Four-year experience with argon laser trabecular surgery in uncontrolled open-angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research

Background:

• Open-angle glaucoma (OAG) management often requires advanced interventions.
• Argon laser trabecular surgery (ALTS) is a potential treatment option for OAG.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of 360-degree ALTS in phakic eyes with uncontrolled OAG.
• To identify factors influencing ALTS success rates.

Main Methods:

• Eighty-two phakic eyes with uncontrolled OAG underwent 360-degree ALTS.
• Success was defined by IOP reduction and long-term follow-up (mean 24 months).
• Patient demographics, glaucoma type, and baseline IOP were analyzed for correlation with success.

Main Results:

• A 77% success rate was observed in the successful group.
• Increased success was associated with exfoliation syndrome or OAG diagnosis, age >60, and baseline IOP <26 mmHg.
• Mean IOP decrease was 9.7 mmHg at 2 months, reducing to 5.9 mmHg by 42 months.
• Long-term tonographic data showed improved outflow through 30 months.

Conclusions:

• ALTS demonstrates an excellent risk-vs-benefit ratio for uncontrolled OAG.
• It is recommended for surgical candidates with uncontrolled OAG on maximum medical therapy.
• Patient selection based on age, diagnosis, and baseline IOP can optimize outcomes.