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Oi Man Mandy Wong, Isabel Sum Wai Lai, Poemen Pui Man Chan, Ching Yan Noel Chan, Christopher Kai-Shun Leung; A randomized controlled trial(RCT) comparing the efficacy and safety of pattern laser trabeculoplasty(PLT) and selective laser trabeculoplasty(SLT). Invest. Ophthalmol. Vis. Sci. 2018;59(9):6098.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the intraocular pressure (IOP) lowering effect and adverse effects of PLT and SLT in the treatment of primary open-angle glaucoma (POAG) or ocular hypertension (OHT).
126 eyes of 126 patients with POAG/OHT were recruited. 62 eyes received SLT and 64 eyes received PLT for 360 degrees of the anterior chamber angle after medication washout. They were followed up at 1 day, 1 week, 1, 3, 6, 9 and 12 months. Mean diurnal Goldmann applanation tonometry measurements at 9-10am, 12-1pm, and 5-6pm were measured at baseline, month 6(M6) and month 12(M12). Humphrey 24-2 visual field, optical coherence tomography of retinal nerve fiber layer (RNFL) imaging were performed. Topical IOP-lowering medication was given if IOP was >=25mmHg and/or functional/structural progression was detected. Complete treatment success was defined as 15% IOP reduction without medication.
62 and 61 eyes reached M6 follow-up, and 47 and 44 eyes reached M12 follow-up in the PLT- and SLT-treated groups, respectively. Mean baseline IOP was 21.0 +/- 4.1mmHg for PLT and 21.2 +/- 4.7mmHg for SLT (p=0.900). In both PLT and SLT group, there were significant reductions in the mean IOP at both M6 by 1.8±3.8 and 2.7±3.5mmHg, respectively(p<0.001), and M12 by 2.9±3.8 and 3.7±4.3 mmHg, respectively (p<0.001). There were no significant differences in mean IOP between the SLT- and PLT-treated groups at M6 and M12 (p>0.05). At M12, the IOP at 9-10am, 12-1pm and 5-6pm was 19.3, 18.5, and 17.6 mmHg, respectively, for PLT; and 18.8, 18.5, and 17.4mmHg, respectively, for SLT. No significant differences in IOP were detected at the individual time points between both groups (p>0.05). Complete success in the PLT- and SLT-treated group were 25.8% and 31.1%, respectively, at M6, and 25.5% and 31.8%, respectively, at M12. 28.6% and 27.8% of eyes required additional medications at M12 in the PLT- and SLT-treated groups, respectively. There was no significant difference in the proportions of patients requiring medications at M6 and M12(p>0.05). There were no major adverse events in both groups.
The IOP-lowering efficacy and safety were similar between PLT and SLT.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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