A Randomized Clinical Trial of Selective Laser Trabeculoplasty Versus Argon Laser Trabeculoplasty in Patients With Pseudoexfoliation. Issue 5 (June 2015)

• Record Type: Journal Article
• Authors: Kent, Shefalee S.; Hutnik, Cindy M. L.; Birt, Catherine M.; Damji, Karim F.; Harasymowycz, Paul; Si, Francie; Hodge, William; Pan, Irene; Crichton, Andrew
• Is Part Of: Journal of glaucoma. Volume 24:Issue 5(2015:Jun./Jul.)
• Publication Date: 2015-06
• Subjects: Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0b013e31829e55e4
• Languages: English
• ISSNs: 1057-0829

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Purpose:</title> <p>To evaluate the efficacy of selective laser trabeculoplasty (SLT) versus argon laser trabeculoplasty (ALT) in lowering the intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension secondary to pseudoexfoliation.</p> </sec> <sec> <title>Design:</title> <p>Multicentered randomized clinical trial.</p> </sec> <sec> <title>Participants</title> <p>A total of 76 eyes from 60 patients with pseudoexfoliation and uncontrolled IOP were recruited from 5 Canadian academic institutions. Patients with prior laser trabeculoplasty, ocular surgery within 6 months, previous glaucoma surgery, an advanced visual field defect, current steroid use, and monocular patients were excluded.</p> </sec> <sec> <title>Methods:</title> <p>Eyes were randomized to receive either 180-degree SLT or 180-degree ALT by a nonblocked randomization schedule stratified by center.</p> </sec> <sec> <title>Main Outcome Measurement:</title> <p>The primary outcome was the change in IOP at 6 months versus baseline and secondary outcomes included change in number of glaucoma medications after laser. Baseline variables included age, sex, angle grade, angle pigmentation, and number of glaucoma medications.</p> </sec> <sec> <title>Results:</title> <p>Of the 76 eyes, 45 eyes received SLT and 31 eyes received ALT. The overall age was 72.9 years (65% females). The baseline IOPs in the SLT and ALT groups were 23.1 and 25.2 mm Hg, respectively (<italic>P</italic>=0.03). The IOP reduction 6 months after SLT was −6.8 mm Hg and post-ALT was −7.7 mm Hg (<italic>P</italic>>0.05). The SLT group had reduced glaucoma medications by 0.16 medications at 6 months and the ALT group had no decrease in medications over the same time period (<italic>P</italic>=0.59). There were no postlaser IOP spikes in either group.</p> </sec> <sec> <title>Discussion:</title> <p>ALT and SLT are equivalent in lowering IOP at 6 months posttreatment in patients with PXF.</p> </sec> </abstract>