Argon laser trabeculoplasty: long-term follow-up of at least 5 years

This retrospective study evaluates the long-term follow-up of 331 eyes of 219 patients treated with argon laser trabeculoplasty (ALT). A total of 258 eyes were included with a follow-up of at least 5 years. Success was defined as an intraocular pressure of under 22 mm Hg with a stable visual field and optic nerve head. Overall, 22% (58/258) were regulated after 5 years (glaucoma chronicum simplex 26%, pigment dispersion glaucoma 31%, pseudoexfoliation glaucoma 19%, angle-closure glaucoma 14%, secondary glaucoma 7%). Filtration surgery was performed in 13% (33/258) mainly (73%) in the first 3 years after ALT. Repeat ALT was done in 43% of the eyes, and 60% of these eyes with repeat ALT underwent filtration surgery in the first year. With repeat ALT the overall success rate increased to 38%. High initial intraocular pressure and the stage of glaucoma documented by the visual field loss correlated with the failure of ALT. These results indicate that ALT and re-ALT were effective in glaucomatous eyes, yet there was a substantial diminishing effect as time progressed. Therefore, close follow-up on ALT-treated patients is necessary.