Glaucoma, Open-Angle Clinical Trial
Titanium Sapphire laser trabeculoplasty is effective in lowering intraocular pressure in glaucoma patients, and is comparable to argon laser trabeculoplasty
Objective: To compare the medium-term outcome of Titanium-Sapphire laser trabeculoplasty
(TiSLT) vs. Argon Laser Trabeculoplasty (ALT) in uncontrolled Open-angle Glaucoma (OAG)
patients.
Methods: Prospective, masked, randomized comparative clinical study. Thirty-seven OAG
patients with uncontrolled IOP and no previous filtration surgery (22 females and 15 males,
mean age of 68 years) participated. Eighteen were treated with TiSLT and 19 with ALT. All
patients underwent a comprehensive eye examination including visual acuity, IOP, goniocscopy
and slit-lamp biomicroscopy and visual field examinations. Patients were examined
pre-operatively and then at 1 hour, 1 day, 1 week, 1, 3 and 6 months, 1 year and 18 months
post-operatively.
Main outcome measures: Final IOP, delta IOP and number of anti-glaucoma medications.
Results: The 18 patients in the TiSLT arm had an average of 8.3(±2.7) mm Hg or 32% reduction
from pre-operative IOP (P<0.001). The 19 patients in the ALT arm had a mean IOP decrease of
6.5 (±4.3) mm Hg (P<0.001) or a 25% IOP reduction. Patients in both groups achieved a
similar decrease in IOP (P>0.05). TiSLT patients had statistically significant fewer IOP
spikes compared to the ALT group. (P=0.002). Two patients (1 in each arm) underwent
trabeculectomy and were considered failures. Mean follow-up time was 15 months.
Conclusions: TiSLT provides similar efficacy to ALT in IOP reduction in OAG patients, and
may offer better safety with fewer IOP spikes see post-operatively.
Application to clinical practice: If confirmed in additional studies, TiSLT may be used as
an alternative to ALT in OAG patients.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double-Blind
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