The medium and long‐term efficacy of primary argon laser trabeculoplasty in avoiding topical medication in open angle glaucoma

Abstract

Results: The probability of treatment success (no medication required) was for chronic open angle glaucoma 77% after 2 years, 67% after 5 years and 67% after 8 years. Corresponding numbers for pseudoexfoliation glaucoma were 80%, 54% and 36%. Prelaser IOP higher than 31 mmHg, pretreatment visual field defect and sparse pigmentation of the trabecular meshwork were independent predictors of failure. Conclusion: Primary argon laser trabeculoplasty gives a long-lasting and favourable effect in chronic open angle glaucoma where 2/3 of the eyes still managed without additional medication for 8 years. The success in pseudoexfoliation glaucoma was even higher the first 3 years, and kept above 50% for 5 years. This makes laser a valuable option as first choice of therapy in glaucoma.Key words: open angle glaucoma -pseudoexfoliation glaucoma -argon laser trabeculoplastyprimary treatment -long-term results -quality of life.

Effects of Argon Laser Trabeculoplasty in the Early Manifest Glaucoma Trial

“…In Moorefields Primary Treatment Trial, IOP reduction was 14 mmHg after 6 monhts, but from a high average pre-treatment level of 35 mmHg. 16 Other investigators [17][18][19][20][21][22][23][24][25] have published values ranging from 5.9 to 12.1 mmHg. There are three possible explanations for these differences:…”

Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

“…3 Overall, studies indicate about 40% of PXFS patients will develop glaucoma. 4 The reported prevalence of PXFS among patients with open-angle glaucoma also shows considerable geographic variation with 26% in Denmark, 75% in Sweden, 60% in Norway, 46.9% in the Mediterranean area of Turkey and 44.5% in the northwest of Spain compared with reports of 1% to 12% in the United States. 5 …”

“…Primary ALT maybe considered in PXFG. In a long-term study, 46 the probability of success after primary ALT was 80% after 2 years, 54% after 5 years and 36% after 8 years in PXFG.…”

Comparative evaluation of diode laser trabeculoplasty vs frequency doubled Nd : YAG laser trabeculoplasty in primary open angle glaucoma

“…With confirmation, that the pressure lowering effect is good, the concept of using ALT as the primary treatment for POAG has become popular. [4][5][6][7][8] Coagulative laser treatment for retinal diseases has shifted to the diode and frequency doubled Nd : YAG lasers and these have almost replaced the use argon lasers in ophthalmic hospitals. The efficacy of ALT has been well proven [4][5][6][7][8] but there are very few studies showing the efficacy of DLT and YLT.…”

“…[4][5][6][7][8] Coagulative laser treatment for retinal diseases has shifted to the diode and frequency doubled Nd : YAG lasers and these have almost replaced the use argon lasers in ophthalmic hospitals. The efficacy of ALT has been well proven [4][5][6][7][8] but there are very few studies showing the efficacy of DLT and YLT. [9][10][11][12][13] To our knowledge, there are no studies comparing the efficacy of DLT to YLT.…”