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A randomized clinical trial of selective laser trabeculoplasty versus argon laser trabeculoplasty in patients with pseudoexfoliation.

Abstract：

PURPOSE: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. DESIGN:Multicentered randomized clinical trial. PARTICIPANTS: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. METHODS:Eyes were randomized to receive either 180-degree SLT or 180-degree ALT by a nonblocked randomization schedule stratified by center. MAIN OUTCOME MEASUREMENT: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. RESULTS: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 (P=0.03). The IOP reduction 6 months after SLT was -6.8 mm Hg and post-ALT was -7.7 mm Hg (P>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 (P=0.59). There were no postlaser IOP spikes in either group. DISCUSSION:ALT and SLT are equivalent in lowering IOP at 6 months posttreatment in patients with PXF.

journal_name

J Glaucoma

journal_title

Journal of glaucoma

authors

Kent SS,Hutnik CM,Birt CM,Damji KF,Harasymowycz P,Si F,Hodge W,Pan I,Crichton A

doi

10.1097/IJG.0b013e31829e55e4

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

344-7

issue

5

eissn

1057-0829

issn

1536-481X

journal_volume

24

pub_type

杂志文章,多中心研究,随机对照试验

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