COAST (COAST)

Investigating Low-Energy Selective Laser Trabeculoplasty (SLT) for Ocular Hypertension and Glaucoma

Recruiting
18 years or above
All
Phase 3
790 participants needed
1 Location

Brief description of study

The goal of this study is to understand if SLT performed at low energy is as effective as SLT performed at standard energy, and also to see if repeating SLT at low energy once a year will prevent or delay the need for daily eye drop medications better than waiting for SLT to wear off before repeating it.

Eligibility of study

You may be eligible for this study if you meet the following criteria:

  • Conditions: Glaucoma and Ocular Hypertension
  • Age: 18 years or above
  • Gender: All

Inclusion Criteria:

  1. Age 18 or older and in good health
  2. Each eye with one of the following qualifying diagnoses (diagnoses may differ between eyes):
    1. High-risk ocular hypertension (OHT): IOP > 21 mmHg without glaucomatous optic neuropathy (excavation, diffuse or focal thinning or notching of the neuroretinal rim, visible nerve fiber layer defects, or asymmetry of the vertical cup-to-disc ratio of >0.2 between eyes)
    2. Mild primary open-angle glaucoma: glaucomatous optic neuropathy, visual field mean deviation better than -6.0 dB with no points in the central 5° <15 dB (see figure on next page)
    3. Moderate primary open-angle glaucoma: glaucomatous optic neuropathy, visual field mean deviation equal to or worse than -6.0 dB but no worse than -12.0 dB and no central 5° points <15 dB or mean deviation -12.0 dB or better with 1 central 5° points <15 dB (see figure on next page).
  3. Each eye with BCVA 20/200 (UK 6/60) or better

Exclusion Criteria:

  1. Use of topical IOP-lowering medications for more than 6 cumulative months at any time in the past 5 years (this is a modification implemented during active enrollment)
  2. Any history of IOP-lowering laser (prophylactic iridotomy not included) or surgical procedure
  3. Advanced POAG in either eye (worse than moderate POAG as defined above)
  4. Glaucoma other than POAG (including pigmentary and pseudoexfoliation glaucoma) in either eye
  5. Mean IOP > 35 mmHg at either the screening or baseline visit in either eye
  6. Narrow or closed angle (Shaffer Grade 0, 1, or 2) in either eye
  7. Contraindications to SLT or any other study intervention
  8. Any corneal pathology that would preclude accurate assessment of IOP by Goldmann tonometry in either eye
  9. Any intraocular surgical procedure within the past 6 months in either eye
  10. Inability to attend all scheduled study visits
  11. Pregnant or planning to become pregnant in the next 4 years

This study investigates the effectiveness of Selective Laser Trabeculoplasty (SLT) at low energy levels for individuals with ocular hypertension and glaucoma. The purpose of this study is to compare the outcomes of low-energy SLT with standard-energy SLT in maintaining eye health.

The study focuses on assessing whether repeating low-energy SLT annually can delay the need for daily eye drop medications. It evaluates the long-term benefits of using low-energy SLT in managing eye conditions.

  • Who can participate: Adults aged 18 and older with good health and specific eye conditions like high-risk ocular hypertension or mild to moderate primary open-angle glaucoma may participate. Key factors include having a best-corrected visual acuity of 20/200 or better and not using topical IOP-lowering medications extensively in the past five years.
  • Study details: Participants will undergo SLT treatments at either low or standard energy levels.
Updated on 02 Oct 2025. Study ID: 23-0529

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