Cindy Hutnik1, Andrew Crichton2, Bryce Ford2, Marcelo Nicolela3, Lesya Shuba3, Catherine Birt4, Enitan Sogbesan5, Karim F Damji6, Michael Dorey6, Hady Saheb7, Neil Klar1, Hui Guo1, William Hodge8. 1. Department of Ophthalmology, Western University, Ontario, Canada. 2. Department of Ophthalmology, University of Calgary, Calgary, Canada. 3. Department of Ophthalmology, Dalhousie University, Halifax, Canada. 4. Department of Ophthalmology, University of Toronto, Toronto, Canada. 5. Department of Ophthalmology, McMaster University, Hamilton, Canada. 6. Department of Ophthalmology, University of Alberta, Alberta, Canada. 7. Department of Ophthalmology, McGill University, Montreal, Canada. 8. Department of Ophthalmology, Western University, Ontario, Canada. Electronic address: William.Hodge@sjhc.london.on.ca.
Abstract
PURPOSE: The effectiveness of selective laser trabeculoplasty (SLT) was compared with argon laser trabeculoplasty (ALT) in a randomized clinical trial for patients with medically uncontrolled open-angle glaucoma who have previously received 360° SLT. DESIGN: An active equivalence parallel armed randomized control trial. PARTICIPANTS: Patients with open-angle glaucoma including pigmentary dispersion syndrome and pseudoexfoliation syndrome were enrolled into the study from 7 different sites across Canada. METHODS: One setting of 180° of either SLT or ALT was assigned randomly and applied to each participant. MAIN OUTCOME MEASURES: The change in intraocular pressure (IOP) from baseline to 12 months was compared between the 2 groups. RESULTS:A total of 132 patients were recruited, 2 of which dropped out early in the study, leaving 130 patients who completed the study as per protocol. For those, the study's primary outcome was calculated. The IOP change at 1 year in comparison to baseline for SLT vs. ALT was found to be different by 0.33 mmHg between the 2 groups (3.16 for SLT and 2.83 for ALT) and was not statistically significant (P = 0.71) Further analysis, though, showed that SLT had a significantly lower IOP reduction at early time points: 1 week and 1 month, but this effect was lost by 3 months. Corresponding to this finding was the strong trend for ALT to fail more quickly than SLT. Although repeatable, the first repeat SLT reduced IOP to only about half compared with initial SLT treatment. CONCLUSIONS: The comparison at 12 months following the laser therapy showed that both modalities lowered the IOP with approximately 3 mmHg, yet essentially all of the time-to-failure analyses favored SLT over ALT. The repeat SLT effect was found to be half of the initial treatment. Crown
RCT Entities:
PURPOSE: The effectiveness of selective laser trabeculoplasty (SLT) was compared with argon laser trabeculoplasty (ALT) in a randomized clinical trial for patients with medically uncontrolled open-angle glaucoma who have previously received 360° SLT. DESIGN: An active equivalence parallel armed randomized control trial. PARTICIPANTS: Patients with open-angle glaucoma including pigmentary dispersion syndrome and pseudoexfoliation syndrome were enrolled into the study from 7 different sites across Canada. METHODS: One setting of 180° of either SLT or ALT was assigned randomly and applied to each participant. MAIN OUTCOME MEASURES: The change in intraocular pressure (IOP) from baseline to 12 months was compared between the 2 groups. RESULTS: A total of 132 patients were recruited, 2 of which dropped out early in the study, leaving 130 patients who completed the study as per protocol. For those, the study's primary outcome was calculated. The IOP change at 1 year in comparison to baseline for SLT vs. ALT was found to be different by 0.33 mmHg between the 2 groups (3.16 for SLT and 2.83 for ALT) and was not statistically significant (P = 0.71) Further analysis, though, showed that SLT had a significantly lower IOP reduction at early time points: 1 week and 1 month, but this effect was lost by 3 months. Corresponding to this finding was the strong trend for ALT to fail more quickly than SLT. Although repeatable, the first repeat SLT reduced IOP to only about half compared with initial SLT treatment. CONCLUSIONS: The comparison at 12 months following the laser therapy showed that both modalities lowered the IOP with approximately 3 mmHg, yet essentially all of the time-to-failure analyses favored SLT over ALT. The repeat SLT effect was found to be half of the initial treatment. Crown
Authors: Christiane R Rolim-de-Moura; Augusto Paranhos; Mohamed Loutfi; David Burton; Richard Wormald; Jennifer R Evans Journal: Cochrane Database Syst Rev Date: 2022-08-09
Authors: Raul E Ruiz-Lozano; Jimena Alamillo-Velazquez; Gustavo Ortiz-Morales; Lucas A Garza-Garza; Manuel E Quiroga-Garza; Carlos Alvarez-Guzman; Alejandro Rodriguez-Garcia Journal: Int Ophthalmol Date: 2022-08-13 Impact factor: 2.029
Authors: Arsham Sheybani; Rachel Scott; Thomas W Samuelson; Malik Y Kahook; Daniel I Bettis; Iqbal Ike K Ahmed; J David Stephens; Delaney Kent; Tanner J Ferguson; Leon W Herndon Journal: Ophthalmol Ther Date: 2019-11-15