A Comparison of Resident-performed Argon and Selective Laser Trabeculoplasty in Patients With Open-angle Glaucoma. Issue 3 (March 2016) - Lowry, Eugene A.
Abstract : Purpose: To compare intraocular pressure (IOP) reduction and complications of resident-performed argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). Patients and Methods: This was a retrospective, interventional, comparative case series performed at the San Francisco Veterans Affairs Hospital. The study included 77 patients each undergoing 1 resident-performed ALT procedure from April 2006 through November 2009, and 81 patients each undergoing 1 resident-performed SLT procedure from November 2009 through December 2011. Reduction in IOP at 12 months and a longitudinal analysis across 24 months was determined. Secondary outcomes investigated included additional interventions of either repeat trabeculoplasty or trabeculectomy as well as change in eye drop medications. Results: There was no evidence of a difference between IOP reductions in patients undergoing ALT compared with SLT at 12 months ( P =0.41, linear modeling) or across all follow-up appointments ( P =0.62, linear-mixed effects regression). Patients undergoing ALT had a significantly increased number of eye drops (+0.6 vs. −0.1 drops, P <0.001, Wilcoxon rank-sum test) and trend toward increased rates of additional interventions ( P =0.06, Weibull regression). There was no difference in immediate postprocedure IOP rise between the 2 groups ( P =0.75, Wilcoxon rank-sum test) or any evidence of change in visual acuity. Conclusions: We found no difference in IOP reduction between patients undergoing resident-performed ALT compared with SLT. However, patients undergoing ALT had a significant increase in eye drop medications and trend toward additional interventions compared with patients undergoing SLT.