NDLI: A study of initial therapy for glaucoma in southern India: India Glaucoma Outcomes and Treatment (INGOT) Study.

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A study of initial therapy for glaucoma in southern India: India Glaucoma Outcomes and Treatment (INGOT) Study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Congdon, Nathan G. Krishnadas, R. Friedman, David S. Goggins, William Ramakrishnan, R. Kader, M. A. Gilbert, Donna Tielsch, James Quigley, Harry A.
Spatial Coverage	India
Description	Author Affiliation: Congdon NG ( Zhongshan Ophthalmic Center, State Key Laboratory and Division of Preventive Ophthalmology, Sun Yat Sen University, Guangzhou, PRC. ncongdon1@gmail.com)
Abstract	PURPOSE: To compare initial glaucoma therapy with medications and trabeculectomy in southern India. METHODS: Patients aged ≥ 30 years newly diagnosed with glaucoma were randomized to trabeculectomy with 5-fluorouracil or medical therapy. Subjects with best-corrected vision <6/18 due to cataract underwent phacoemulsification (phaco/intraocular lens, IOL). Intraocular pressure (IOP), vision and visual function were assessed at 12 months. RESULTS: Patients assigned to medications and surgery received the expected therapy in 86% (172/199) and 64% (126/199) of cases, respectively. Forty patients (20%) assigned to surgery refused any treatment and 33 (17%) received medications. Among 199 patients randomized to medications, 52 (26.1%) underwent phaco/IOL, as did 89/199 (43.7%) of patients randomized to trabeculectomy. Baseline parameters of the two groups did not differ, nor did 1-year follow-up rates (medication 65%, trabeculectomy 58%, P = 0.15). Final IOP was lower with randomization to trabeculectomy (16.3 ± 5.1 mmHg) than medication (18.8 ± 6.7 mmHg, P < 0.0001). In regression models, randomization to trabeculectomy (P < 0.0001) was associated with lower IOP, and simultaneous trabeculectomy and cataract surgery was associated with higher IOP (P = 0.008) than trabeculectomy alone. Subjects receiving Phaco/IOL had significantly better final acuity (P < 0.0001) and visual function (P = 0.035), despite concurrent glaucoma treatment. Final visual acuity was worse in those receiving trabeculectomy in addition to cataract surgery, but this was of borderline significance (P = 0.06). CONCLUSIONS: Trabeculectomy lowered IOP significantly more than medical treatment, but with slightly greater loss of visual acuity. Combined phaco/IOL and trabeculectomy improved visual acuity with substantial IOP lowering.
File Format	HTM / HTML
ISSN	09286586
Issue Number	3
Volume Number	19
e-ISSN	17445086
Journal	Ophthalmic Epidemiology
Language	English
Publisher	Taylor & Francis
Publisher Date	2012-06-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Ophthalmology Discipline Epidemiology Antihypertensive Agents Therapeutic Use Glaucoma Drug Therapy Surgery Trabeculectomy Aged Antimetabolites, Antineoplastic Administration & Dosage Brimonidine Tartrate Drug Combinations Female Fluorouracil Physiopathology Humans India Intraocular Pressure Physiology Lens Implantation, Intraocular Male Middle Aged Phacoemulsification Prospective Studies Prostaglandins F, Synthetic Quinoxalines Sulfonamides Questionnaires Thiophenes Timolol Tonometry, Ocular Visual Acuity Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Ophthalmology Epidemiology

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