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Ophthalmology ; 121(12): 2356-61, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25234015

ABSTRACT

PURPOSE: To investigate the effect of anti-inflammatory therapy on selective laser trabeculoplasty (SLT) outcomes. DESIGN: Randomized, double-masked, placebo-controlled trial. PARTICIPANTS: Patients with primary open-angle or pseudo-exfoliation glaucoma. METHODS: Patients undergoing SLT were randomized to receive placebo (artificial tears), prednisolone acetate 1%, or ketorolac tromethamine 0.5% eye drops 4 times per day for 5 days commencing immediately after SLT. MAIN OUTCOME MEASURES: Change in intraocular pressure (IOP) from baseline to the 1-month post-SLT visit. RESULTS: Mean change in IOP at the 1-month primary outcome time point, as well as all other time points, was not significantly different among groups (P = 0.99). Likewise, a repeated-measures, mixed-effects model did not find significant differences in IOP outcome at the 1-month time point (P = 0.95). The IOP was reduced in all groups at the 1-month post-SLT time point and all other time points, and no significant differences were found between groups using separate unadjusted cross-sectional analyses of variance (P > 0.15 for analyses at all time points). Treatment failure rates were not different among groups (P = 0.75), and at 1 year after SLT, the percentage of patients maintaining a 20% IOP reduction ranged from 18% to 22% in the 3 study groups. CONCLUSIONS: Anti-inflammatory therapy after SLT does not seem to substantially influence the IOP-lowering effect of SLT. In this study of patients with low baseline IOP, SLT showed limited efficacy in achieving a sustained reduction in IOP.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Exfoliation Syndrome , Glaucoma, Open-Angle , Ketorolac Tromethamine/therapeutic use , Ocular Hypertension/drug therapy , Prednisolone/analogs & derivatives , Trabeculectomy/methods , Aged , Aged, 80 and over , Analysis of Variance , Cross-Sectional Studies , Double-Blind Method , Exfoliation Syndrome/drug therapy , Exfoliation Syndrome/surgery , Female , Glaucoma, Open-Angle/drug therapy , Glaucoma, Open-Angle/surgery , Humans , Intraocular Pressure/drug effects , Laser Therapy , Male , Middle Aged , Prednisolone/therapeutic use , Trabecular Meshwork/surgery , Treatment Failure
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