[Laser Trabeculoplasty in Modern Glaucoma Therapy - a Review]

Laser trabeculoplasty (LTP) is a well established treatment modality in the management of chronic open angle glaucoma. Nonetheless there is much variation in practice.

A literature search in the PubMed database was conducted and the most important evidence-based results were summarised.

Argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) are safe and effective treatment modalities, achieving an IOP reduction of 20 - 30%. Similar success rates have been reported for both procedures. A 50% rate of failure occurs after 2 - 5 years. Repeat-ALT is associated with a lower IOP decrease and a shorter duration of treatment effect. Repetition of SLT after initial SLT seems to be associated with loss of efficiency as well. SLT has been shown to be successful after initial ALT, whereas there are no data on ALT after initial SLT. For advanced glaucoma on maximum medical therapy, low success rates have been reported with regard to additional interventions.

LTP is a good option for initial and adjunctive treatment. In advanced glaucoma on maximum medical therapy, low target pressures are needed, and filtering surgery has to be considered.