AGIS CLINIC

这是威尔斯眼科医院修改后的申请 参与晚期青光眼干预研究(AGIS)。 我们参加AGIS的资格是详细的，包括 病人有空时间。在截至6月的18个月期间， 1986年，56只符合AGIS标准的眼睛接受了我们中的一人的治疗(38眼 一年一双可食的眼睛)。自1986年6月以来，我们的外科手术能力 增加了。首席调查员加入了威尔斯之眼 医院工作人员和接受治疗的14只合格眼(28只合格眼 年)。这两名调查人员现在都参与了驻地服务 患者，预计每年有15只符合条件的眼睛。因此，我们， 预计每年总共有80只符合条件的眼睛。有50%的招聘 速度，40只眼应该进入一年。 AGIS的主要目标是系统地评估长期和长期的气候变化。 840只眼连续介入治疗的结果 青光眼的初步治疗都失败了。符合条件的眼睛 将被随机分配到两个干预序列中的一个；1) 小梁切除术(T)，然后行激光小梁成形术(ALT) 如果T失败，则第二个T将失败；以及2) 如果ALT失败，则按ALT后按T，然后按另一个T 如果第一个T失败了。眼睛没有通过指定的序列 三项干预措施将通过额外的手术进行管理。这个 干预措施将辅之以医疗，如 需要的。我们计划对所有患者进行五年的跟踪调查，以确定 视功能丧失程度、干预失败率和 干预顺序、并发症发生率和是否需要 补充治疗。眼部，全身， 将对个人、社会因素，包括合规进行研究。 参与机构将坚持共同、特定的 定义、资格标准、衡量方法以及 作为诊断、治疗、质量控制和管理 程序。协调中心将收集、处理和 分析研究数据和协调研究活动；政策和 治疗效果监测委员会将监督 这项研究。

This is a revised application from Wills Eye Hospital to participate in the Advanced Glaucoma Intervention Study (AGIS). Our qualifications to participate in AGIS are detailed, including patient availability. During the 18-month period ending June, 1986 56 AGIS-eligible eyes were treated by one of us (a rate of 38 elibible eyes a year). Since June 1986 our surgical capacity has increased. The principal investigator has joined the Wills Eye Hospital staff and treated 14 eligible eyes (28 eligible eyes a year). Both investigators are now involved with resident service patients, with an expected 15 eligible eyes a year. We, therefore, expect a total of 80 eligible eyes a year. With a 50% recruitment rate, 40 eyes should enter a year. The primary goal of the AGIS is to assess systematically the long- range outcomes of sequences of interventions in 840 eyes that have failed initial medical treatment of glaucoma. Eligible eyes will be randomly assigned to one of two intervention sequences; 1) trabeculectomy (T), followed by argon laser trabeculoplasty (ALT) should T fail, and followed by a second T should ALT fail; and 2) ALT followed by T should ALT fail, and followed by another T should the first T fail. Eyes that fail the assigned sequence of three interventions will be managed by additional surgery. The interventions will be supplemented with medical treatment as needed. We plan to follow all patients for five years to determine degree of visual function loss, rates of failure of interventions and intervention sequences, rates of complications, and need for supplemental therapy. The prognostic value of ocular, systemic, personal, and social factors, including compliance, will be studied. Participating institutions will adhere to common, specified definitions, eligibility criteria, methods of measurement, as well as diagnostic, treatment, quality control, and administrative procedures. A Coordinating Center will collect, process, and analyze study data and coordinate study activities; a Policy and Treatment Effects Monitoring Board will supervise the conduct of the study.