Does lacrimal duct occlusion decrease intraocular pressure in patients refractory to medical treatment for glaucoma? A randomized, sham-controlled, crossover trial.

Journal Article (Clinical Trial;Journal Article)

We temporarily occluded lacrimal ducts with dissolvable collagen inserts in a randomized, double masked, sham-controlled crossover trial to test whether longer ocular contact of eye drops lowers intraocular pressure in patients with refractory glaucoma. Patients were randomized to the sequence temporary lacrimal duct occlusion----21 day washout----sham occlusion (6 patients), or the reverse order (5 patients); all maintained their usual medication. Compliance was greater than 90% for every patient as assessed by medication diaries kept by each patient's medication partner. There was no treatment effect (bivariate Wilcoxon chi 2 = 0.10, p = 0.95) or treatment-period interaction (chi 2 = 2.87, p = 0.24). However, whichever treatment was received first significantly lowered intraocular pressure (left eye first period X:[ipr50] = 3.0: [-6.0, -1.0] mmHg, right eye = -3.0:[-6.0, -1.0] mmHg, bivariate response chi 2 = 5.92, p = 0.05). Although lacrimal duct occlusion appears to have no clinical benefit, more careful supervision of eye drop administration may be efficacious for treating some patients with medically refractory glaucoma.

Full Text

Duke Authors

Cited Authors

  • Simel, DL; Simel, PJ

Published Date

  • 1988

Published In

Volume / Issue

  • 41 / 9

Start / End Page

  • 859 - 865

PubMed ID

  • 3183692

International Standard Serial Number (ISSN)

  • 0895-4356

Digital Object Identifier (DOI)

  • 10.1016/0895-4356(88)90102-3


  • eng

Conference Location

  • United States