Reopening blocked trabeculectomy sites with the YAG laser

After unsuccessful attempts to reduce the intraocular pressure of a 70-year-old man with advanced open-angle glaucoma by drugs, trabeculoplasty, and trabeculectomy, we used a mode-locked, pulsed picosecond neodymium YAG laser to cut away an opaque nonpigmented membrane that had occluded the trabeculectomy site. The intraocular pressure decreased immediately from 18 mm Hg to 5 mm Hg and a diffuse conjunctival bleb formed. One month later, the intraocular pressure was 11 mm Hg and the bleb was still present.