Long-term follow-up of argon laser trabeculoplasty for uncontrolled open-angle glaucoma

Between May 1978 and October 1981, 82 phakic eyes in 72 patients with uncontrolled open-angle glaucoma underwent 360 degrees argon laser trabeculoplasty. Continued long-term follow-up has shown a decreasing pressure-lowering effect. The peak pressure lowering was 9.7 mm Hg at two months, 7.3 mm Hg at two years, 6.8 mm Hg at four years, and 4.9 mm Hg at five years. In 1982, we reported a 77% success rate, but, after five years of observation, the success rate is 46%. However, our clinical population is unique in that the majority of our patients (57%) are black. The most important factor in the long-term success rate appears to be race. Only 32% of cases involving black patients were successful, while 65% of cases involving white patients were successful. A Kaplan-Meier survival curve analysis revealed that the median time to an intraocular pressure greater than 21 mm Hg was 12 months for black patients and 60 months for white patients.