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Anti-inflammatory therapy after selective laser trabeculoplasty: a randomized, double-masked, placebo-controlled clinical trial.

Author(s): Jinapriya D(1), D'Souza M(1), Hollands H(1), El-Defrawy SR(1), Irrcher I(1), Smallman D(1), Farmer JP(1), Cheung J(1), Urton T(2), Day A(3), Sun X(3), Campbell RJ(4).

Affiliation(s): Author information: (1)Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, Ontario, Canada. (2)Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, Ontario, Canada; Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada. (3)Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada. (4)Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, Ontario, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada. Electronic address: rob.campbell@queensu.ca.

Publication date & source: 2014, Ophthalmology. , 121(12):2356-61

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.

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