Laser trabeculoplasty in newly diagnosed multi-treated glaucoma patients

Erika Rasmuson; Boel Bengtsson; Christina Lindén; Anders Heijl; Johan Aspberg; Sabina Andersson-Geimer; Gauti Jóhannesson

doi:10.1111/aos.14576

Laser trabeculoplasty in newly diagnosed multi-treated glaucoma patients

Erika Rasmuson, Boel Bengtsson, Christina Lindén, Anders Heijl, Johan Aspberg, Sabina Andersson-Geimer, Gauti Jóhannesson

Faculty of Medicine

University of Iceland

Research output: Contribution to journal › Article › peer-review

Abstract

PURPOSE: To evaluate the intraocular pressure (IOP)-lowering effect of laser trabeculoplasty (LTP) in eyes which IOP had been substantially reduced by intensive topical treatment for one week.

METHODS: Patients with newly diagnosed open-angle glaucoma were randomized to treatment with three IOP-lowering substances. One week later, 360° argon or selective LTP was performed. IOP was measured before LTP and at one-, three-, six- and 12-month post-LTP. The patients were part of the Glaucoma Intensive Treatment Study (GITS).

RESULTS: Mean IOP (± SD) in 152 eyes of 122 patients was 14.0 (± 3.5) mmHg just before LTP. For every mmHg higher IOP prior to LTP, the IOP was reduced by an additional 0.6 mmHg at 12 months. The IOP was significantly reduced at all follow-up visits from -2.6 (± 3.1) mmHg at one month to -2.1 (± 3.8) mmHg at 12 months in eyes with pre-LTP IOP ≥ 15 mmHg, while no significant IOP reduction was seen in eyes with pre-LTP IOP < 15 mmHg. Older age, argon LTP and male sex were associated with larger IOP reduction after 12 months, whereas presence of exfoliation syndrome was associated with a smaller IOP reduction. No severe complications were reported.

CONCLUSION: Success of LTP was highly dependent on the IOP level prior to LTP treatment. A sustained significant IOP reduction was seen in eyes with pre-LTP IOP ≥ 15 mmHg whereas no such effect was seen in eyes with pre-LTP IOP < 15 mmHg. Thus, LTP can be considered in eyes with multi-treatment when target pressure of < 15 mmHg is not achieved.

Original language	English
Pages (from-to)	269-274
Number of pages	6
Journal	Acta Ophthalmologica
Volume	99
Issue number	3
Early online date	29 Oct 2020
DOIs	https://doi.org/10.1111/aos.14576
Publication status	Published - May 2021

Bibliographical note

This study was presented in part at the 5th Nordic Glaucoma Meeting in Bergen, Norway, 24–25 May 2019. Financial support was provided through regional agreements between Umeå University and Västerbotten County Council and between Lund University and Skåne Regional Council (ALF), and also by grants from Crown Princess Margareta’s Foundation, Ögonfonden, Insamlingsstiftelserna vid Umeå universitet, the Swedish Medical Society Foundation, the Cronqvist Foundation, the Herman Järnhardt Foundation, the Foundation for Visually Impaired in Former Malmöhus County, Ingrid Nordmark’s Foundation, the Margit and Kjell Stolz Foundation, foundations and donations administered by Skåne University Hospital, and King Gustav V and Queen Victoria’s Freemason Foundation and Swedish Society for Medical Research. The funding organizations had no role in the design or conduct of this research. The corresponding author is a member of the Nordic Ophthalmological Societies only. © 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Other keywords

Aged
Combined Modality Therapy
Female
Glaucoma, Open-Angle/surgery
Humans
Intraocular Pressure/drug effects
Laser Therapy/methods
Male
Middle Aged
Ophthalmic Solutions/therapeutic use
Trabeculectomy/methods

Access to Document

10.1111/aos.14576

Cite this

@article{34c5bf11bfe74fea8fb5ef1910e9a088,

title = "Laser trabeculoplasty in newly diagnosed multi-treated glaucoma patients",

abstract = "PURPOSE: To evaluate the intraocular pressure (IOP)-lowering effect of laser trabeculoplasty (LTP) in eyes which IOP had been substantially reduced by intensive topical treatment for one week.METHODS: Patients with newly diagnosed open-angle glaucoma were randomized to treatment with three IOP-lowering substances. One week later, 360° argon or selective LTP was performed. IOP was measured before LTP and at one-, three-, six- and 12-month post-LTP. The patients were part of the Glaucoma Intensive Treatment Study (GITS).RESULTS: Mean IOP (± SD) in 152 eyes of 122 patients was 14.0 (± 3.5) mmHg just before LTP. For every mmHg higher IOP prior to LTP, the IOP was reduced by an additional 0.6 mmHg at 12 months. The IOP was significantly reduced at all follow-up visits from -2.6 (± 3.1) mmHg at one month to -2.1 (± 3.8) mmHg at 12 months in eyes with pre-LTP IOP ≥ 15 mmHg, while no significant IOP reduction was seen in eyes with pre-LTP IOP < 15 mmHg. Older age, argon LTP and male sex were associated with larger IOP reduction after 12 months, whereas presence of exfoliation syndrome was associated with a smaller IOP reduction. No severe complications were reported.CONCLUSION: Success of LTP was highly dependent on the IOP level prior to LTP treatment. A sustained significant IOP reduction was seen in eyes with pre-LTP IOP ≥ 15 mmHg whereas no such effect was seen in eyes with pre-LTP IOP < 15 mmHg. Thus, LTP can be considered in eyes with multi-treatment when target pressure of < 15 mmHg is not achieved.",

keywords = "Aged, Combined Modality Therapy, Female, Glaucoma, Open-Angle/surgery, Humans, Intraocular Pressure/drug effects, Laser Therapy/methods, Male, Middle Aged, Ophthalmic Solutions/therapeutic use, Trabeculectomy/methods",

author = "Erika Rasmuson and Boel Bengtsson and Christina Lind{\'e}n and Anders Heijl and Johan Aspberg and Sabina Andersson-Geimer and Gauti J{\'o}hannesson",

note = "This study was presented in part at the 5th Nordic Glaucoma Meeting in Bergen, Norway, 24–25 May 2019. Financial support was provided through regional agreements between Ume{\aa} University and V{\"a}sterbotten County Council and between Lund University and Sk{\aa}ne Regional Council (ALF), and also by grants from Crown Princess Margareta{\textquoteright}s Foundation, {\"O}gonfonden, Insamlingsstiftelserna vid Ume{\aa} universitet, the Swedish Medical Society Foundation, the Cronqvist Foundation, the Herman J{\"a}rnhardt Foundation, the Foundation for Visually Impaired in Former Malm{\"o}hus County, Ingrid Nordmark{\textquoteright}s Foundation, the Margit and Kjell Stolz Foundation, foundations and donations administered by Sk{\aa}ne University Hospital, and King Gustav V and Queen Victoria{\textquoteright}s Freemason Foundation and Swedish Society for Medical Research. The funding organizations had no role in the design or conduct of this research. The corresponding author is a member of the Nordic Ophthalmological Societies only. {\textcopyright} 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley \& Sons Ltd.",

year = "2021",

month = may,

doi = "10.1111/aos.14576",

language = "English",

volume = "99",

pages = "269--274",

journal = "Acta Ophthalmologica",

issn = "1755-375X",

publisher = "John Wiley and Sons Inc.",

number = "3",

}

TY - JOUR

T1 - Laser trabeculoplasty in newly diagnosed multi-treated glaucoma patients

AU - Rasmuson, Erika

AU - Bengtsson, Boel

AU - Lindén, Christina

AU - Heijl, Anders

AU - Aspberg, Johan

AU - Andersson-Geimer, Sabina

AU - Jóhannesson, Gauti

N1 - This study was presented in part at the 5th Nordic Glaucoma Meeting in Bergen, Norway, 24–25 May 2019. Financial support was provided through regional agreements between Umeå University and Västerbotten County Council and between Lund University and Skåne Regional Council (ALF), and also by grants from Crown Princess Margareta’s Foundation, Ögonfonden, Insamlingsstiftelserna vid Umeå universitet, the Swedish Medical Society Foundation, the Cronqvist Foundation, the Herman Järnhardt Foundation, the Foundation for Visually Impaired in Former Malmöhus County, Ingrid Nordmark’s Foundation, the Margit and Kjell Stolz Foundation, foundations and donations administered by Skåne University Hospital, and King Gustav V and Queen Victoria’s Freemason Foundation and Swedish Society for Medical Research. The funding organizations had no role in the design or conduct of this research. The corresponding author is a member of the Nordic Ophthalmological Societies only. © 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2021/5

Y1 - 2021/5

N2 - PURPOSE: To evaluate the intraocular pressure (IOP)-lowering effect of laser trabeculoplasty (LTP) in eyes which IOP had been substantially reduced by intensive topical treatment for one week.METHODS: Patients with newly diagnosed open-angle glaucoma were randomized to treatment with three IOP-lowering substances. One week later, 360° argon or selective LTP was performed. IOP was measured before LTP and at one-, three-, six- and 12-month post-LTP. The patients were part of the Glaucoma Intensive Treatment Study (GITS).RESULTS: Mean IOP (± SD) in 152 eyes of 122 patients was 14.0 (± 3.5) mmHg just before LTP. For every mmHg higher IOP prior to LTP, the IOP was reduced by an additional 0.6 mmHg at 12 months. The IOP was significantly reduced at all follow-up visits from -2.6 (± 3.1) mmHg at one month to -2.1 (± 3.8) mmHg at 12 months in eyes with pre-LTP IOP ≥ 15 mmHg, while no significant IOP reduction was seen in eyes with pre-LTP IOP < 15 mmHg. Older age, argon LTP and male sex were associated with larger IOP reduction after 12 months, whereas presence of exfoliation syndrome was associated with a smaller IOP reduction. No severe complications were reported.CONCLUSION: Success of LTP was highly dependent on the IOP level prior to LTP treatment. A sustained significant IOP reduction was seen in eyes with pre-LTP IOP ≥ 15 mmHg whereas no such effect was seen in eyes with pre-LTP IOP < 15 mmHg. Thus, LTP can be considered in eyes with multi-treatment when target pressure of < 15 mmHg is not achieved.

AB - PURPOSE: To evaluate the intraocular pressure (IOP)-lowering effect of laser trabeculoplasty (LTP) in eyes which IOP had been substantially reduced by intensive topical treatment for one week.METHODS: Patients with newly diagnosed open-angle glaucoma were randomized to treatment with three IOP-lowering substances. One week later, 360° argon or selective LTP was performed. IOP was measured before LTP and at one-, three-, six- and 12-month post-LTP. The patients were part of the Glaucoma Intensive Treatment Study (GITS).RESULTS: Mean IOP (± SD) in 152 eyes of 122 patients was 14.0 (± 3.5) mmHg just before LTP. For every mmHg higher IOP prior to LTP, the IOP was reduced by an additional 0.6 mmHg at 12 months. The IOP was significantly reduced at all follow-up visits from -2.6 (± 3.1) mmHg at one month to -2.1 (± 3.8) mmHg at 12 months in eyes with pre-LTP IOP ≥ 15 mmHg, while no significant IOP reduction was seen in eyes with pre-LTP IOP < 15 mmHg. Older age, argon LTP and male sex were associated with larger IOP reduction after 12 months, whereas presence of exfoliation syndrome was associated with a smaller IOP reduction. No severe complications were reported.CONCLUSION: Success of LTP was highly dependent on the IOP level prior to LTP treatment. A sustained significant IOP reduction was seen in eyes with pre-LTP IOP ≥ 15 mmHg whereas no such effect was seen in eyes with pre-LTP IOP < 15 mmHg. Thus, LTP can be considered in eyes with multi-treatment when target pressure of < 15 mmHg is not achieved.

KW - Aged

KW - Combined Modality Therapy

KW - Female

KW - Glaucoma, Open-Angle/surgery

KW - Humans

KW - Intraocular Pressure/drug effects

KW - Laser Therapy/methods

KW - Male

KW - Middle Aged

KW - Ophthalmic Solutions/therapeutic use

KW - Trabeculectomy/methods

UR - https://www.scopus.com/pages/publications/85094186017

U2 - 10.1111/aos.14576

DO - 10.1111/aos.14576

M3 - Article

C2 - 33124189

SN - 1755-375X

VL - 99

SP - 269

EP - 274

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

IS - 3

ER -

Laser trabeculoplasty in newly diagnosed multi-treated glaucoma patients

Abstract

Bibliographical note

Other keywords

Access to Document

Fingerprint

Cite this