[Argon laser trabeculoplasty. Initial results of a prospective study]

This paper presents the results of a prospective study on argon laser trabeculoplasty with clinical application in 166 cases up to now. So far, patients have been followed up for between 2 and 12 months. Low-intensity coagulation was performed over 360 degrees of the trabecular meshwork. The coagulation site within the trabecular meshwork was chosen according to the outflow facility as measured by tonography. In eyes with high outflow facility (C greater than 0.08) the unpigmented, so-called nonfunctioning trabecular meshwork was coagulated. Where the outflow facility was lower (C less than 0.03), a pigmented area of the trabecular meshwork was aimed at. Where the facility was intermediate (0.08 greater than C greater than 0.03) the border area between pigmented and nonpigmented meshwork was coagulated. Three groups of patients were treated: (1) older patients with insufficient compliance; (2) patients whose intraocular pressure (IOP) was poorly controlled by drugs and was under 35 mm Hg; (3) patients suffering from glaucoma in aphakia or status post trabeculectomy and poor control of IOP. Applying these criteria , IOP was controlled in 26.8% without additional drugs and in 68% in combination with local medication after 6 weeks. Very few complications were seen (8 cases), and they did not lead to deterioration or loss of vision. In the light of theoretical considerations and initial histopathologic findings in human eyes, the authors assume that low-intensity coagulation causes a denaturation and shrinkage of the trabecular collagen, leading to stretching of the surrounding trabecular structures.(ABSTRACT TRUNCATED AT 250 WORDS)