Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2021
[Laser trials].
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Hommer Nikolaus, Hommer Anton
Аннотация
This article presents some high-quality and/or frequently cited glaucoma studies. The LiGHT study, which compared selective laser trabeculoplasty (SLT) with eye drops for reducing intraocular pressure (IOP) in ocular hypertension or early primary open-angle glaucoma (POAG), a British study on real-world results after SLT treatment and the ZAP study, which evaluated the effectiveness and safety of prophylactic peripheral iridotomy in suspected bilateral angle closure. The primary endpoint of the LiGHT study was health-related quality of life (HRQoL) after 3 years. Furthermore, the costs and cost-effectiveness, disease-specific HRQoL, clinical effectiveness and safety were compiled. The SLT group achieved the target ocular pressure with more visits than the eye drops group. The authors stated that a cost analysis was in favor of the laser group and therefore recommend SLT as a first-line treatment for open-angle glaucoma and ocular hypertension. Nevertheless, there are limitations of this trial. The publication by Khawaja et al. on the results after SLT treatment shows that SLT initially has a good effectiveness but this decreases from 70 to 27% after 2 years. The authors also name further limitations of SLT, as its effectiveness depends on the concomitant medication, initial IOP and the severity of glaucoma. The aim of the ZAP trial was to investigate the efficacy and safety of prophylactic laser peripheral iridotomy in primary angle closure glaucoma in a Chinese study population. Their results indicate that prophylactic laser iridotomy for suspected angle closure is not to be recommended. This study also has limitations and further studies on this topic are necessary.