METHODS OF ARGON-LASER TRABECULOPLASTY, COMPLICATIONS AND LONG-TERM FOLLOW-UP OF THE RESULTS

  • 1 January 1985
    • journal article
    • research article
    • Vol. 29  (2) , 198-211
Abstract
A laser trabeculoplasty (ALT) was performed on 125 eyes with primary open-angle glaucoma (POAG) and 32 eyes with capsular glaucoma; all eyes were surgical candidates where maximum tolerable medication had failed to control the intraocular pressure (IOP) below 20 mm Hg. There were 93 eyes of men and 64 eyes of women, in the 20-40 yr age range. Three methods were used: Group 1, 36 eyes treated with .apprx. 100 laser shots to the trabecular pigment band over 360.degree. ; Group 2, 84 eyes with about 50 shots to the pigment band over 180.degree.; and Group 3, 37 eyes with similar treatment to the anterior part of the trabecular band. The frequency of the initial IOP rise and the maximum postoperative IOP level were in the order of Groups 1, 2 and 3. Other complications, iritis, hemorrhage and peripheral anterior synechiae, were most frequent in Group 1. The success rate of the postoperative IOP control below 20 mm Hg with continued medication was analyzed by the life-table method: it was 39 .+-. 8% over the period averaging 39 mo. in Group 1, 66.5 .+-. 6% over 17.3 mo. in Group 2 and 33.7 .+-. 15% over 8.1 mo. in Group 3. The ALT over 180.degree. aimed at the pigment band gave better IOP control with less complications than 360.degree. ALT. The success rate in the eyes of Group 2 was 57 .+-. 6% and 94 .+-. 6% in POAG and capsular glaucoma, respectively. The IOP distribution after the ALT had a peak at 16-17 mm Hg; the IOP was lower than 15 mm Hg in about 21% of the eyes. Concurrent IOP measurement and tonography revealed that the IOP reduction after ALT was due largely to a reduction of the outflow resistance in the aqueous outflow channel.

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