Reopening of occluded filtering blebs by argon laser photocoagulation

We attempted to re-establish filtration in 11 glaucomatous eyes of patients who had undergone fistulizing surgery in the past, had poor or no filtration at various periods of time after surgery, and intraocular pressure above normal levels. Our technique consisted of applying an argon laser beam to the anterior chamber angle at the sclerotomy site of previous filtering and anterior to the iridectomy. Approximately 200 spots of 50 mu size were applied to this target with the help of a Goldmann prismatic goniolens. In five of 11 eyes the fistulizing blebs showed signs of activity shortly after the laser treatment with normalization of IOP during a follow-up period of over one year. Success was obtained in eyes with incomplete scarring of their fistulizing blebs with poor and nonfunctioning filtering cysts. Pigmentation of the target at the occluded sclerotomy site was significant.