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Date: December 15, 1995 For Immediate Release Contact: NEI (301) 496-5248 or JAS@B31,nei.nih.gov
The finding comes from a followup study of patients in the nationwide Glaucoma Laser Trial (GLT), sponsored by the National Eye Institute of the National Institutes of Health. The study was done to learn if early laser treatment is safe and whether it offers any medical advantages over eyedrops for newly diagnosed open-angle glaucoma.
After some 7 years of followup, all measures used to evaluate the two treatments showed that the "laser first" eyes and the "medication first" eyes had a similar status on all measures used to evaluate the two treatments. Researchers assessed changes in the patient's visual field, visual acuity (sharpness), intraocular pressure, and optic nerve.
"Our results suggest that initial treatment with laser is at least as effective as initial treatment with eyedrops," said Hugh Beckman, M.D. of Sinai Hospital in Detroit, the study's chairman.
However, researchers cautioned that neither treatment method is a "magic bullet" for long-term control of glaucoma. They noted that two years after the start of treatment, 56 percent of "laser first" eyes and 70 percent of "medication first" eyes needed new or extra medications to control pressure inside the eye.
Carl Kupfer, M.D., director of the National Eye Institute, stated that whichever first treatment is chosen for newly diagnosed glaucoma, "the disease is a long-term, chronic illness that must be controlled over the patient's lifetime in order to save vision."
About 3 million Americans have open-angle glaucoma, the most common form of glaucoma in the U.S. For unknown reasons, small changes within the eye gradually interfere with the normal flow of fluids that feed tissues in the front of the eye. If these fluids do not drain properly, the resulting higher pressure inside the eye can damage the optic nerve and narrow the field of vision. This change happens so slowly that many people are not diagnosed with glaucoma until they have significant loss of vision.
A total of 271 patients were enrolled in the initial GLT. Each patient had laser treatment in one eye and medication in the other eye. The final results on 203 patients who were followed for an average of 7 years after treatment were reported in today's American Journal of Ophthalmology.
Researchers noted that both treatments caused side effects. However, the side effects of laser treatment were temporary or made no apparent difference in the long run, while the side effects of eyedrops were troublesome for some patients for as long as the drops were used. Eyedrops used for glaucoma treatment can cause discomfort in the eye, blurry vision, headaches, and fast or slow heartbeat.
In 34 percent of "laser first" eyes the laser treatment caused a temporary jump in intraocular pressure for the first few days after treatment. Also, some 30 percent of the "laser first" eyes developed peripheral anterior synechiae--adhesions that form when the iris sticks to part of the cornea. However, on all clinical measures the eyes with adhesions were the same as eyes with no adhesions.
(A list of participating clinical centers follows):
Georgia Illinois
M. Angela Vela-Thomas, M.D. Jacob Wilensky, M.D.
Emory Eye Center University of Illinois Eye
2004 Peachtree Road, N.W. and Ear Infirmary
Atlanta, GA 30367 1855 West Taylor Street
[Dr. Vela-Thomas is now in Chicago, IL 60612
private practice and can be (312) 996-7030
reached at (404) 351-0770]
Massachusetts Michigan
Joseph Krug, Jr., M.D. Hugh Beckman, M.D. (Study Chairman)
Massachusetts Eye and Ear Infirmary Sinai Hospital of Detroit
243 Charles Street 6767 West Outer Drive
Boston, MA 02114 Detroit, MI 48235
[Dr. Krug is now in private (313) 493-5157
practice and can be reached
at (704) 377-4448]
New York Ohio
Robert Ritch, M.D. Paul Weber, M.D.
New York Eye and Ear Ohio State University
Infirmary 456 West 10th Avenue
310 East 14th Street Columbus, OH 43210
New York, NY 10003 (614) 293-8119
(212) 477-7540
Pennsylvania Wisconsin
George Spaeth, M.D. Ronald Radius, M.D. (retired>
Wills Eye Hospital Medical College of Wisconsin
9th and Walnut Streets Milwaukee County Medical Complex
Philadelphia, PA 19107 8700 West Wisconsin Avenue
(215) 928-3429 Milwaukee, WI 53226
(414) 257-6034
Resource Centers
Study Chairman Coordinating Center
Hugh Beckman, M.D. Curtis Meinert, Ph.D.
Sinai Hospital of Detroit School of Hygiene and Public Health
6767 West Outer Drive The Johns Hopkins University
Detroit, MI 48235 615 North Wolfe Street, Room 5010
(313) 493-5157 Baltimore, MD 21205
(410) 955-8198
Disc Stereophotography Reading Center Visual Field Reading Center
George Spaeth, M.D. Jacob Wilensky, M.D.
Wills Eye Hospital University of Illinois Eye
9th and Walnut Streets and Ear Infirmary
Philadelphia, PA 19107 1855 West Taylor Street
(215) 928-3429 Chicago, IL 60612
(312) 996-7030