Effect of SLT Location on Treatment Outcomes (SLOS)

St. Joseph's Healthcare Hamilton

Status

Unknown

Conditions

Glaucoma

Treatments

Procedure: Selective Laser Trabeculoplasty

Study type

Observational

Funder types

Other

Identifiers

NCT03164941

0000000000

Details and patient eligibility

About

Selective Laser Trabeculoplasty (SLT) is a glaucoma treatment that has been shown to effectively lower intraocular pressure by increasing aqueous outflow through macrophage recruitment. There is evidence of increased drainage in the nasal quadrants of the eye. This study aims to compare whether there is a difference in the reduction of eye pressure when SLT is performed nasally and temporally.

Full description

This study aims to evaluate if there is a difference between 180 degree nasal and temporal selective laser trabeculoplasty (SLT) in treatment outcomes. It is known that there is increased aqueous collectors and veins and thus aqueous drainage in the nasal quadrants of the eye. If SLT works by the hypothesized biologic mechanism in which macrophages remodel the aqueous drainage system to increase outflow, performing SLT in an area concentrated with aqueous veins may increase outflow more. As a result, we hypothesize that nasal 180 degree SLT may have better outcomes compared to the temporal counterpart. The results of this study may help inform decisions when performing 180 degree SLT and provide insight to SLT's mechanism of action. The primary objective of this study is to determine if there is a difference in treatment efficacy between nasal and temporal 180 degree SLT by measuring differences in baseline and post-operative intraocular pressures. We hypothesize that nasal SLT will have superior outcomes compared to temporal SLT due to increased number of aqueous veins.

Enrollment

84 estimated patients

Sex

All

Ages

18+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Diagnosis of open angle glaucoma, ocular hypertension, pigmentary dispersion syndrome and pseudoexfoliation syndrome
Participant must be over 18 years of age
IOP > 16mmHg on at least two consecutive occasions separated by one month
Two sighted eyes with visual acuity of 20/200 or better
Informed consent from patient

Exclusion criteria

Diagnosis of secondary OAG (aside from pigmentary and pseudoexfoliation glaucoma) or narrow angle glaucoma
Previous incisional glaucoma surgery
Incisional glaucoma surgery scheduled within 1 year of intervention
Corneal disease affecting visualization of anterior chamber of the eye
Treatment or plan to treat with topical or systemic steroids
Previous selective laser trabeculoplasty treatment