West Indies Glaucoma Laser Study (WIGLS): 1.?12-Month Efficacy of Selective Laser Trabeculoplasty in Afro-Caribbeans With Glaucoma


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Purpose To characterize the 12-month intraocular pressure (IOP)-lowering efficacy of selective laser trabeculoplasty (SLT) as sole therapy for primary open-angle glaucoma (POAG) in an Afro-Caribbean population. Design Stepped-wedge trial. Methods Subjects in St. Lucia and Dominica with established POAG were randomized to prompt washout of IOP-lowering medications followed by SLT, 3-month delay followed by washout and SLT, or 6-month delay followed by washout and SLT. Baseline IOP was obtained on 2 different days after washout. Bilateral 360-degree SLT was performed in 1 session. Posttreatment assessments took place 1 hour, 1?week, and 3, 6, 9, and 12?months post-SLT. The main outcome measure was SLT success (defined as IOP ≤ target IOP in both eyes) at 12?months. Target IOP was a 20% or greater reduction in IOP from postwashout baseline. Results Overall, 72 patients underwent SLT treatment. Mean IOP at enrollment was 15.4 ± 3.6?mm Hg in right eyes and 15.4 ± 3.6?mm Hg in left eyes, which rose to 21.0 ± 3.3?mm Hg and 20.9 ± 3.0?mm Hg, respectively, after washout. Mean IOP at 3, 6, 9, and 12?months ranged from 12.5?mm Hg to 14.5?mm Hg (29.7% to 39.5%; P Conclusions SLT monotherapy safely provides significant IOP reduction in Afro-Caribbean eyes with POAG. This treatment can play a significant role in preventing glaucoma vision loss and blindness in people of African descent living in resource-limited regions.
机译:目的是表征12个月的眼内压(IOP) - 选择性激光Trabeculoplacty(SLT)作为唯一的加勒比人口初级开角青光眼(POAG)的唯一疗法。设计阶梯式楔形试验。方法在圣卢西亚和多米尼加与已建立的Poag中的受试者随机化以迅速洗涤降低Iop-降低的药物,然后进行SL​​T,3个月的延迟,然后是冲洗和SLT,或6个月的延迟,然后是冲洗和SLT。基线IOP在冲洗后的2次不同的日子里获得。双边360度SLT在1次会议中进行。后病理评估1小时,1?周和3,6,9和12?几个月后的SLT。主要结果测量是SLT成功(在12个月内定义为IOP≤靶IOP)。从后邦基线的IOP靶IOP均为IOP的20%或更大。结果总体而言,72例患者接受了SLT治疗。在右眼时,入学的平均IOP为15.4±3.6?mm Hg,左眼15.4±3.6?mm hg,分别在冲洗后升至21.0±3.3Ωmmhg和20.9±3.0?mm hg。平均IOP在3,6,9和12?个月内,从12.5μmHg至14.5?mm hg(29.7%至39.5%; P结论SLT单疗法安全地通过POAG获得了乌黑加勒比眼睛的显着减少。这种治疗可以在预防资源限制地区的非洲血统人民中的青光眼视觉丧失和失明方面发挥重要作用。



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