ViaLase, Inc. has announced the completion of the first commercial femtosecond laser image-guided, high precision trabeculotomy (FLIGHT) procedures, marking the global commercial introduction of the technique.¹ According to the company, procedures were performed at Centre for Sight in London by Sheraz Daya, MD, and Gus Gazzard, MD, and at Breyer, Kaymak & Klabe Augenchirurgie in Düsseldorf, Germany, by Karsten Klabe, MD.

The FLIGHT procedure is performed using a novel laser system (ViaLuxe), which combines high-resolution OCT imaging with proprietary femtosecond laser technology. According to ViaLase, the system is designed to create precise channels through the trabecular meshwork to restore aqueous outflow and reduce IOP in patients with open-angle glaucoma, without the need for an incision.¹

European launch and regulatory status

ViaLase noted it is supporting its initial European launch through a network of distributor partners in select markets, including an exclusive distribution agreement with Carleton Optical in the United Kingdom.¹ Pete England, chief commercial officer at ViaLase, said the company believes the treatment has the potential to enable earlier intervention in glaucoma management: “We believe this treatment has the potential to advance interventional glaucoma by enabling earlier, safer intervention to help patients reach target pressures and slow disease progression.”¹

The ViaLuxe laser system is commercialised in Europe. In the United States, it remains an investigational device limited to investigational use under US law.¹

Physician perspective

Gazzard—who is director of surgery at Moorfields Eye Hospital and professor of ophthalmology at University College London—spoke with Ophthalmology Times Europe about the first commercial FLIGHT procedures and what the technology may mean for the future of interventional glaucoma.

Ophthalmology Times Europe: The FLIGHT procedure is being described as an “incision-free” approach to glaucoma treatment. From your perspective, how does this differ from existing laser or minimally invasive glaucoma procedures, and why is that significant for patients?

Prof Gazzard: The FLIGHT procedure represents a fundamentally different approach because it enables treatment of the trabecular meshwork without creating a surgical incision or entering the eye with handheld instruments. Traditional MIGS procedures, while less invasive than conventional glaucoma surgery, still require incisional access and intraocular manipulation. Existing laser therapies such as SLT also work through a different mechanism and do not directly create distinct physical channels through the trabecular meshwork. What is significant is that FLIGHT has the potential to deliver a highly precise, image-guided intervention in a manner that may reduce procedural burden for both the surgeon and patient. That has important implications for safety, recovery, and potentially expanding earlier interventional treatment options in glaucoma care.

ViaLase combines high-resolution OCT imaging with femtosecond laser technology to create precise channels through the trabecular meshwork. What advantages does that level of image guidance and micron-level precision provide during treatment?

Gazzard: One of the most impressive aspects of the platform is the level of visualization and control it provides throughout the procedure. The integration of high-resolution gonioscopic and OCT imaging with femtosecond laser technology allows me to visualize the target anatomy and precisely guide treatment delivery at a micron level.

In glaucoma, precision matters greatly because we are working within extremely delicate structures and very confined anatomical spaces. The ability to accurately localize treatment and consistently create channels through the trabecular meshwork without the need to open up the eye is a very compelling advancement.

The first commercial FLIGHT procedures have now been performed in Europe. What were your initial impressions of the patient experience and recovery compared with more traditional glaucoma interventions?

Gazzard: My initial impressions were positive, particularly regarding the patient experience and the overall efficiency of the procedure. Because the treatment is incision-free and avoids many of the elements associated with more invasive glaucoma interventions, the experience felt significantly less disruptive from both a surgical and patient perspective.

Early recovery appeared quite favorable, and the procedure itself integrated smoothly into the clinical workflow. While it is still early in the commercial experience, the combination of visualization, precision, and procedural efficiency was particularly encouraging.

Glaucoma treatment has historically followed a stepwise approach beginning with eye drops before progressing to surgery. Do you believe technologies like FLIGHT could shift the field toward earlier interventional treatment aimed at slowing disease progression sooner?

Gazzard: I do believe technologies like FLIGHT have the potential to contribute to a broader shift toward earlier interventional glaucoma treatment. Historically, we have relied heavily on topical medications for long periods before considering procedural intervention, but we know glaucoma is a progressive disease and long-term adherence to drops can be challenging for many patients. There is now clear evidence from the LiGHT and HORIZON trials that early, non-medical IOP control offers better long-term preservation of visual field.^2,3 As interventional technologies become safer, less invasive, and more precise, there is growing interest in treating patients earlier in the disease continuum with the goal of lowering IOP sooner and potentially reducing long-term disease progression. Whether FLIGHT ultimately changes treatment paradigms will depend on continued clinical evidence and real-world experience, but the concept is certainly very compelling.

References

1. ViaLase announces global commercial introduction of the FLIGHT procedure. News release. ViaLase. May 26, 2026. Accessed May 28, 2026. https://www.vialase.com/vialase-announces-global-commercial-introduction-of-the-flight-procedure/?region=us

2. Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial: six-year results of primary selective laser trabeculoplasty versus eye drops for the treatment of glaucoma and ocular hypertension. Ophthalmology. 2023;130(2):139-151. doi:10.1016/j.ophtha.2022.09.009

3. Montesano G, Ometto G, Ahmed IIK, et al. Five-year visual field outcomes of the HORIZON Trial. Am J Ophthalmol. 2023;251:143-155. doi:10.1016/j.ajo.2023.02.008