Effect of primary selective laser trabeculoplasty on tonographic outflow facility: a randomised clinical trial


Goyal, S; Beltran-Agullo, L; Rashid, S; Shah, SP; Nath, R; Obi, A; Lim, KS; (2010) Effect of primary selective laser trabeculoplasty on tonographic outflow facility: a randomised clinical trial. The British journal of ophthalmology, 94 (11). pp. 1443-1447. ISSN 0007-1161 DOI: https://doi.org/10.1136/bjo.2009.176024

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Abstract

Purpose To investigate the effect of 180 degrees versus 360 degrees primary selective laser trabeculoplasty (SLT) on tonographic outflow facility and intraocular pressure (IOP). Design Prospective, single masked randomised clinical trial. Participants Patients with untreated primary open angle glaucoma or ocular hypertension both with IOP>21-35 mmHg. Methods 40 patients randomly treated with 180 degrees or 360 degrees SLT after baseline tonographic outflow facility (electronic Schiotz tonography) and IOP measurements were repeated after 1 month. One eye from each patient was randomly selected for analysis. Eight untreated eyes were included as a control group. Main Outcome Measures Tonographic outflow facility and IOP difference. Responders were defined as having at least a 20% reduction in IOP. Results Three patients were excluded due to poor tonography. There were 18 eyes in the 180 degrees group and 19 eyes in the 360 degrees group. Tonographic outflow facility increased significantly (180 degrees p=0.003, 360 degrees p=0.005) and IOP decreased significantly (180 degrees and 360 degrees p<0.001) from baseline. There were no significant differences between the two groups as regards the increase in tonographic outflow facility (180 degrees group 37.5%, 360 degrees group 41%, p-0.23) and decrease in IOP (180 degrees group 24%, 360 degrees group 35%, p=0.35). There were similar number of responders in 180 degrees group (72%) as compared to 360 degrees group (89.5%, p=0.23). Tonographic outflow facility and IOP did not change significantly from baseline in the control group (tonographic outflow facility: 8% increase p=0.48, IOP: 4% decrease p=0.33). Conclusions Primary SLT significantly increased the tonographic outflow facility and decreased IOP in patients with primary open angle glaucoma and ocular hypertension but no statistically significant differences were found between the 360 degrees and 180 degrees groups. The level of IOP reduction due to primary SLT treatment could not be explained by the increase in tonographic outflow facility alone.

Item Type: Article
Keywords: OPEN-ANGLE GLAUCOMA, AQUEOUS-HUMOR DYNAMICS, INTRAOCULAR-PRESSURE, OCULAR HYPERTENSION, HUMAN-EYE, THERAPY, LATANOPROST, PILOT
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 20472748
Web of Science ID: 283256200007
URI: http://researchonline.lshtm.ac.uk/id/eprint/2288

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