Gus M Gazzard

Gus M Gazzard
University College London | UCL · Institute of Ophthalmology

MA MD MBBChir FRCOphth

About

179
Publications
51,363
Reads
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13,076
Citations
Citations since 2016
61 Research Items
9453 Citations
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201620172018201920202021202205001,0001,5002,000
Introduction
Gus has run several clinical trials in glaucoma surgery and his research interests include angle closure glaucoma, randomised controlled trials of glaucoma treatments, and anterior segment imaging. He has published extensively, and is currently working as the chief investigator on the LiGHT Trial.
Additional affiliations
January 2011 - present
January 2011 - present
The University of Sydney
January 2009 - present

Publications

Publications (179)
Article
Full-text available
Purpose The LiGHT trial has shown selective laser trabeculoplasty (SLT) to be clinically and cost-effective as a primary treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT) at 3 years. This paper reports health-related quality of life (HRQL) and clinical effectiveness of initial treatment with SLT compared to intra-ocular pressure...
Article
Full-text available
Prcis: A literature review of SLT energy dose response found no definitive relationship between IOP reduction with respect to total or pulse energy, race, pigmentation, or application pattern. Purpose: Selective laser trabeculoplasty (SLT) is a safe and effective treatment for lowering intraocular pressure (IOP). While evidence is mounting for t...
Article
Full-text available
In 2019, the Laser in Glaucoma and Ocular Hypertension (LiGHT) randomised controlled trial reported that initial treatment with selective laser trabeculoplasty (SLT) is more cost effective than initial treatment with pressure-lowering eye drops, leading to a reduced number of glaucoma surgeries and very low rates of adverse events while providing d...
Article
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Purpose The purpose of this study is to establish consensus among experts on outcomes and methods to be used in clinical trials to assess adverse effects of anti-glaucomatous eye drops. Design Modified Delphi method. Methods Clinical experts from Europe, North America, South America, the Middle East, and Asia were invited to participate in two se...
Article
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Aims To report the baseline intraocular pressure (IOP) characteristics and its diurnal fluctuation in the Laser in Glaucoma and Ocular Hypertension China cohort. Methods 622 primary open-angle glaucoma (POAG) patients and 149 ocular hypertension (OHT) patients were recruited at Zhongshan Ophthalmic Center from 2015 to 2019. Standardised ocular exa...
Article
Purpose There are large variations in how adverse events, safety and tolerability related to intraocular pressure (IOP)-lowering eye drops are reported. Inconsistencies and discrepancies in outcomes and methods lead to missed opportunities when comparing studies and combining results in meta-analyses, making it difficult to translate the findings i...
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Background Glaucoma is a major cause of sight loss worldwide, with the highest regional prevalence and incidence reported in Africa. The most common low-cost treatment used to control glaucoma is long-term timolol eye drops. However, low adherence is a major challenge. We aimed to investigate whether selective laser trabeculoplasty (SLT) was superi...
Article
Full-text available
Introduction Laser trabeculoplasty is an effective and widely used treatment for glaucoma. A new laser technology, the Eagle direct selective laser trabeculoplasty (DSLT) device, may provide automated, fast, simple, safe and effective laser treatment for glaucoma in a broader range of clinical settings. This trial aims to test the hypothesis that t...
Article
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Background/objectives To explore the acceptability, training requirements, enablers and barriers of optometrist-delivered SLT. Subjects/methods Optometrists, fellowship and consultant grade ophthalmologists, hospital managers and patients were interviewed using pre-defined topic guides. Interviews were audio-recorded, transcribed, and subjected to...
Article
The provision of timely care to the high volume of glaucoma patients stratified as “low risk” following pandemic-related appointment deferrals continues to prove challenging for glaucoma specialists. It is unknown whether stratification as “low risk” remains valid over time, raising the potential risk of harm during this period if left unmonitored....
Article
Aims The virtual glaucoma clinic (VGC) is a well-established diagnostic pathway for delivery of glaucoma care. Current UK national guidance recommends VGCs for patients with ocular hypertension, glaucoma suspects or early glaucoma. This study evaluates whether expanded eligibility criteria, including other glaucoma phenotypes and disease stages, ca...
Article
Importance Glaucoma affects more than 75 million people worldwide. Intraocular pressure (IOP)–lowering surgery is an important treatment for this disease. Interest in reducing surgical morbidity has led to the introduction of minimally invasive glaucoma surgeries (MIGS). Understanding the comparative effectiveness and safety of MIGS is necessary fo...
Article
Background: Glaucoma is the leading cause of global irreversible blindness, often associated with raised intraocular pressure (IOP). Where medical or laser treatment has failed or is not tolerated, surgery is often required. Minimally-invasive surgical approaches have been developed in recent years to reduce IOP with lower surgical risks. Supracil...
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Prcis: Multiple questionnaires exist to measure glaucoma's impact on quality of life. Selecting the right questionnaire for the research question is essential, as is patients' acceptability of the questionnaire to enable collection of relevant patient-reported outcomes. Purpose: Quality of life (QoL) relating to a disease and its treatment is an...
Article
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Purpose: To describe the baseline characteristics of a trial to evaluate whether selective laser trabeculoplasty (SLT), as a first-line treatment, provides superior economic and health-related quality of life outcomes to medical treatment in China. Design: LiGHT China trial is an unmasked, single-center, pragmatic, Randomized controlled trial....
Article
Full-text available
Objective To compare the effectiveness and safety of the MicroShunt versus trabeculectomy in patients with primary open-angle glaucoma (POAG). Design One-year results from a 2-year, prospective, randomized, multicenter, non-inferiority study (NCT01881425) conducted in the USA and Europe. Participants Eligible patients were aged 40–85 years with i...
Article
Full-text available
Selective laser trabeculoplasty (SLT) has been established as an effective treatment to lower intraocular pressure in people with glaucoma and ocular hypertension. The procedure is typically within the remit of ophthalmologists; however, there is potential to upskill optometrists and other healthcare professionals (HCPs) to deliver the treatment. W...
Article
Full-text available
Summary Background Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World...
Article
Background: Glaucoma is the leading cause of irreversible blindness. Minimally invasive surgical techniques, such as ab interno trabecular bypass surgery, have been introduced to prevent glaucoma from progressing. OBJECTIVES: In light of the potential benefits for people with open-angle glaucoma and the widespread uptake of the technique, it is im...
Article
Full-text available
Summary Background To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990–2020, and forecasts for 2050....
Article
Objective: To report 3-year outcomes of the HORIZON study comparing cataract surgery with Hydrus Microstent versus cataract surgery alone. Design: Multicenter randomized clinical trial. Participants: Five hundred fifty-six eyes from 556 patients with cataract and POAG treated with ≥ 1 glaucoma medication, washed out diurnal intraocular pressur...
Article
Full-text available
Introduction In the UK, the National Institute for Health and Clinical Excellence are amending guidelines to support use of selective laser trabeculoplasty (SLT) as a first-line treatment for patients with glaucoma and ocular hypertension. The procedure is quick, effective in lowering intraocular pressure, cost-effective for the National Health Ser...
Article
Objective To compare visual field outcomes of ocular hypertensive and glaucoma patients treated with Medicine-1st against those treated with selective laser trabeculoplasty (SLT, Laser-1st). Design Secondary analysis of patients from Laser in Glaucoma and Ocular Hypertension (LiGHT), a multicentre randomised controlled trial. Participants and con...
Article
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Background/Aims This work aimed to study the effect of long-term intraocular pressure (IOP) fluctuation on visual field (VF) progression 8 years post-trabeculectomy in Asian eyes. Methods This was a retrospective analysis of 8-year post-trabeculectomy data from The Singapore 5-Fluorouracil (5-FU) Study. VFs were analysed using Progressor software...
Article
Background: Glaucoma is a leading cause of irreversible blindness. A number of minimally-invasive surgical techniques have been introduced as a treatment to prevent glaucoma from progressing; ab interno trabecular bypass surgery with the Schlemm's canal Hydrus microstent is one of them. Objectives: To evaluate the efficacy and safety of ab inter...
Article
Purpose To determine the test-retest reliability and diagnostic accuracy of a binocular optical coherence tomography (OCT) prototype (Envision Diagnostics, USA) for pupillometry. Design Assessment of diagnostic reliability and accuracy. Methods Fifty participants with RAPD confirmed using the swinging flashlight method (mean age 49.6 years) and 5...
Article
Despite advances in our knowledge of the aetiology and pathophysiology of glaucoma, the sole proven, effective intervention for treating primary open-angle glaucoma (POAG) and ocular hypertension (OHT) remains lowering of intraocular pressure (IOP) to prevent further progression and visual loss. The purpose of this review is to evaluate the treatme...
Article
Angle-closure glaucoma is an aggressive condition that causes millions to become blind worldwide. This review explores the use of prophylactic laser peripheral iridotomy (PI) in patients classified as primary angle-closure suspects (PACS), and additionally, the use of clear lens exchange as a primary treatment option in established angle-closure di...
Article
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Article
Full-text available
Purpose: To determine the efficacy of repeat selective laser trabeculoplasty (SLT) in medication-naive open-angle glaucoma (OAG) and ocular hypertensive (OHT) patients requiring repeat treatment for early to medium-term failure during the Laser in Glaucoma and Ocular Hypertension (LiGHT) trial. Design: Post hoc analysis of SLT treatment arm of a...
Article
Full-text available
Background Newly diagnosed open-angle glaucoma (OAG) and ocular hypertension (OHT) are habitually treated with intraocular pressure (IOP)-lowering eyedrops. Selective laser trabeculoplasty (SLT) is a safe alternative to drops and is rarely used as first-line treatment. Objectives To compare health-related quality of life (HRQoL) in newly diagnosed...
Article
Full-text available
Purpose: To report clinical efficacy, predictors of success, and safety of primary selective laser trabeculoplasty (SLT) used in treatment-naive patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Design: Post hoc analysis of a multicenter, prospective, randomized, controlled trial. Participants: Treatment-naive patients with...
Article
Full-text available
BACKGROUND: Primary open angle glaucoma and ocular hypertension are habitually treated with eye drops that lower intraocular pressure. Selective laser trabeculoplasty is a safe alternative but is rarely used as first-line treatment. We compared the two. METHODS: In this observer-masked, randomised controlled trial treatment-naive patients with open...
Article
Background: Glaucoma is a leading cause of irreversible blindness. A number of minimally invasive surgical techniques have been introduced as a treatment to prevent glaucoma progressing. Among them, endoscopic cyclophotocoagulation (ECP) is a cyclodestructive procedure developed by Martin Uram in 1992. Objectives: To evaluate the efficacy and sa...
Article
Full-text available
Background: Primary angle-closure glaucoma is a type of glaucoma associated with a physically obstructed anterior chamber angle. Obstruction of the anterior chamber angle blocks drainage of fluids (aqueous humor) within the eye and may raise intraocular pressure (IOP). Elevated IOP is associated with glaucomatous optic nerve damage and visual fiel...
Article
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Background: To describe the surgical technique and refractive outcomes following clear lens extraction (CLE) in the Effectiveness, in Angle-closure Glaucoma, of Lens Extraction trial. Methods: Review of prospectively collected data from a multicentre, randomised controlled trial comparing CLE and laser peripheral iridotomy. Eligible participants...
Article
Full-text available
Over the past two decades, selective laser trabeculoplasty (SLT) has increasingly become an established laser treatment used to lower intraocular pressure in open-angle glaucoma and ocular hypertensive patients. In this review we trace the origins of SLT from previous argon laser trabeculoplasty and review the current role it has in clinical practi...
Article
Purpose: We determined whether there is relative sparing of pupil function in glaucoma patients with normal pressures compared to those with high pressures. Methods: A cross-sectional study was done of 68 patients with primary open angle glaucoma (POAG): 38 had normal IOPs on all-day phasing before treatment (never >21 mm Hg), with confirmed pro...
Article
Full-text available
Background Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. M...
Article
Purpose The laser in glaucoma and ocular hypertension (LiGHT) trial aims to establish whether initial treatment with selective laser trabeculoplasty (SLT) is superior to initial treatment with topical medication for primary open angle glaucoma (POAG) or ocular hypertension (OHT). Design LiGHT is a prospective unmasked, multicentre, pragmatic, rand...
Article
Full-text available
Background: Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. M...
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The main objective is to assess the results at two years of supraciliary drainage devices for OAG in comparison to conventional medical, laser, surgical treatment in terms of efficacy and safety. A secondary objective will be to examine the effects of supracilia...
Article
Full-text available
Purpose The Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial aims to establish whether initial treatment with selective laser trabeculoplasty (SLT) is superior to initial treatment with topical medication for primary open-angle glaucoma (POAG) or ocular hypertension (OHT). Design The LiGHT Trial is a prospective, unmasked, multicentre, prag...
Article
Full-text available
Background: Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. Methods: We did a systematic review and meta-analysis of population-based datasets relevant to...
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The main objective is to assess the results at two years of ab interno trabecular bypass surgery with Hydrus for OAG in comparison to conventional medical, laser, or surgical treatment in terms of efficacy and safety. A secondary objective will be to examine the...
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The main objective is to assess the results at two years of ECP for OAG and primary angle closure in comparison to conventional medical, laser, or surgical treatment, in terms of efficacy and safety. A secondary objective will be to examine the effect of the eff...
Article
Full-text available
Background: Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. Methods: We did a systematic review and meta-analysis of population-based datasets relevant...
Article
Full-text available
In the publication [1] there were errors in the acknowledgments. An investigator's name was not spelt correctly and the Department of Health disclaimer was not included.
Article
Purpose To evaluate the intraocular pressure (IOP) reducing effect of cataract operation combined with either trabecular bypass microstent (iStent) implantation or internal trabeculectomy (Trabectome). Methods A retrospective interventional case series involving 61 eyes who underwent cataract surgery combined with either iStent implantation or Tra...
Article
Laser Trabeculoplasty: drop-free nirvana or false-hope? Evolution of laser trabeculoplasty continues, as does debate about its place in the glaucoma treatment hierarchy. Evidence of clinical effectiveness, patient choice, cost-effectiveness and impact on health-related quality of life guide treatment choices: I shall review the latest developments...
Chapter
Background: Glaucoma is the leading cause of irreversible blindness. Minimally invasive surgical techniques, such as ab interno trabecular bypass surgery, have been introduced to prevent glaucoma progressing. Objectives: The main objective was to assess the results at two years of ab interno trabecular bypass surgery with Trabectome for open ang...
Article
BACKGROUND: Glaucoma is the leading cause of irreversible blindness. Minimally invasive surgical techniques, such as ab interno trabecular bypass surgery, have been introduced to prevent glaucoma progressing. OBJECTIVES: The main objective was to assess the results at two years of ab interno trabecular bypass surgery with Trabectome for open angle...
Chapter
This is the protocol for a review and there is no abstract. The objectives are as follows: The primary objective is to assess the role of iridotomy-compared with observation-in the prevention of visual field loss for individuals who have primary angle closure or primary angle-closure glaucoma in at least one eye. We will also examine the role of ir...
Article
The objectives are as follows: The primary objective is to assess the role of iridotomy - compared with observation - in the prevention of visual field loss for individuals who have primary angle closure or primary angle-closure glaucoma in at least one eye. We will also examine the role of iridotomy in the prevention of elevated intraocular pressu...
Article
Full-text available
Background The LiGHT trial (Laser-1st versus Drops-1st for Glaucoma and Ocular Hypertension Trial) is a multicentre randomised controlled trial of two treatment pathways for patients who are newly diagnosed with open-angle glaucoma (OAG) and ocular hypertension (OHT). The main hypothesis for the trial is that lowering intraocular pressure (IOP) wit...
Chapter
This is the protocol for a review and there is no abstract. The objectives are as follows: The main objective is to assess the results at two years of ab interno trabecular bypass surgery with Trabectome for OAG in comparison to conventional medical, laser or surgical treatment in terms of efficacy and safety. A secondary objective will be to exami...
Article
Full-text available
Background: With the use of ultrasound biomicroscopy, we aim to look at differences in anterior segment parameters of eyes with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) in dark and light conditions. Methods: Ultrasound biomicroscopy was performed for 30 subjects with PACG and 30 subjects with POAG at initial pres...
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Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.
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ragmatic trials of treatment pathways can require patient awareness of treatment allocation in order to better represent clinical reality, for example when concordance with a treatment has an important effect on outcome. Conversely, masking of treating clinicians to allocation group can be impossible when full clinical assessment requires knowledge...