us to see more patients—ultimately expanding access to this treatment,” said Dr. Wiley.6,7
The excellent patient satisfaction and outcomes that Dr. Wiley has experienced have reinforced his confidence in DSLT as a viable alternative to manual SLT, leaving him excited to recommend it to patients who are a fit.
“The ease of use with DSLT will make it that much easier for surgeons to start confidently recommending it to patients—which in turn, often leads to higher rates of patients accepting doctors’ recommendations.”
While DSLT is easier than manual SLT to perform, does the technology deliver effective results? A randomized, controlled trial has shown that DSLT is safe, effective and delivers high satisfaction to patients and eye care professionals.6,†† This control data led the U.S. Food and Drug Administration (FDA) to grant 510(k) clearance determining the DSLT to be substantially equivalent to Selective Laser Trabeculoplasty (SLT).
The data and early feedback demonstrate:
DSLT delivers effective IOP control and a strong safety profile with a low risk of adverse events.6,†
Nearly 2 out of 3 (62%) DSLT participants were medication-free at 12 months.6,††
After 6 months, nearly all DSLT patients indicated they would recommend the treatment to a friend with glaucoma.6,††,§
96% of physicians who participated in a DSLT demo agreed they would want to be offered first-line DSLT if they were patients.8
Delivering Comprehensive Eye Care
With comfort and efficiency in mind, Voyager DSLT can have major advantages for comprehensive ophthalmologists like Dr. Wiley who want to treat patients across the vision spectrum.6,7
“Although I primarily perform cataract and refractive procedures, I’ve always been happy to discuss glaucoma with glaucoma patients,” said Dr. Wiley. “Now with DSLT, I don’t hesitate to provide laser therapy for these patients, and, as a result, I’m able to provide comprehensive care for all of my patients.”
Dr. Wiley’s experience is a testament to how Voyager DSLT can offer early intervention for glaucoma patients as well as a new solution for practitioners looking for comprehensive solutions for their patients.1-3
Physicians who are interested in learning more about Voyager DSLT can speak with an Alcon Sales Representative or visit the Voyager DSLT webpage, HERE.
Caution: Federal (USA) law restricts this device to sale by, or on the order of, a physician.
Intended Use: Voyager™ DSLT is a prescription device intended for use in performing selective laser trabeculoplasty.
Indications: Voyager™ DSLT is indicated for use in selective laser trabeculoplasty (SLT).
Contraindications: Use of the Voyager™ DSLT device is contraindicated in the following patients:
Patients who are unable to fixate their head and/or eyes, such as patients suffering from uncontrolled nystagmus, tremors or similar conditions.
Patients with a pupil that cannot constrict to a diameter of 4 mm or less.
Warnings:
Users should wear laser safety eyewear while performing a procedure with the Voyager DSLT device to avoid injury to the user’s eyes.
Use of controls or adjustments or performance of procedures other than those specified herein may result in hazardous laser radiation exposure.
Caution should be used when treating patients who have active uveitis or neovascularization that involves the iridocorneal angle with the Voyager DSLT device.
The effect of selective laser trabeculoplasty energy on glaucoma implants located in the iridocorneal angle has not been studied. Because your version of the Voyager DSLT device does not allow masking of the implant area (i.e. ability to program a laser pattern which skips the local area of the implant), the use of the device is not recommended in eyes which have a glaucoma implant at any clock hour in the iridocorneal angle.
In the pivotal clinical study of the Voyager DSLT device, the safety and effectiveness of re-treatment was not studied; therefore, the level of IOP reduction and potential for complications associated with re-treatment has not been established. Re-treatment is not recommended.
ATTENTION: Refer to the Voyager™ DSLT Directions for Use operating instructions and for the accessories/consumables and User Guide for a complete listing of indications, warnings, cautions and notes.
*Compared to the Voyager DSLT procedure
**2-3 seconds
†There were no ocular serious adverse events reported with DSLT. The most common adverse event was mild, self-resolving, punctate sub-conjunctival hemorrhage, which was reported in 20 DSLT participants (20.2%). These events resolved without clinical sequelae.
††n=80
§92.5% of DSLT patients (n=80)
References
1. Takusagawa HL, Hoguet A, Sit AJ, et al. Selective laser trabeculoplasty for the treatment of glaucoma. Ophthalmology. 2024;131(1):37-47. doi:10.1016/j.ophtha.2023.07.029.
2. European Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition. Br J Ophthalmol. 2021;105(Suppl 1):1-169. doi:10.1136/bjophthalmol-2021-egsguidelines.
3. National Institute for Health and Care Excellence. Glaucoma: Diagnosis and Management. London: National Institute for Health and Care Excellence (NICE); 2022.
4. Philippin H, Matayan E, Knoll KM, et al. Selective laser trabeculoplasty versus 0.5% timolol eye drops for the treatment of glaucoma in Tanzania: A randomised controlled trial. Lancet Glob Health. 2021;9(11):E1589-E1599.
5. Nagar M, Ogunyomade A, O'Brart DP, Howes F, Marshall J. A randomised, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol. 2005;89(11):1413-1417.
6. Alcon Data on File 2022. REF-24791.
7. Voyager™ DSLT Directions for Use.
8. Alcon Data on File, 2024. REF-25577.
© 2025 Alcon Inc. US-DLT-2500143