Late failures of trabeculoplasty

The effects of trabeculoplasty, or Argon laser trabeculoretraction (A.L.T.R.) resulting from a study pursued over two years in 194 eyes, over 3 years in 45 eyes, and over 4 years in 22 eyes, show early and late failures. 151 phakic patients (76 women and 75 men aged between 25 and 93 with an average of 67 years) were treated. After a follow-up of two years we have an intra-ocular pressure (I.O.P.) drop of 6.93 mmHg and a failure rate of 28%; after a follow-up of 3 years the I.O.P. drop is 6.30 mmHg and the failure rate 36%; after a follow-up of 4 years the I.O.P. drop is 7.87 mmHg and the failure rate 41%. The initial medical treatment could be decreased in less than 50% of the cases. The frequency of failure is more important in the presurgical glaucoma with an intra-ocular pressure higher than 28 mmHg and submitted to maximum tolerated medical therapy. A.L.T.R. gives good results in combined mechanism glaucoma and after failure of trabeculectomy; a two-year follow-up shows similar efficacy in primary open angle glaucoma (P.O.A.G.) and in pigmentary glaucoma, bad results in myopic or in aphakic glaucoma (12 cases not included in this study) and 'escape' in pseudo-capsular glaucoma. The total study conducted over 4 years shows 10% new failure cases per year.(ABSTRACT TRUNCATED AT 250 WORDS)