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Argon laser trabeculoplasty in narrow angle glaucoma
P K Wishart1, S Nagasubramanian, R A Hitchings
1Glaucoma Unit, Moorfields Eye Hospital, London.
Eye (London, England)
|January 1, 1987
Summary
Argon laser trabeculoplasty is ineffective for narrow angle glaucoma, especially with visual field loss. Relieving pupil block alone may benefit early cases without vision damage.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Laser Therapy
Background:
- Narrow angle glaucoma (NAG) involves pupil block and increased outflow resistance.
- Effective treatment for NAG requires addressing both pupil block and outflow resistance.
Purpose of the Study:
- To evaluate the efficacy of argon laser trabeculoplasty (ALT) in narrow angle glaucoma (NAG).
- To assess different methods for pupil block relief prior to or in conjunction with ALT.
Main Methods:
- Prospective trial involving 52 eyes with NAG.
- Treatments included laser iridotomy (LI), peripheral iridectomy (PI), and argon laser iridoplasty (IP) before or instead of ALT.
- Follow-up ranged from 12 to 22 months.
Main Results:
- High failure rate in controlling intraocular pressure (IOP) and preventing visual field loss across all groups.
- Iridoplasty followed by ALT led to progressive synechial closure in 50% of cases.
- ALT combined with PI/LI showed limited IOP control (12% improved) and satisfactory outcomes in only 24% of eyes with visual field loss.
- Eyes treated with PI/LI without ALT had a 90% satisfactory outcome.
Conclusions:
- Argon laser iridoplasty followed by ALT is unsuitable for NAG.
- ALT is unlikely to benefit NAG eyes with existing visual field loss, even after pupil block relief.
- Relief of pupil block alone may be beneficial for early NAG without visual field loss.