Does lacrimal duct occlusion decrease intraocular pressure in patients refractory to medical treatment for glaucoma? A randomized, sham-controlled, crossover trial.
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.
Duke Scholars
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Random Allocation
- Prostheses and Implants
- Ophthalmic Solutions
- Nasolacrimal Duct
- Lacrimal Apparatus
- Intraocular Pressure
- Humans
- Glaucoma
- Epidemiology
- Double-Blind Method
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Random Allocation
- Prostheses and Implants
- Ophthalmic Solutions
- Nasolacrimal Duct
- Lacrimal Apparatus
- Intraocular Pressure
- Humans
- Glaucoma
- Epidemiology
- Double-Blind Method