FLIGHT: Femtosecond Laser Image-Guided High-Precision Trabeculotomy

The FLIGHT procedure, short for Femtosecond Laser, Image-Guided, High-Precision Trabeculotomy, is a novel, incision-free approach to glaucoma treatment. Performed with the ViaLuxe™ femtosecond laser system, FLIGHT creates precisely placed apertures in the trabecular meshwork to reestablish fluid outflow from the anterior chamber to Schlemm’s canal (Fig). Guided by advanced OCT imaging, FLIGHT is performed through the clear cornea without incisions, blades, or implants. This breakthrough represents a new class of noninvasive glaucoma intervention—one that is poised to address multiple unmet needs in the glaucoma space.

A Different Approach to Glaucoma

FLIGHT offers a fundamentally different approach to interventional glaucoma. As a noninvasive, laser-based procedure, FLIGHT uses femtosecond laser photodisruption to create precisely placed apertures in the trabecular meshwork. This mechanism minimizes adjacent tissue damage, allowing the apertures to remain patent, indicating the potential of long-term, durable IOP lowering effect. Further, FLIGHT offers surgeons greater customization and long-term treatment optionality. Because it targets only about 5° of the iridocorneal angle, FLIGHT preserves future options for intervening. Taken together, these advantages position FLIGHT as a safe, noninvasive, standalone intervention, free from the constraints of cataract surgery, and well-suited to address a broad and underserved phakic and pseudophakic patient population.

First-in-Human Data

The FLIGHT procedure was studied in 18 eyes of 12 patients who underwent a FLIGHT procedure with a single 500 µm X 200 µm channel through the trabecular meshwork and into the canal of Schlemm.¹ There were no serious adverse events related to the laser treatment. As for efficacy, mean IOP was reduced by 34.6% from 22.3 ±5.5 mm Hg at baseline to 14.5 ±2.6 mm Hg at 24 months. Furthermore, 14 of the 17 study eyes (82%) achieved a ≥ 20% reduction in IOP at 24 months. Additionally, well-defined channels were clearly visible at 24 months with gonioscopy and anterior segment OCT, with no evidence of closure.

We have continued to follow this cohort of patients out to 4 years and will be publishing the data soon; in short, it demonstrates continued patency of the channels and stable IOP reduction after longer-term follow-up. To support our FDA clearance pathway, we are currently in the planning phase of a prospective, randomized controlled trial designed to more rigorously evaluate the safety and efficacy of the FLIGHT procedure.

Future Direction

ViaLase is in the final stages of obtaining CE Mark for the FLIGHT procedure, which we anticipate receiving in the second half of 2025. This milestone will enable us to initiate commercialization activities in select European markets. Entry into the U.S. market will follow the successful completion of the randomized controlled clinical trial referenced above. In the meantime, we remain confident that our team’s deep expertise in femtosecond laser innovation positions us to reshape the glaucoma treatment landscape, by introducing a noninvasive, image-guided option where none has existed before.

1. Nagy ZZ, et al. Ophthalmol Sci. 2023;3(4):100313.

For more information: https://vialase.com

For inquiries, contact Michele Gray at michele@mgraycommunications.com