Ontology highlight
ABSTRACT: Objective
To evaluate whether beta radiation may offer a practical method of improving surgical success for glaucoma drainage surgery in South Africa.Design
Double blind, randomised controlled trial.Setting
Three public hospitals in South Africa.Participants
450 black Africans with primary glaucoma.Interventions
Trabeculectomy with 1000 cGy beta radiation or standard trabeculectomy without beta radiation (placebo).Main outcome measures
Primary outcome measure was surgical failure within 12 months (intraocular pressure > 21 mm Hg while receiving no treatment for ocular hypotension). Secondary outcomes were visual acuity, surgical reintervention for cataract, and intraoperative and postoperative complications.Results
320 people were recruited. beta radiation was given to 164; 20 (6%) were not seen again after surgery. One year after surgery the estimated risk of surgical failure was 30% (95% confidence interval 22% to 38%) in the placebo arm compared with 5% (2% to 10%) in the radiation arm. The radiation group experienced a higher incidence of operable cataract (18 participants) than the placebo group (five participants; P = 0.01). At two years the estimated risks with placebo and beta radiation were, respectively, 2.8% (0.9% to 8.3%) and 16.7% (10.0% to 27.3%).Conclusion
beta radiation substantially reduced the risk of surgical failure after glaucoma surgery. Some evidence was, however, found of an increased risk for cataract surgery (a known complication of trabeculectomy) in the beta radiation arm during the two years after surgery.Trial registration
ISRCTN62430622 [controlled-trials.com].
SUBMITTER: Kirwan JF
PROVIDER: S-EPMC1633773 | biostudies-literature | 2006 Nov
REPOSITORIES: biostudies-literature
BMJ (Clinical research ed.) 20061005 7575
<h4>Objective</h4>To evaluate whether beta radiation may offer a practical method of improving surgical success for glaucoma drainage surgery in South Africa.<h4>Design</h4>Double blind, randomised controlled trial.<h4>Setting</h4>Three public hospitals in South Africa.<h4>Participants</h4>450 black Africans with primary glaucoma.<h4>Interventions</h4>Trabeculectomy with 1000 cGy beta radiation or standard trabeculectomy without beta radiation (placebo).<h4>Main outcome measures</h4>Primary outc ...[more]