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Efficacy and safety of selective laser trabeculoplasty and pattern scanning laser trabeculoplasty: a randomised clinical trial
  1. Mandy Oi Man Wong1,2,
  2. Isabel SW Lai1,2,
  3. Poemen Puiman Chan1,2,
  4. Noel CY Chan1,3,
  5. Alison YY Chan1,2,
  6. Gilda WK Lai1,
  7. Vivian SM Chiu1,
  8. Christopher Kai-Shun Leung1,2
  1. 1Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
  2. 2Department of Ophthalmology, Hong Kong Eye Hospital, Kowloon City, Hong Kong
  3. 3Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong
  1. Correspondence to Dr Christopher Kai-Shun Leung, The Chinese University of Hong Kong, Hong Kong, Hong Kong; cksleung{at}gmail.com

Abstract

Aims To compare the intraocular pressure (IOP) lowering effect and safety profile between pattern scanning laser trabeculoplasty (PSLT) and selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) over a 12-month follow-up.

Methods 132 patients with POAG or OHT were consecutively enrolled and randomised (1:1) to receive PSLT (n=65) or SLT (n=67) in a single centre. IOP was measured before and then on 1 day, 1 week, 1, 3, 6, 9 and 12 months after PSLT/SLT. The primary outcome measure was the proportion of patients with ≥20% IOP reduction at 12 months without IOP-lowering medications (complete success).

Results The mean baseline IOP was 21.2±4.1 mm Hg for eyes randomised to PSLT and 21.3±4.7 mm Hg for eyes randomised to SLT (p=0.898). At 12 months, the IOP was 18.3±3.1 and 17.8±3.4 mm Hg, respectively (p=0.402). IOP measurements were comparable between the groups over 12 months (overall mean difference 0.4 mm Hg, 95% CI: −0.5 to 1.3 mm Hg). 15.4% of PSLT-treated and 25.4% of SLT-treated patients achieved treatment success (difference: 10.0%, 95% CI: −3.6 to 23.6) (p=0.155), respectively. A higher baseline IOP and a greater percentage of IOP reduction at day 1 were associated with a greater percentage of IOP reduction at 12 months (p<0.001). There were no significant differences in visual field mean deviation, average retinal nerve fibre layer thickness, corneal endothelial cell count and visual acuity between the treatment groups at the baseline and 12-month follow-up (p≥0.062).

Conclusions PSLT was not superior to SLT in terms of safety and IOP-lowering efficacy in patients with POAG or OHT.

Trial registration number The clinical trial was registered in the Centre for Research and Biostatistics Clinical Trials Registry, the Chinese University of Hong Kong (Identifier CUHK_CCT00407). The full trial protocol can be accessed from the authors on request.

  • glaucoma
  • treatment lasers
  • intraocular pressure
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Footnotes

  • MOMW and ISL contributed equally.

  • Contributors Study design: CK-SL. Obtained funding: CK-SL. Patient recruitment: TTW, GL, PPC, NCYC, AC, CK-SL. Data collection: TTW, GL, PPC, NCYC, AC, CK-SL, VSMC, GL. Data analysis: TTW, AC, VSMC, GL, CK-SL. Drafting manuscript: TTW, CK-SL.

  • Funding This study was funded by Hong Kong Food and Health Bureau Health and Medical Research Fund (02130446).

  • Competing interests CK-SL has received research support in the form of instrument (Cirrus HD-OCT) from Carl Zeiss Meditec, and in the form of research grant, speaker honorarium and instrument (Triton OCT) from Topcon.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Kowloon Central Cluster research ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. De-identified participant data will be available upon request from the corresponding author—Christopher Leung (cksleung@cuhk.edu.hk).

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