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

Authors

Shefalee S. Kent, University of Western Ontario, Canada
Cindy M L. Hutnik, University of Western Ontario, Canada
Catherine M. Birt, University of Toronto, Canada
Karim F. Damji, University of Alberta, CanadaFollow
Paul Harasymowycz, University of Montreal, Canada
Francie Si, University of Western Ontario, Canada
William Hodge, University of Western Ontario, Canada
Irene Pan, University of Western Ontario, Canada
Andrew Crichton, University of Calgary, Canada

Document Type

Article

Department

Ophthalmology

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.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Journal of Glaucoma

Recommended Citation

Kent, S. S., Hutnik, C. L., Birt, C. M., Damji, K. F., Harasymowycz, P., Si, F., Hodge, W., Pan, I., Crichton, A. (2015). A randomized clinical trial of selective laser trabeculoplasty versus argon laser trabeculoplasty in patients with pseudoexfoliation. Journal of Glaucoma, 24(5), 344-347.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_ophthalmol/49