Ophthalmology Department, Universidade de São Paulo, São Paulo, SP, Brazil.
Centro de Excelência em Oftalmologia, Bauru, SP, Brazil.
Arq Bras Oftalmol. 2021 Jul-Aug;84(4):361-366. doi: 10.5935/0004-2749.20210052.
Glaucoma is the main cause of irreversible blindness worldwide. Peak intraocular pressure is one of the main risk factors for glaucoma progression, and intraocular pressure reduction remains the only therapeutic strategy for all types of glaucoma. The main purpose of our study was to compare the baseline and peak intraocular pressure reduction obtained with the water drinking test between the two eyes of the same patients using 0.005% latanoprost in one eye and selective laser trabeculoplasty application in the contralateral eye.
This was a prospective, interventional, longitudinal, and randomized clinical trial, in which 30 consecutive glaucomatous patients, medically controlled using latanoprost monotherapy, were recruited from a single ophthalmological center. The patients' eyes were randomized, and one eye was selected for SLT treatment and topical 0.005% latanoprost was introduced in the contralateral eye. The baseline intraocular pressure and peak intraocular pressure were evaluated 1 month (water drinking test 2) and 6 months (water drinking test 3) after treatment.
There was no significant difference between the mean pre-washout intraocular pressure in the randomized eyes for selective laser trabeculoplasty and latanoprost (13.6 ± 2.1 and 13.3 ± 1.8 mmHg, respectively; p=0.182). Regarding baseline intraocular pressure, there was no significant difference in the water drinking test 2 (p=0.689) and water drinking test 3 (p=0.06) between the groups. There was no significant difference in the intraocular pressure peak between the SLT and latanoprost groups at water drinking test 2 (p=0.771) or water drinking test 3 (p=0.774).
The intraocular pressure reduction efficacy is similar between latanoprost and selective laser trabeculoplasty. Glaucomatous patients who are medically controlled with latanoprost and switch treatment to selective laser trabeculoplasty maintain control of intraocular pressure.
青光眼是全球范围内导致不可逆性失明的主要原因。眼内压峰值是青光眼进展的主要危险因素之一，而降低眼内压仍然是所有类型青光眼的唯一治疗策略。我们研究的主要目的是比较单眼使用 0.005%拉坦前列素和对侧眼选择性激光小梁成形术应用时，同一患者双眼的基础眼压和眼压峰值的降低情况。
这是一项前瞻性、干预性、纵向和随机临床试验，共纳入 30 例连续的青光眼患者，这些患者使用拉坦前列素单药治疗，眼压得到了控制，均来自于一家眼科中心。将患者的眼睛随机分组，一只眼选择 SLT 治疗，另一只眼给予局部 0.005%拉坦前列素。在治疗后 1 个月（水负荷试验 2）和 6 个月（水负荷试验 3）评估基础眼压和眼压峰值。
选择性激光小梁成形术和拉坦前列素随机眼的预冲洗前平均眼压无显著差异（分别为 13.6±2.1mmHg 和 13.3±1.8mmHg；p=0.182）。关于基础眼压，水负荷试验 2（p=0.689）和水负荷试验 3（p=0.06）两组间无显著差异。水负荷试验 2（p=0.771）和水负荷试验 3（p=0.774）两组间的眼压峰值也无显著差异。
拉坦前列素和选择性激光小梁成形术的降眼压效果相似。使用拉坦前列素药物控制眼压的青光眼患者转换为选择性激光小梁成形术治疗后，仍能保持眼压控制。
