Anti-Inflammatory Therapy Following Selective Laser Trabeculoplasty: A Randomized Clinical Trial

Abstract

Purpose: : To evaluate the impact of post laser anti-inflammatory therapy on the IOP lowering effect of SLT.

Methods: : Randomized observer-masked clinical trial of patients with primary open angle and pseudoexfoliation glaucoma undergoing 180 degree SLT. One eye from each of 99 patients enrolled to date. Treatment arms were: prednisolone acetate 1.0% (PA), ketorolac tromethamine 0.5% (KT) or artificial tear placebo (PL) four times daily for five days post laser. All IOP measures were carried out according to a strict protocol. Baseline IOP was measured on two separate days.

Results: : Overall mean baseline IOP was 19.0 mmHg (SD=4.5) and patients in the study were taking an average of 1.6 IOP lowering agents at enrollment. There were no statistically significant differences in baseline variables among the treatment groups. The mean IOP decreases at 1-month post SLT were 16.6%, 11.2%, and 13.8% in the PA, KT and PL groups respectively (p=0.56). The proportions of patients attaining a 20% or greater decrease in IOP at 1-month post SLT were 50%, 40%, and 36% in the PA, KT and PL groups respectively (p=0.57). Multivariate logistic regression analyses with backward selection demonstrated that those patients with higher baseline IOP had a greater probability of achieving a 20% IOP decrease at 1-month post laser (p=0.02).

Conclusions: : Anti-inflammatory therapy in the doses studied in this trial did not significantly modify the IOP lowering effect of SLT.

Clinical Trial: : www.clinicaltrials.gov NCT00485108

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials