Glaucoma
Conditions
Keywords
glaucoma, laser, SLT, ALT
Brief summary
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.
Interventions
PROCEDUREArgon laser trabeculoplasty
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.
PROCEDURESelective laser trabeculoplasty
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.
Sponsors
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Over age of 18 yo. * OAG including pigmentary dispersion syndrome and pseudoexfoliation * OAG has been treated with 360 degrees of SLT * two sighted eyes, * willing to participate after being informed of and reading the patient information material.
Exclusion criteria
* Narrow angle glaucoma * Previous glaucoma surgery * Eye surgery expected in the next 12 months * Severe corneal disease * On or anticipated steroid in 6 months * Pregnant or breast feeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intraocular Pressure | 12 months post operatively | IOP difference between baseline and 12 month post-laser. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To compare the IOP lowering effect between the groups at other postoperative visits | 12 months | IOP difference between baseline, 1hr, 1 wk, and 1, 3, 6 and 12 mon post-laser. |
| To compare the visual acuity between the groups at all visits. | 12 months | VA difference between baseline, 1hr, 1 wk, and 1, 3, 6 and 12 mon post-laser. |
| To compare the trabecular meshwork pigmentation between the groups at all visits. | 12 months | — |
| To compare any adverse events between the two groups at all visits. | 12 months | — |
| SLT repeatability of long term follow up in glaucoma patients | 36 months after initial enrollment of the primary study | The follow up time has been extended two more years. Patients will be followed up Q6 months. |
Countries
Canada
Outcome results
None listed