A study for the AGES! In the AGIS study, 789 eyes with medically recalcitrant open-angle glaucoma (OAG) were randomized to two different treatment sequences: argon laser trabeculoplasty - trabeculectomy - trabeculectomy (ATT; n=404) and trabeculectomy - argon laser trabeculoplasty - trabeculectomy (TAT; n=385). The primary outcomes include visual field (VF) & visual acuity (VA), and other outcomes included intraocular pressure (IOP), surgical complications, time to treatment failure, additional medical therapy needed.
Overall, the AGIS study is a landmark study because it studied varying sequences of surgical and procedural interventions in glaucoma patients. The key conclusion at the time surrounded the different optimal treatment algorithm for white and black patients. However, given the development of treatment options such as SLT and MIGS since the study, the outcomes of the study should be considered in the context of the times of the study.
- Compared to TAT, ATT provided less overall loss of visual acuity (VA) and visual field (VF) in black patients, whereas white patients with TAT had less overall VA & VF loss.
- Less visual field loss was associated with an average IOP of 14mmHg or less during the first 18 months after the first surgical intervention, as well as for eyes with IOP of 18mm Hg or less for all study visits.
- Younger age and higher IOP were related to decreased ALT efficacy.