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Advanced Glaucoma Intervention Study (AGIS)

This study is ongoing, but not recruiting participants.

Sponsored by: National Eye Institute (NEI)
Information provided by: National Eye Institute (NEI)
ClinicalTrials.gov Identifier: NCT00000148
  Purpose

To assess the long-range outcomes of sequences of interventions involving trabeculectomy and argon laser trabeculoplasty in eyes that have failed initial medical treatment for glaucoma.


Condition Intervention Phase
Glaucoma
Procedure: Argon Laser Trabeculoplasty
Procedure: Trabeculectomy
Phase III

Genetics Home Reference related topics:   early-onset glaucoma   

MedlinePlus related topics:   Glaucoma   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Randomized, Efficacy Study

Further study details as provided by National Eye Institute (NEI):

Study Start Date:   April 1988

Detailed Description:

In advanced glaucoma, medication alone no longer reduces intraocular pressure adequately, and the eye has field defects. Before 1980, some type of filtering surgery, such as trabeculectomy, was the usual method of intervention. Since then, laser trabeculoplasty has become a popular alternative. Sometimes the first intervention chosen succeeds in controlling pressure for many years; at other times, the success lasts only a few weeks or months. Because success is limited, some patients, over time, need to undergo a sequence of surgical interventions. Little is known about which sequence gives the best long-range outcome.

The Advanced Glaucoma Intervention Study (AGIS) is designed to provide a comprehensive assessment of the long-range outcomes of medical and surgical management in advanced glaucoma. The study uses visual function status to compare two intervention sequences in managing the disease.

Eligible eyes are randomly assigned to one of two intervention sequences: (1) trabeculectomy, followed by argon laser trabeculoplasty (ALT) should trabeculectomy fail, followed by a second trabeculectomy should ALT fail; or (2) ALT, followed by trabeculectomy should ALT fail, followed by another trabeculectomy should the first trabeculectomy fail. Antifibrotic agents may be used as an adjunct to trabeculectomy, but only in eyes with a previous history of invasive surgery. Eyes that fail the entire assigned sequence of interventions are managed at the discretion of the AGIS physician in collaboration with the patient.

Interventions are supplemented with medical treatment as needed. A total of 789 eyes with advanced glaucoma have been enrolled. All patients are being followed under a standardized protocol for a minimum of 5 years to determine degree of visual function loss, failure rates of interventions, rates of complications, and need for supplemental therapy.

After the initial intervention, followup examinations are scheduled at 1 week, 4 weeks, 3 months, 6 months, and every 6 months thereafter. After second and third interventions, followup examinations are scheduled at 1 and 4 weeks. Additional visits are scheduled as necessary for the management of the disease.

The primary outcome variable in AGIS is average percent of eyes with decrease of vision, where decrease of vision is a substantial decline of either visual field or visual acuity attributable to the effect of glaucoma. Secondary outcome variables include sustained decrease of vision, failure of interventions, number of prescribed glaucoma medications, and level of intraocular pressure. An ancillary study is assessing filtering bleb encapsulation.

  Eligibility
Ages Eligible for Study:   35 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

Men and women between the ages of 35 and 80 with open-angle glaucoma that was not successfully controlled by medication were eligible for enrollment.

  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00000148

Locations
United States, Connecticut
Yale University School of Medicine, Yale Eye Center    
      New Haven, Connecticut, United States
United States, District of Columbia
Georgetown University, University Ophthalmic Consultants of Washington, Eye Associates of Washington, D.C.    
      Washington, District of Columbia, United States
United States, Georgia
Emory University, Emory Eye Center    
      Atlanta, Georgia, United States
Piedmont Hospital, Eye Consultants of Atlanta    
      Atlanta, Georgia, United States
United States, Illinois
University of Illinois, Eye and Ear Infirmary    
      Chicago, Illinois, United States
Humana Health Plan Sykes Center    
      Chicago, Illinois, United States
United States, Maryland
Washington Hospital Center, Washington Eye Physicians and Surgeons    
      Chevy Chase, Maryland, United States
United States, Michigan
University of Michigan, W.K. Kellogg Eye Center    
      Ann Arbor, Michigan, United States
Sinai Hospital, Detroit, Franklin Eye Consultants    
      Southfield, Michigan, United States
United States, Ohio
Ohio State University, Department of Ophthalmology, Ophthalmic Surgeons and Consultants    
      Columbus, Ohio, United States
United States, Pennsylvania
Wills Eye Hospital, Glaucoma Service    
      Philadelphia, Pennsylvania, United States
United States, Virginia
University of Virginia Medical Center, Department of Ophthalmology    
      Charlottesville, Virginia, United States
Medical College of Virginia, Department of Ophthalmology    
      Richmond, Virginia, United States

Sponsors and Collaborators
  More Information


NEI Press Release-Blacks, Whites Benefit from Different Surgical Glaucoma Treatments  This link exits the ClinicalTrials.gov site
 

Publications:

Study ID Numbers:   NEI-49
First Received:   September 23, 1999
Last Updated:   June 2, 2006
ClinicalTrials.gov Identifier:   NCT00000148
Health Authority:   United States: Federal Government

Study placed in the following topic categories:
Glaucoma
Eye Diseases
Hypertension
Ocular Hypertension

ClinicalTrials.gov processed this record on December 03, 2008




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