No abstract

Selective laser trabeculoplasty and brimonidine tartrate 0.2%/timolol maleate 0.5% were shown to be equivalent in lowering intraocular pressure in uncontrolled primary open angle glaucoma patients when used as adjunct therapy for patients on a prostaglandin analog. Additionally, this is the first prospective study of optometrists performing selective laser trabeculoplasty. Although this study had a small sample size, the results appeared to show that efficacy and complication rates were comparable to previously published data; however, these results need to be confirmed with a larger multi-centered trial

Purpose: To compare the intraocular pressure lowering efficacy of selective laser trabeculoplasty to brimonidine tartrate 0.2%/timolol maleate 0.5% (FCBT, Combigan, Allergan inc. Irvine, CA/USA) in patients with uncontrolled primary open-angle glaucoma on a prostaglandin analog alone. A secondary outcome was to evaluate the complication rates of selective laser trabeculoplasty. Patients and Methods: Twenty-three patients were randomized to two treatment groups within this prospective, observer-masked single site, all optometrist, pilot study. Group 1 (N=12) received 360 degrees of selective laser trabeculoplasty as additional treatment while Group 2 (N=11) was started on FCBT. Outcomes of both groups were measured at eight weeks. Results: Both treatment regimens were found to be statistically significant in lowering IOP when used as adjunct therapy. The average IOP reduction for Group 1 and Group 2 was 28.43% (SD = .17) and 28.22% (SD = .12) respectively. The incidence of an intraocular pressure spike following SLT in this patient population was found to be 8.3%. No major complications were observed in this study. Conclusion: Selective laser trabeculoplasty and brimonidine tartrate 0.2%/timolol maleate 0.5% (FCBT, Combigan, Allergan inc. Irvine, CA/USA) were shown to be equivalent in lowering intraocular pressure in uncontrolled primary open angle glaucoma patients when used as adjunct therapy for patients on a prostaglandin analog. Additionally, this is the first prospective study of optometrists performing selective laser trabeculoplasty. Although this study had a small sample size, the results appeared to show that efficacy and complication rates were comparable to previously published data; however, these results need to be confirmed with a larger multi-centered trial.

Background: Glaucoma has been associated with low corneal hysteresis, a characteristic that may provide additional information in identifying those who are considered glaucoma suspects. The current study aimed to determine the relationship between corneal hysteresis, corneal compensated intraocular pressure, and GCC analysis in patients who are labeled clinically as open angle glaucoma suspects.Methods: Participants were categorized into 2 groups, control (n = 14) or suspect (n = 27), based on clinical examination. Corneal hysteresis and optical coherence tomography were performed and analyzed for any correlation between these two groups. Results: Correlations between corneal hysteresis and parapapillary retinal nerve fiber layer thickness or corneal hysteresis and ganglion cell complex thickness in the macula were weak to moderate and ranged from r = -0.340 to r = 0.316. The correlations between corneal compensated intraocular pressure and parapapillary retinal nerve fiber layer thickness or corneal compensated intraocular pressure and ganglion cell complex thickness were also weak to moderate and ranged from r = -0.489 to r = 0.396. Conclusion:In the current study, corneal hysteresis and corneal compensated intraocular pressure did not provide a definitive relationship when trying to identify patients as glaucoma suspects. The relationships between corneal hysteresis and retinal nerve fiber layer thickness or corneal hysteresis and ganglion cell complex thickness were weak to moderate. The weak to moderate correlation was consistent even when considering retinal nerve fiber layer and ganglion cell complex global indices as well as the individual clock hours for both measurements.

Purpose: To compare the intraocular pressure lowering efficacy of selective laser trabeculoplasty to brimonidine tartrate 0.2%/timolol maleate 0.5% in patients with uncontrolled primary open-angle glaucoma on a prostaglandin analog alone. A secondary outcome was to evaluate the complication rates of selective laser trabeculoplasty.Patients and Methods: Twenty-three patients were randomized to two treatment groups within this prospective, observer-masked single site, all optometrist, pilot study. Group 1 (N=12) received 360 degrees of selective laser trabeculoplasty as additional treatment while Group 2 (N=11) was started on FCBT. Outcomes of both groups were measured at eight weeks.Results: Both treatment regimens were found to be statistically significant in lowering IOP when used as adjunct therapy. The average IOP reduction for Group 1 and Group 2 was 28.4% (SD = .17) and 28.2% (SD = .12) respectively. The incidence of an intraocular pressure spike following SLT in this patient population was found to be 8.3%. No major complications were observed in this study.Conclusion: Selective laser trabeculoplasty and brimonidine tartrate 0.2%/timolol maleate 0.5% were shown to be equivalent in lowering intraocular pressure in uncontrolled primary open angle glaucoma patients when used as adjunct therapy for patients on a prostaglandin analog. Additionally, this is the first prospective study of optometrists performing selective laser trabeculoplasty. Although this study had a small sample size, the results appeared to show that efficacy and complication rates were comparable to previously published data; however, these results need to be confirmed with a larger multi-centered trial.Trial Registration: ISRCTN Study ID ISRCTN30070325, retrospectively registered 12/14/2018. http://www.isrctn.com/ISRCTN30070325.