Results From a Multi-Center, Randomized Clinical Trial Comparing Argon Laser and Titanium:Sapphire Laser Trabeculoplasty to Treat Primary Open Angle Glaucoma

Abstract

Purpose: : To compare the clinical findings following laser trabeculoplasty using argon (ALT) and Titanium:Sapphire (TLT) lasers in eyes with primary open angle glaucoma (POAG).

Methods: : 167 eyes (83 ALT; 88 TLT) of 160 patients at least 18 years old with POAG and baseline intraocular pressure (IOP) ≥ 22mmHg; while failed either maximally tolerated glaucoma medication or previous laser trabeculoplasty were enrolled in the study. Demographics for the two groups were comparable in terms of age (ALT 67.4+12.9; TLT 67.1+11.0) and gender (ALT 61.0% female; TLT 62.7% female). Baseline IOP (ALT 24.8+3.4; TLT 25.4+3.4 mmHg) and number of glaucoma meds (ALT 1.7+0.9; TLT 1.6+1.0) were also comparable.Treatment consisted of 50 laser exposures over 180 degrees of trabecular meshwork for both the CW argon (488/514nm; 50-100um spot size; 50-100mW) and pulsed Titanium:Sapphire (790nm; 200um spot size; 30 to 80 mJ/pulse) lasers.

Results: : Primary endpoint for success was percent IOP reduction from baseline at follow-up visits of 1 week, and 1, 3, 6 and 12 months. All IOP were measured using a Goldmann tonometer. Percent IOP reduction was comparable at 6 months for ALT 23.9+17.2 % (n=60) and TLT 26.9+17.3 % (n=61) (p=0.34); and 12 months 20.2+17.3 % for ALT (n=45) and 26.8+16.2% for TLT (n=41) (p=0.07). Incidences of minor complications commonly associated with trabeculoplasty were infrequent and also comparable between the two groups.

Clinical Trial: : www.clinicaltrials.gov NCT00145535

Keywords: laser • clinical (human) or epidemiologic studies: outcomes/complications • trabecular meshwork