Selective laser trabeculoplasty versus topical medication as initial glaucoma treatment: the glaucoma initial treatment study randomised clinical trial.
Ang GS, Fenwick EK, Constantinou M, Gan ATL, Man REK, Casson RJ, Finkelstein EA, Goldberg I, Healey PR, Pesudovs K, Sanmugasundram S, Xie J, McIntosh R, Jackson J, Wells AP, White A, Martin K, Walland MJ, Crowston JG, Lamoureux EL.
Main finding: SLT was superior to medication in improving glaucoma-specific QoL. The medication arm achieved superior IOL reduction at 24 months.
Purpose: To determine if selective laser trabeculoplasty is superior to topical medication as a first-line treatment for glaucoma on quality of life and clinical outcomes.
Study type: Randomized controlled Trial
Condition: Primary open angle glaucoma, exfoliative glaucoma
Participants: Mild-to-moderate Primary open angle glaucoma or exfoliative glaucoma
-Treatment naive
n=167
Intervention:
Group 1: SLT
Group 2: topical medications
Both treatment arms achieved significant within-group gains in Glaucoma-specific QoL as assessed by the Glaucoma Outcomes Assessment Tool. SLT patients reported a greater between-group improvement in ‘social well-being’ compared with medication patients.
At month 24, the rate of successful IOP reduction was 18.6% higher in the medication compared with SLT group. More individuals in the medication group however had conjunctival hyperaemia and eyelid erythema vs SLT group.
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