Alcon launches Voyager laser trabeculoplasty platform in US

19 Feb 2025

Direct selective laser trabeculoplasty method improves treatment for glaucoma.

Alcon has announced the US release of its Voyager direct selective laser trabeculoplasty (DSLT) platform, with a launch event scheduled for the American Glaucoma Society annual meeting later in February 2025.

The device represents an evolution of the standard selective laser trabeculoplasty (SLT) procedure already in wide use for suitable glaucoma patients, overcoming some of the older technique's disadvantages.

With glaucoma the leading cause of irreversible blindness worldwide in an aging global population, advances in glaucoma care are important for clinicians and patients.

Traditional SLT involves using a laser to manipulate the eye's trabecular meshwork, located around the base of the cornea, which acts as the natural drain for the eyeball's aqueous humor. Glaucoma is caused by an excess of humor leading to elevated fluid pressure in the eye, so massaging the meshwork with a laser can help to restore higher flow.

However, the procedure is not without difficulties. It requires gonioscopy, in which the clinician holds an exterior lens against the surface of the eye so as to direct the incident laser at an oblique angle towards the meshwork, which can be uncomfortable for patients.

The exterior lens must also be held in place for the full duration of the treatment, which takes a time-consuming number of individual laser shots.

DSLT promises to be easier to carry out and more rapid. It involves delivering laser light directly to the trabecular network through the peripheral cornea and adjacent limbus areas of the eye, rather than requiring an exterior lens to orientate the incident light. It can also direct beams near-simultaneously to multiple locations, and the laser energy does not travel across the iris during the procedure.

Broaden access to glaucoma treatment

The DSLT technology was initially developed by Belkin Vision, which announced investigations into improved laser trabeculoplasty treatments for glaucoma in 2017. Belkin developed a DSLT platform marketed as the Belkin Vision Eagle, employing a Q-switched 532-nanometer frequency-doubled Nd:YAG laser. The Eagle was granted FDA clearance in December 2023.

In July 2024 Belkin Vision was acquired by Alcon, with the DSLT technique a specific focus of the acquisition.

"As a therapy with significant advantages for the patient and practice, we believe our newly acquired DSLT technology is uniquely positioned to accelerate the evolution toward first-line use of SLT in the glaucoma treatment paradigm," commented Alcon at the time of the acquisition.

While the Alcon Voyager delivers its 532-nm 400-micron diameter laser without any contact with the patient's eyeball, an image-processing algorithm automatically locates the target area on the surface of the eye. In use, an eye-tracking algorithm tracks eye movement so that the laser pulses are delivered accurately to the targeted location on the limbus area where the cornea and sclera meet, said the company.

"By introducing Voyager DSLT, we're able to broaden access to first-line SLT therapy and provide eye care professionals with crucial early intervention for their glaucoma patients," commented Terry Kim of Alcon.

Voyager DSLT is currently available in select markets in the EU, the UK and now the US.