Tomaž Gračner (Author), Bojan Gračner (Author), Dušica Pahor (Author)

Abstract

Background. To compare the efficacy of selective laser trabeculoplasty (SLT) as treatment of pseudoexfoliation glaucoma (PG) and primary open-angle glaucoma (POAG) in a prospective clinical study. Methods. Ten eyes of 10 patients suffering from uncontrolled PG (PG group) and 10 eyes of 10 patients with uncontrolled POAG (POAG group) were treated with a frequency-doubled, Q-switched NdČYAG laser (532 nm). The baseline characteristics were similar inboth groups. The intraocular pressure (IOP) was measured before the treatment and 1day, 1 week, 1 month and 3, 6, 9, 12, 15, 18, 24, 30, and 36 months after the treatment. Success was defined as an IOP lowering, exceeding 20% of pretreatment IOP. Any modification of hypotensive medication led to exclude the eye from the study. Statistical analysis comparing the two groups was carried out using the independent-sample t test for continuous variables and the Log-Rank test for survival analysis. All tests were conducted considering p< 0.05 as significant. Results. The mean follow-up time was 22.8 months (SD 12.5) for the PG group and 24.3 months (SD 10.8) for the POAG group(n. s.). No significant difference was found between the two groups for mean pretreatment IOP (23.6 mm Hg šSD 5.7đ in the PG group vs. 22.8 mm Hg šSD 2.4đ in the POAG group) and for mean IOPs during the whole follow-up period. At all follow-up visits, the mean IOP reductions were smaller in the PG group than in the POAG group (7.0 mm Hg šSD 3.3đ vs. 7.7 mm Hg šSD 2.0đ at 24 months). However such difference was statistically signifficant only at 36 months (4.7 mm Hg šSD 1.1đ vs. 8.3 mm Hg šSD 1.5đ). At all follow-up visits, the mean percent IOP reduction was smaller in the PG group than in the POAG group (27.6% šSD 7.1đ vs. 32.1% šSD 7.1đ at 24 months). Furthermore, such a difference was statistically significant at 9, 12, and 36 months (21.8% šSD 1.6đ vs. 34.1% šSD 4.7đ). According to the Kaplan-Meier survival analysis, the36-month success rate was 47% in the PG group and 59% in the POAG group, but the differences between the two groups were nonsignificant (p> 0.05). Conclusions. SLT is an effective procedure for lowering IOP, although within 3years there has been a substantial failure rate in both PG and POAG eyes, andthe success seems to decline faster in PG eyes.

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Data

Language: Slovenian
Year of publishing:
Typology: 1.01 - Original Scientific Article
Organization: UM - University of Maribor
UDC: 617.7
COBISS: 1570367 Link will open in a new window
ISSN: 1318-0347
Parent publication: Zdravniški vestnik
Views: 735
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Secondary language: English
Secondary title: Primerjava učinkovitosti selektivne laserske trabekuloplastike pri psevdoeksfoliacijskem glavkomu in primarnem glavkomu z odprtim zakotjem
Secondary abstract: Izhodišča. Primerjati učinkovitost selektivne laserske trabekuloplastike (SLT) pri zdravljenju psevdoeksfoliacijskega glavkoma (PG) in pri primarnem glavkomu z odprtim zakotjem (POAG) s prospektivno klinično raziskavo. Metode. 10 očes 10 bolnikov z neurejenim PG (skupina PG) in 10 očes 10 bolnikov z neurejenim POAG (skupina POAG) je bilo zdravljenih s frekvenčno podvojenim, Q-preklopljenim laserjem Nd:YAG (532 nm). Osnovne značilnosti so bile podobne v obeh skupinah. Očesni pritisk (IOP) je bil izmerjen pred zdravljenjem in nato 1 dan, 1 teden, 1 mesec ter 3, 6, 9, 12, 15, 18, 24, 30 in 36 mesecev po SLT. Uspeh je bil določen z znižanjem IOP, ki je bilo večje kot 20% glede na IOP pred zdravljenjem. Vsaka sprememba lokalnega protiglavkomskega zdravljenjaje vodila v izključitev očesa iz klinične raziskave. Statistična analiza primerjave dveh skupin je bila narejena s testom t neodvisnih vzorcev in testom Log-Rank za analizo preživetja. Pri vseh testih je bil p< 0,05 upoštevan kot statistično značilen. Rezultati. Za skupino PG je bil povprečen čas opazovanja 22,8 meseca (SD 12,5), za skupino POAG pa 24,3 meseca (SD 10,8), (stat. nezn.). Med povprečnima IOP pred zdravljenjem obeh skupin ni bilo statistično značilne razlike (23,6 mm Hg [SD 5,7] v skupini PG proti 22,8 mm Hg [SD 2,4] v skupini POAG), prav tako pa tudi ne med povprečnima IOP po zdravljenju v celotnem času opazovanja. Pri vseh kontrolah po SLT je bilo povprečno znižanje IOP manjše v skupini PG kot v skupini POAG (7,0 mm Hg [SD 3,3] proti 7,7 mm Hg [SD 2,0] pri 24 mesecih), vendar pa je bila razlika statistično značilna le pri 36 mesecih (4,7 mm Hg [SD 1,1] proti 8,3 mm Hg [SD1,5]). Pri vseh kontrolah po SLT je bil povprečen odstotek znižanja IOP manjši v PG skupini kot v POAG skupini (27,6% [SD 7,1] proti 32,1% [SD 7,1] pri 24 mesecih), razlika pa je bila statistično značilna pri 9, 12 in 36 mesecih (21.8% [SD 1,6] proti 34,1% [SD 4,7]). Glede na Kaplan-Meierjevo analizo preživetja je bila 36-mesečna uspešnost v skupini PG 47% in v skupini POAG 59%, vendar pa je bila razlika med skupinama statistično neznačilna (p> 0,05). Zaključki. SLT je učinkovita metoda za znižanje IOP, čeprav smo v 3 letih opazovanja ugotovili padec učinkovitosti tako pri očeh s PG kot pri očeh s POAG. Kaže, da uspešnost hitreje pada pri očeh s PG.
Secondary keywords: Trabeculoplasty;Trabekuloplastika;Ophthalmologic surgical procedures;Oftalmološki kirurški postopki;Glaucoma, open-angle;Glavkom odprtega kota;
URN: URN:NBN:SI
Type (COBISS): Not categorized
Pages: str. 439-443
Volume: ǂLetn. ǂ73
Issue: ǂšt. ǂ5
Chronology: 2004
ID: 9108168