Selective Laser Trabeculoplasty versus Argon Laser Trabeculoplasty in Glaucoma Patients Treated Previously with 360° Selective Laser Trabeculoplasty: A Randomized, Single-Blind, Equivalence Clinical Trial
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. An active equivalence parallel armed randomized control tr...
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Veröffentlicht in: | Ophthalmology (Rochester, Minn.) Minn.), 2019-02, Vol.126 (2), p.223-232 |
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creator | Hutnik, Cindy Crichton, Andrew Ford, Bryce Nicolela, Marcelo Shuba, Lesya Birt, Catherine Sogbesan, Enitan Damji, Karim F Dorey, Michael Saheb, Hady Klar, Neil Guo, Hui Hodge, William |
description | 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.
An active equivalence parallel armed randomized control trial.
Patients with open-angle glaucoma including pigmentary dispersion syndrome and pseudoexfoliation syndrome were enrolled into the study from 7 different sites across Canada.
One setting of 180° of either SLT or ALT was assigned randomly and applied to each participant.
The change in intraocular pressure (IOP) from baseline to 12 months was compared between the 2 groups.
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.
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. |
doi_str_mv | 10.1016/j.ophtha.2018.09.037 |
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An active equivalence parallel armed randomized control trial.
Patients with open-angle glaucoma including pigmentary dispersion syndrome and pseudoexfoliation syndrome were enrolled into the study from 7 different sites across Canada.
One setting of 180° of either SLT or ALT was assigned randomly and applied to each participant.
The change in intraocular pressure (IOP) from baseline to 12 months was compared between the 2 groups.
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.
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.</description><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/j.ophtha.2018.09.037</identifier><identifier>PMID: 30278197</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Equivalence Trials as Topic ; Exfoliation Syndrome - surgery ; Female ; Glaucoma, Open-Angle - physiopathology ; Glaucoma, Open-Angle - surgery ; Humans ; Intraocular Pressure - physiology ; Laser Therapy - methods ; Lasers, Gas - therapeutic use ; Male ; Middle Aged ; Single-Blind Method ; Tonometry, Ocular ; Trabecular Meshwork - surgery ; Trabeculectomy - methods ; Treatment Outcome</subject><ispartof>Ophthalmology (Rochester, Minn.), 2019-02, Vol.126 (2), p.223-232</ispartof><rights>Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30278197$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hutnik, Cindy</creatorcontrib><creatorcontrib>Crichton, Andrew</creatorcontrib><creatorcontrib>Ford, Bryce</creatorcontrib><creatorcontrib>Nicolela, Marcelo</creatorcontrib><creatorcontrib>Shuba, Lesya</creatorcontrib><creatorcontrib>Birt, Catherine</creatorcontrib><creatorcontrib>Sogbesan, Enitan</creatorcontrib><creatorcontrib>Damji, Karim F</creatorcontrib><creatorcontrib>Dorey, Michael</creatorcontrib><creatorcontrib>Saheb, Hady</creatorcontrib><creatorcontrib>Klar, Neil</creatorcontrib><creatorcontrib>Guo, Hui</creatorcontrib><creatorcontrib>Hodge, William</creatorcontrib><title>Selective Laser Trabeculoplasty versus Argon Laser Trabeculoplasty in Glaucoma Patients Treated Previously with 360° Selective Laser Trabeculoplasty: A Randomized, Single-Blind, Equivalence Clinical Trial</title><title>Ophthalmology (Rochester, Minn.)</title><addtitle>Ophthalmology</addtitle><description>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.
An active equivalence parallel armed randomized control trial.
Patients with open-angle glaucoma including pigmentary dispersion syndrome and pseudoexfoliation syndrome were enrolled into the study from 7 different sites across Canada.
One setting of 180° of either SLT or ALT was assigned randomly and applied to each participant.
The change in intraocular pressure (IOP) from baseline to 12 months was compared between the 2 groups.
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.
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.</description><subject>Aged</subject><subject>Equivalence Trials as Topic</subject><subject>Exfoliation Syndrome - surgery</subject><subject>Female</subject><subject>Glaucoma, Open-Angle - physiopathology</subject><subject>Glaucoma, Open-Angle - surgery</subject><subject>Humans</subject><subject>Intraocular Pressure - physiology</subject><subject>Laser Therapy - methods</subject><subject>Lasers, Gas - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Single-Blind Method</subject><subject>Tonometry, Ocular</subject><subject>Trabecular Meshwork - surgery</subject><subject>Trabeculectomy - methods</subject><subject>Treatment Outcome</subject><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkdtKxDAQhoMgnt9AJJde2Jo0bdN6ty7rARYUD9fLNJm6kfRgk66sT-UzeO87GVAvRfhhmOGb_2cYQg45iznj-elz3PVLv4Q4YbyIWRkzITfIDs_SMkolF9tk17lnxliei3SLbAuWyIKXcod83qNF5c0K6RwcDvRhgArVaLvegvNrusLBjY5Ohqeu_QMxLb20MKquAXoL3mDrXYAQPGp6O-DKdKOza_pq_JKKnH28039Sz-iE3kGru8a8oT6h96Z9shidW9OGbvYymhVYbBXSaRgZBTY4GLD7ZLMG6_Dgp-6Rx4vZw_Qqmt9cXk8n86jnSe6jWtdpKiUvMl1nSgpVKKy4BMmh0pCrCuoiZ4VGEDKoQgZFmrGEqQJ1GRb2yPG3bz90LyM6v2iMU2gttBhuXSSc50GlyAJ69IOOVYN60Q-mgWG9-H2B-AIJvI7t</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Hutnik, Cindy</creator><creator>Crichton, Andrew</creator><creator>Ford, Bryce</creator><creator>Nicolela, Marcelo</creator><creator>Shuba, Lesya</creator><creator>Birt, Catherine</creator><creator>Sogbesan, Enitan</creator><creator>Damji, Karim F</creator><creator>Dorey, Michael</creator><creator>Saheb, Hady</creator><creator>Klar, Neil</creator><creator>Guo, Hui</creator><creator>Hodge, William</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201902</creationdate><title>Selective Laser Trabeculoplasty versus Argon Laser Trabeculoplasty in Glaucoma Patients Treated Previously with 360° Selective Laser Trabeculoplasty: A Randomized, Single-Blind, Equivalence Clinical Trial</title><author>Hutnik, Cindy ; Crichton, Andrew ; Ford, Bryce ; Nicolela, Marcelo ; Shuba, Lesya ; Birt, Catherine ; Sogbesan, Enitan ; Damji, Karim F ; Dorey, Michael ; Saheb, Hady ; Klar, Neil ; Guo, Hui ; Hodge, William</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p126t-fdf4477185df5c73c8ceb17a71abda6cbaf8608dea37a37be0a845020c8ed9c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Equivalence Trials as Topic</topic><topic>Exfoliation Syndrome - surgery</topic><topic>Female</topic><topic>Glaucoma, Open-Angle - physiopathology</topic><topic>Glaucoma, Open-Angle - surgery</topic><topic>Humans</topic><topic>Intraocular Pressure - physiology</topic><topic>Laser Therapy - methods</topic><topic>Lasers, Gas - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Single-Blind Method</topic><topic>Tonometry, Ocular</topic><topic>Trabecular Meshwork - surgery</topic><topic>Trabeculectomy - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hutnik, Cindy</creatorcontrib><creatorcontrib>Crichton, Andrew</creatorcontrib><creatorcontrib>Ford, Bryce</creatorcontrib><creatorcontrib>Nicolela, Marcelo</creatorcontrib><creatorcontrib>Shuba, Lesya</creatorcontrib><creatorcontrib>Birt, Catherine</creatorcontrib><creatorcontrib>Sogbesan, Enitan</creatorcontrib><creatorcontrib>Damji, Karim F</creatorcontrib><creatorcontrib>Dorey, Michael</creatorcontrib><creatorcontrib>Saheb, Hady</creatorcontrib><creatorcontrib>Klar, Neil</creatorcontrib><creatorcontrib>Guo, Hui</creatorcontrib><creatorcontrib>Hodge, William</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology (Rochester, Minn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hutnik, Cindy</au><au>Crichton, Andrew</au><au>Ford, Bryce</au><au>Nicolela, Marcelo</au><au>Shuba, Lesya</au><au>Birt, Catherine</au><au>Sogbesan, Enitan</au><au>Damji, Karim F</au><au>Dorey, Michael</au><au>Saheb, Hady</au><au>Klar, Neil</au><au>Guo, Hui</au><au>Hodge, William</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Selective Laser Trabeculoplasty versus Argon Laser Trabeculoplasty in Glaucoma Patients Treated Previously with 360° Selective Laser Trabeculoplasty: A Randomized, Single-Blind, Equivalence Clinical Trial</atitle><jtitle>Ophthalmology (Rochester, Minn.)</jtitle><addtitle>Ophthalmology</addtitle><date>2019-02</date><risdate>2019</risdate><volume>126</volume><issue>2</issue><spage>223</spage><epage>232</epage><pages>223-232</pages><eissn>1549-4713</eissn><abstract>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.
An active equivalence parallel armed randomized control trial.
Patients with open-angle glaucoma including pigmentary dispersion syndrome and pseudoexfoliation syndrome were enrolled into the study from 7 different sites across Canada.
One setting of 180° of either SLT or ALT was assigned randomly and applied to each participant.
The change in intraocular pressure (IOP) from baseline to 12 months was compared between the 2 groups.
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.
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.</abstract><cop>United States</cop><pmid>30278197</pmid><doi>10.1016/j.ophtha.2018.09.037</doi><tpages>10</tpages></addata></record> |
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subjects | Aged Equivalence Trials as Topic Exfoliation Syndrome - surgery Female Glaucoma, Open-Angle - physiopathology Glaucoma, Open-Angle - surgery Humans Intraocular Pressure - physiology Laser Therapy - methods Lasers, Gas - therapeutic use Male Middle Aged Single-Blind Method Tonometry, Ocular Trabecular Meshwork - surgery Trabeculectomy - methods Treatment Outcome |
title | Selective Laser Trabeculoplasty versus Argon Laser Trabeculoplasty in Glaucoma Patients Treated Previously with 360° Selective Laser Trabeculoplasty: A Randomized, Single-Blind, Equivalence Clinical Trial |
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