The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform

Xiulan Zhang - One of the best experts on this subject based on the ideXlab platform.

  • Selective laser Trabeculoplasty versus argon laser Trabeculoplasty in patients with open-angle glaucoma: A systematic review and meta-analysis
    PLoS ONE, 2013
    Co-Authors: Wei Wang, Minwen Zhou, Miao He, Xiulan Zhang
    Abstract:

    OBJECTIVE: To examine possible differences in clinical outcomes between selective laser Trabeculoplasty (SLT) and argon laser Trabeculoplasty (ALT) in open-angle glaucoma at different times post-treatment.\n\nMETHODS: Randomized controlled trials (RCTs) comparing SLT versus ALT were searched through August 2013. The main outcome measure was IOP, and secondary outcomes included the number of glaucoma medications, the success rate, and adverse events.\n\nRESULTS: Six RCTs, involving 482 eyes treated with laser Trabeculoplasty, were included in the meta-analysis. For all patients (including first and previous laser trabeculoplasy), no significant difference in IOP lowering was observed between SLT and ALT at one hour (P = 0.40), one week (P = 0.72), one month (P = 0.37), six months (P = 0.08), one year (P = 0.34), two years (P = 0.58), three years (P = 0.34), four years (P = 0.47), and five years (P = 0.50). A statistically significant difference in favor of SLT was found when comparing the IOP reduction at three months after intervention (weighted mean difference (WMD): 1.19 mmHg [0.41; 1.97]; I(2)=0%; P = 0.003). For patients who were naive to laser, there was no significant difference of reduction in IOP comparing SLT with ALT at any time point. In patients' previous LT, no statistically significant difference in IOP reduction was found at six months (WMD: 1.92 mmHg [-0.91; 4.74]; I(2) = 77.3%; P = 0.18). There was no significant difference in the reduction in the number of glaucoma medications, the success rate, or adverse event rates between the two treatments.\n\nCONCLUSIONS: SLT has equivalent efficacy to ALT with a similar constellation of side effects. In the case of retreatment, SLT appears to be similar to ALT in IOP lowering at six months.

Dong H. Shin - One of the best experts on this subject based on the ideXlab platform.

  • Effect of topical anti-inflammatory treatment on the long-term outcome of laser Trabeculoplasty ☆
    American Journal of Ophthalmology, 1998
    Co-Authors: Bernice K. Glover, Ronald E. P. Frenkel, Dong H. Shin, M. Marc Abreu
    Abstract:

    Abstract PURPOSE: To investigate the effect of anti-inflammatory treatment on the long-term outcome of argon laser Trabeculoplasty, we extended the short-term study of the Fluorometholone-Laser Trabeculoplasty Study Group. METHODS: Among the chronic open-angle glaucoma patients randomly assigned to the 0.25% fluorometholone or placebo eyedrops four times daily before and after argon laser Trabeculoplasty in the Fluorometholone-Laser Trabeculoplasty Study, the long-term records of 27 patients (13 eyes in the fluorometholone group and 14 eyes in the placebo group) were available for our review and analysis. RESULTS: There were no statistically significant differences in the success rate of argon laser Trabeculoplasty between the fluorometholone and control groups over the follow-up period of 4.6 ± 3.4 years. CONCLUSION: While it decreased ocular inflammation and discomfort during the early postoperative period, peri–argon laser Trabeculoplasty use of a topical corticosteroid did not influence the long-term intraocular pressure outcome of argon laser Trabeculoplasty.

  • Effect of Topical Anti-inflammatory Treatment on the Outcome of Laser Trabeculoplasty
    American journal of ophthalmology, 1996
    Co-Authors: Dong H. Shin, Ronald E. P. Frenkel, Robert David, Janet K. Cheetham
    Abstract:

    Purpose We investigated the effect of antiinflammatory treatment on the outcome of argon laser Trabeculoplasty. Methods In this multicenter, double-masked, randomized, placebo-controlled, parallel comparison study, 140 chronic open-angle glaucoma patients received either 0.25% fluorometholone or vehicle four times a day unilaterally, beginning 24 hours before and continuing one week after argon laser Trabeculoplasty. The laser surgeon placed 50 to 60 burns over the inferior 180 degrees of the trabecular meshwork. The patients were followed up frequently for five weeks after the procedure. Results Following argon laser Trabeculoplasty, signs of anterior chamber inflammation were significantly lower in the fluorometholone group. However, there was no significant difference between the fluorometholone and the vehicle groups in the incidence of increased intraocular pressure in the immediate post-argon laser Trabeculoplasty period. Intraocular pressure decreased significantly in both groups from day 1 throughout the follow-up period. A significant between-group difference in intraocular pressure decrease was found only at week 5 (7.83 ± 6.27 [S.D.] mm Hg for the fluorometholone group vs 6.63 ± 5.79 mm Hg for the vehicle group, P = .046). No drugrelated clinically significant adverse events were observed. Conclusions Use of fluorometholone is effective in attenuating inflammation and has no clinically significant impact on the outcome of argon laser Trabeculoplasty or on the incidence of intraocular pressure spikes during the immediate postargon laser Trabeculoplasty period.

Richard Wormald - One of the best experts on this subject based on the ideXlab platform.

  • Selective laser Trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial
    The Lancet, 2019
    Co-Authors: Gus Gazzard, David Garway-heath, Neil Nathwani, Evgenia Konstantakopoulou, Richard Wormald, Anurag Garg, Catey Bunce, Keith Barton
    Abstract:

    Background: Primary open angle glaucoma and ocular hypertension are habitually treated with eye drops that lower intraocular pressure. Selective laser Trabeculoplasty is a safe alternative but is rarely used as first-line treatment. We compared the two. Methods: In this observer-masked, randomised controlled trial treatment-naive patients with open angle glaucoma or ocular hypertension and no ocular comorbidities were recruited between 2012 and 2014 at six UK hospitals. They were randomly allocated (web-based randomisation) to initial selective laser Trabeculoplasty or to eye drops. An objective target intraocular pressure was set according to glaucoma severity. The primary outcome was health-related quality of life (HRQoL) at 3 years (assessed by EQ-5D). Secondary outcomes were cost and cost-effectiveness, disease-specific HRQoL, clinical effectiveness, and safety. Analysis was by intention to treat. This study is registered at controlled-trials.com (ISRCTN32038223). Findings: Of 718 patients enrolled, 356 were randomised to the selective laser Trabeculoplasty and 362 to the eye drops group. 652 (91%) returned the primary outcome questionnaire at 36 months. Average EQ-5D score was 0·89 (SD 0·18) in the selective laser Trabeculoplasty group versus 0·90 (SD 0·16) in the eye drops group, with no significant difference (difference 0·01, 95% CI −0·01 to 0·03; p=0·23). At 36 months, 74·2% (95% CI 69·3–78·6) of patients in the selective laser Trabeculoplasty group required no drops to maintain intraocular pressure at target. Eyes of patients in the selective laser Trabeculoplasty group were within target intracoluar pressure at more visits (93·0%) than in the eye drops group (91·3%), with glaucoma surgery to lower intraocular pressure required in none versus 11 patients. Over 36 months, from an ophthalmology cost perspective, there was a 97% probability of selective laser Trabeculoplasty as first treatment being more cost-effective than eye drops first at a willingness to pay of £20 000 per quality-adjusted life-year gained. Interpretation: Selective laser Trabeculoplasty should be offered as a first-line treatment for open angle glaucoma and ocular hypertension, supporting a change in clinical practice. Funding: National Institute for Health Research, Health and Technology Assessment Programme.

  • The Cochrane Library - Laser Trabeculoplasty for open angle glaucoma
    The Cochrane database of systematic reviews, 2007
    Co-Authors: Christiane Rolim De Moura, Augusto Paranhos, Richard Wormald
    Abstract:

    Background Open angle glaucoma (OAG) is an important cause of blindness worldwide. Laser Trabeculoplasty, a treatment modality, still does not have a clear position in the treatment sequence. Objectives The objective of this review was to study the effects of laser Trabeculoplasty for OAG. Search methods We identified trials from CENTRAL in The Cochrane Library, MEDLINE, EMBASE, LILACS and manual searching. We also contacted researchers in the field. Selection criteria We included randomised controlled trials comparing laser Trabeculoplasty with no intervention, with medical treatment, or with surgery. We also included trials comparing different technical modalities of laser Trabeculoplasty. Data collection and analysis Two authors independently assessed trial quality and extracted the data. We contacted trial investigators for missing information. Main results This review included 19 trials involving 2137 participants. Only five trials fulfilled the criteria of good methodological quality. One trial compared laser Trabeculoplasty with topical beta-blocker to no intervention in early glaucoma. The risk of glaucoma progression was higher in the control group at six years of follow up (risk ratio (RR) 0.71 95% confidence interval (CI) 0.53 to 0.95). No difference in health-related quality of life was observed between the two groups. Three trials compared laser Trabeculoplasty to medication (regimens used before the 1990s) in people with newly diagnosed OAG. The risk of uncontrolled intraocular pressure (IOP) was higher in the medication group compared to the Trabeculoplasty group at six months and two years of follow up. Three trials compared laser Trabeculoplasty with trabeculectomy. The risk of uncontrolled IOP was significantly higher in the Trabeculoplasty group at six months but significant heterogeneity was observed at two years. Diode and selective laser are compared to argon laser Trabeculoplasty in three trials and there is some evidence showing a comparable effect in controlling IOP at six months and one year of follow up. Authors' conclusions Evidence suggests that, in people with newly diagnosed OAG, the risk of uncontrolled IOP is higher in people treated with medication used before the 1990s when compared to laser Trabeculoplasty at two years follow up. Trabeculoplasty is less effective than trabeculectomy in controlling IOP at six months and two years follow up. Different laser technology and protocol modalities were compared to the traditional laser Trabeculoplasty and more evidence is necessary to determine if they are equivalent or not. There is no evidence to determine the effectiveness of laser Trabeculoplasty compared to contemporary medication (prostaglandin analogues, topical anhydrase inhibitors and alpha2-agonists) and also with contemporary surgical techniques. Also there should be further investigation in to the effectiveness of laser Trabeculoplasty in specific racial groups, specific diagnostic groups, such as pseudoexfoliation and pigmentary glaucoma and different stages of OAG. More research is also required determining cost-effectiveness of laser Trabeculoplasty in the management of glaucoma.

  • laser Trabeculoplasty for open angle glaucoma
    Cochrane Database of Systematic Reviews, 2007
    Co-Authors: Christiane Rolim De Moura, Augusto Paranhos, Richard Wormald
    Abstract:

    Background Open angle glaucoma (OAG) is an important cause of blindness worldwide. Laser Trabeculoplasty, a treatment modality, still does not have a clear position in the treatment sequence. Objectives The objective of this review was to study the effects of laser Trabeculoplasty for OAG. Search methods We identified trials from CENTRAL in The Cochrane Library, MEDLINE, EMBASE, LILACS and manual searching. We also contacted researchers in the field. Selection criteria We included randomised controlled trials comparing laser Trabeculoplasty with no intervention, with medical treatment, or with surgery. We also included trials comparing different technical modalities of laser Trabeculoplasty. Data collection and analysis Two authors independently assessed trial quality and extracted the data. We contacted trial investigators for missing information. Main results This review included 19 trials involving 2137 participants. Only five trials fulfilled the criteria of good methodological quality. One trial compared laser Trabeculoplasty with topical beta-blocker to no intervention in early glaucoma. The risk of glaucoma progression was higher in the control group at six years of follow up (risk ratio (RR) 0.71 95% confidence interval (CI) 0.53 to 0.95). No difference in health-related quality of life was observed between the two groups. Three trials compared laser Trabeculoplasty to medication (regimens used before the 1990s) in people with newly diagnosed OAG. The risk of uncontrolled intraocular pressure (IOP) was higher in the medication group compared to the Trabeculoplasty group at six months and two years of follow up. Three trials compared laser Trabeculoplasty with trabeculectomy. The risk of uncontrolled IOP was significantly higher in the Trabeculoplasty group at six months but significant heterogeneity was observed at two years. Diode and selective laser are compared to argon laser Trabeculoplasty in three trials and there is some evidence showing a comparable effect in controlling IOP at six months and one year of follow up. Authors' conclusions Evidence suggests that, in people with newly diagnosed OAG, the risk of uncontrolled IOP is higher in people treated with medication used before the 1990s when compared to laser Trabeculoplasty at two years follow up. Trabeculoplasty is less effective than trabeculectomy in controlling IOP at six months and two years follow up. Different laser technology and protocol modalities were compared to the traditional laser Trabeculoplasty and more evidence is necessary to determine if they are equivalent or not. There is no evidence to determine the effectiveness of laser Trabeculoplasty compared to contemporary medication (prostaglandin analogues, topical anhydrase inhibitors and alpha2-agonists) and also with contemporary surgical techniques. Also there should be further investigation in to the effectiveness of laser Trabeculoplasty in specific racial groups, specific diagnostic groups, such as pseudoexfoliation and pigmentary glaucoma and different stages of OAG. More research is also required determining cost-effectiveness of laser Trabeculoplasty in the management of glaucoma.

M. Marc Abreu - One of the best experts on this subject based on the ideXlab platform.

  • Effect of topical anti-inflammatory treatment on the long-term outcome of laser Trabeculoplasty ☆
    American Journal of Ophthalmology, 1998
    Co-Authors: Bernice K. Glover, Ronald E. P. Frenkel, Dong H. Shin, M. Marc Abreu
    Abstract:

    Abstract PURPOSE: To investigate the effect of anti-inflammatory treatment on the long-term outcome of argon laser Trabeculoplasty, we extended the short-term study of the Fluorometholone-Laser Trabeculoplasty Study Group. METHODS: Among the chronic open-angle glaucoma patients randomly assigned to the 0.25% fluorometholone or placebo eyedrops four times daily before and after argon laser Trabeculoplasty in the Fluorometholone-Laser Trabeculoplasty Study, the long-term records of 27 patients (13 eyes in the fluorometholone group and 14 eyes in the placebo group) were available for our review and analysis. RESULTS: There were no statistically significant differences in the success rate of argon laser Trabeculoplasty between the fluorometholone and control groups over the follow-up period of 4.6 ± 3.4 years. CONCLUSION: While it decreased ocular inflammation and discomfort during the early postoperative period, peri–argon laser Trabeculoplasty use of a topical corticosteroid did not influence the long-term intraocular pressure outcome of argon laser Trabeculoplasty.

Ronald E. P. Frenkel - One of the best experts on this subject based on the ideXlab platform.

  • Effect of topical anti-inflammatory treatment on the long-term outcome of laser Trabeculoplasty ☆
    American Journal of Ophthalmology, 1998
    Co-Authors: Bernice K. Glover, Ronald E. P. Frenkel, Dong H. Shin, M. Marc Abreu
    Abstract:

    Abstract PURPOSE: To investigate the effect of anti-inflammatory treatment on the long-term outcome of argon laser Trabeculoplasty, we extended the short-term study of the Fluorometholone-Laser Trabeculoplasty Study Group. METHODS: Among the chronic open-angle glaucoma patients randomly assigned to the 0.25% fluorometholone or placebo eyedrops four times daily before and after argon laser Trabeculoplasty in the Fluorometholone-Laser Trabeculoplasty Study, the long-term records of 27 patients (13 eyes in the fluorometholone group and 14 eyes in the placebo group) were available for our review and analysis. RESULTS: There were no statistically significant differences in the success rate of argon laser Trabeculoplasty between the fluorometholone and control groups over the follow-up period of 4.6 ± 3.4 years. CONCLUSION: While it decreased ocular inflammation and discomfort during the early postoperative period, peri–argon laser Trabeculoplasty use of a topical corticosteroid did not influence the long-term intraocular pressure outcome of argon laser Trabeculoplasty.

  • Effect of Topical Anti-inflammatory Treatment on the Outcome of Laser Trabeculoplasty
    American journal of ophthalmology, 1996
    Co-Authors: Dong H. Shin, Ronald E. P. Frenkel, Robert David, Janet K. Cheetham
    Abstract:

    Purpose We investigated the effect of antiinflammatory treatment on the outcome of argon laser Trabeculoplasty. Methods In this multicenter, double-masked, randomized, placebo-controlled, parallel comparison study, 140 chronic open-angle glaucoma patients received either 0.25% fluorometholone or vehicle four times a day unilaterally, beginning 24 hours before and continuing one week after argon laser Trabeculoplasty. The laser surgeon placed 50 to 60 burns over the inferior 180 degrees of the trabecular meshwork. The patients were followed up frequently for five weeks after the procedure. Results Following argon laser Trabeculoplasty, signs of anterior chamber inflammation were significantly lower in the fluorometholone group. However, there was no significant difference between the fluorometholone and the vehicle groups in the incidence of increased intraocular pressure in the immediate post-argon laser Trabeculoplasty period. Intraocular pressure decreased significantly in both groups from day 1 throughout the follow-up period. A significant between-group difference in intraocular pressure decrease was found only at week 5 (7.83 ± 6.27 [S.D.] mm Hg for the fluorometholone group vs 6.63 ± 5.79 mm Hg for the vehicle group, P = .046). No drugrelated clinically significant adverse events were observed. Conclusions Use of fluorometholone is effective in attenuating inflammation and has no clinically significant impact on the outcome of argon laser Trabeculoplasty or on the incidence of intraocular pressure spikes during the immediate postargon laser Trabeculoplasty period.