PURPOSE The effectiveness of selective laser trabeculoplasty (SLT) was compared with argon laser trabeculoplasty (ALT) in a randomized clinical trial for patients with medically uncontrolled open-angle glaucoma who have previously received 360° SLT. DESIGN An active equivalence parallel armed randomized control trial. PARTICIPANTS Patients with open-angle glaucoma including pigmentary dispersion syndrome and pseudoexfoliation syndrome were enrolled into the study from 7 different sites across Canada. METHODS One setting of 180° of either SLT or ALT was assigned randomly and applied to each participant. MAIN OUTCOME MEASURES The change in intraocular pressure (IOP) from baseline to 12 months was compared between the 2 groups. RESULTS A total of 132 patients were recruited, 2 of which dropped out early in the study, leaving 130 patients who completed the study as per protocol. For those, the study's primary outcome was calculated. The IOP change at 1 year in comparison to baseline for SLT vs. ALT was found to be different by 0.33 mmHg between the 2 groups (3.16 for SLT and 2.83 for ALT) and was not statistically significant (P = 0.71) Further analysis, though, showed that SLT had a significantly lower IOP reduction at early time points: 1 week and 1 month, but this effect was lost by 3 months. Corresponding to this finding was the strong trend for ALT to fail more quickly than SLT. Although repeatable, the first repeat SLT reduced IOP to only about half compared with initial SLT treatment. CONCLUSIONS The comparison at 12 months following the laser therapy showed that both modalities lowered the IOP with approximately 3 mmHg, yet essentially all of the time-to-failure analyses favored SLT over ALT. The repeat SLT effect was found to be half of the initial treatment.

中文翻译：

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青光眼患者中的选择性激光小梁成形术与氩激光小梁成形术之前接受过360°选择性激光小梁成形术治疗：一项随机，单盲，等效临床试验。

目的在一项随机临床试验中，对先前接受过360°SLT的医学上不受控制的开角型青光眼患者，将选择性激光小梁成形术（SLT）与氩激光小梁成形术（ALT）的疗效进行了比较。设计一项主动当量并行武装随机对照试验。研究对象来自加拿大7个不同地点的包括色素弥散综合症和假性剥脱综合症的开角型青光眼患者被纳入研究。方法随机分配一种180°的SLT或ALT设置，并将其应用于每个参与者。主要观察指标比较了两组从基线到12个月的眼内压（IOP）的变化。结果总共招募了132位患者，其中2位在研究初期退出，剩下130位按照方案完成研究的患者。对于这些患者，计算出了研究的主要结果。与两组相比，SLT与ALT的基线在1年时的IOP变化相差0.33 mmHg（SLT为3.16，ALT为2.83），但无统计学意义（P = 0.71），但需要进一步分析，表明SLT在早期时间点（1周和1个月）的IOP降低明显降低，但这种效果在3个月后消失。与这一发现相对应的是，ALT较SLT更快地衰竭的强烈趋势。尽管可以重复，但与最初的SLT治疗相比，第一次重复的SLT可使IOP降低到仅约一半。结论激光治疗后12个月的比较显示，两种方式均使IOP降低约3 mmHg，但是基本上所有的失效时间分析都倾向于SLT而不是ALT。发现重复的SLT效应是初始治疗的一半。