Lasers are important therapy in glaucoma. They are a pivotal point in treatment between medical and surgical care. Over the last 10 years a new laser has emerged as the usual laser treatment: Selective laser trabeculoplasty (SLT). SLT works as well as the older laser used: argon laser trabeculoplasty (ALT). However SLT has many theoretical benefits over ALT including causing less damage to the tissue it affects. One of the potential patient centered benefits of this laser is that it may be repeatable. It is even possible that the old laser ALT may be useable after an SLT treatment. This study aims to uncover whether repeat laser is possible after SLT and if so which laser is more effective (ALT vs SLT). The potential of repeating laser therapies may delay surgical treatment and its complications. Also understanding which laser to use will help eye doctors know how to treat their patients at this point of the disease.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
139
With Argon laser trabeculoplasty (ALT), thermal energy is used directed towards the Trabecular Meshwork (the site of aqueous drainage from the eye),which causes focal scarring of trabecular meshwork, thus enable fluid drainage more effectively. However, this procedure may not be repeatable since it causes too much damage to the trabecular meshwork.
Selective laser trabeculoplasty is a relatively newer technology that uses a Nd:YAG laser to target specific cells within the trabecular meshwork. SLT does not cause coagulative damage to the trabecular meshwork, and thus has the advantage of being repeatable.
Rockyview General Hospital, University of Calgary
Calgary, Alberta, Canada
Royal Alexandra Hospital, University of Alberta
Edmonton, Alberta, Canada
Eye Care Centre, Dalhousie University
Halifax, Nova Scotia, Canada
McMaser University, St. Joseph's Healthcare Hamilton, CAHS Regional Eye Institute
Hamilton, Ontario, Canada
Ivey Eye Institute, St. Joseph's Hospital, Western University
London, Ontario, Canada
Sunnybrook Health Sciences Centre, University of Toronto
Toronto, Ontario, Canada
McGill University, Dept. of Ophthalmology, Royal Victoria Hospital,
Montreal, Quebec, Canada
Intraocular Pressure
IOP difference between baseline and 12 month post-laser.
Time frame: 12 months post operatively
To compare the IOP lowering effect between the groups at other postoperative visits
IOP difference between baseline, 1hr, 1 wk, and 1, 3, 6 and 12 mon post-laser.
Time frame: 12 months
To compare the visual acuity between the groups at all visits.
VA difference between baseline, 1hr, 1 wk, and 1, 3, 6 and 12 mon post-laser.
Time frame: 12 months
To compare the trabecular meshwork pigmentation between the groups at all visits.
Time frame: 12 months
To compare any adverse events between the two groups at all visits.
Time frame: 12 months
SLT repeatability of long term follow up in glaucoma patients
The follow up time has been extended two more years. Patients will be followed up Q6 months.
Time frame: 36 months after initial enrollment of the primary study
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