Anti-inflammatory therapy after selective laser trabeculoplasty
Authors:
Delan Jinapriya, MD, Mark D’Souza, MD, Hussein Hollands, MD, MSc, Sherif R. El-Defrawy, MD, PhD, Isabella Irrcher, PhD, Donald Smallman, MD, James P. Farmer, MD, John Cheung, MD, Todd Urton, MD, Andrew Day, MSc, Xiaoquin Sun, MSc, & Robert J. Campbell, MD, MSc
Summary:
Purpose - To investigate the effect of anti-inflammatory therapy on selective laser trabeculoplasty (SLT) outcomes.
Design - Randomized, double-masked, placebo-controlled trial.
Participants - Patients with primary open-angle or pseudo-exfoliation glaucoma.
Methods - Patients undergoing SLT were randomized to receive placebo (artificial tears), prednisolone acetate 1%, or ketorolac tromethamine 0.5% eye drops 4 times per day for 5 days commencing immediately after SLT.
Main Outcome Measures - Change in intraocular pressure (IOP) from baseline to the 1-month post-SLT visit.
Results - Mean change in IOP at the 1-month primary outcome time point, as well as all other time points, was not significantly different among groups (P = 0.99). Likewise, a repeated-measures, mixed-effects model did not find significant differences in IOP outcome at the 1-month time point (P = 0.95). The IOP was reduced in all groups at the 1-month post-SLT time point and all other time points, and no significant differences were found between groups using separate unadjusted cross-sectional analyses of variance (P > 0.15 for analyses at all time points). Treatment failure rates were not different among groups (P = 0.75), and at 1 year after SLT, the percentage of patients maintaining a 20% IOP reduction ranged from 18% to 22% in the 3 study groups.
Conclusions - Anti-inflammatory therapy after SLT does not seem to substantially influence the IOP-lowering effect of SLT. In this study of patients with low baseline IOP, SLT showed limited efficacy in achieving a sustained reduction in IOP.
Source: Ophthalmology; (09/15/14)
Summary:
Purpose - To investigate the effect of anti-inflammatory therapy on selective laser trabeculoplasty (SLT) outcomes.
Design - Randomized, double-masked, placebo-controlled trial.
Participants - Patients with primary open-angle or pseudo-exfoliation glaucoma.
Methods - Patients undergoing SLT were randomized to receive placebo (artificial tears), prednisolone acetate 1%, or ketorolac tromethamine 0.5% eye drops 4 times per day for 5 days commencing immediately after SLT.
Main Outcome Measures - Change in intraocular pressure (IOP) from baseline to the 1-month post-SLT visit.
Results - Mean change in IOP at the 1-month primary outcome time point, as well as all other time points, was not significantly different among groups (P = 0.99). Likewise, a repeated-measures, mixed-effects model did not find significant differences in IOP outcome at the 1-month time point (P = 0.95). The IOP was reduced in all groups at the 1-month post-SLT time point and all other time points, and no significant differences were found between groups using separate unadjusted cross-sectional analyses of variance (P > 0.15 for analyses at all time points). Treatment failure rates were not different among groups (P = 0.75), and at 1 year after SLT, the percentage of patients maintaining a 20% IOP reduction ranged from 18% to 22% in the 3 study groups.
Conclusions - Anti-inflammatory therapy after SLT does not seem to substantially influence the IOP-lowering effect of SLT. In this study of patients with low baseline IOP, SLT showed limited efficacy in achieving a sustained reduction in IOP.
Source: Ophthalmology; (09/15/14)