Argon laser trabeculoplasty: its effect on medical control of open-angle glaucoma

Twenty persons with primary open-angle glaucoma (POAG) were followed for an average of one year in a prospective study after argon laser trabeculoplasty was performed in one eye. By one month the mean intraocular pressure (IOP) had fallen 39% and was associated with an 80% increase in mean facility of aqueous outflow. Eighteen persons with POAG were evaluated for the possibility of maintaining an IOP of less than 22 mm Hg with less medication than was required prior to laser treatment. One third of these patients required no medication after treatment, and 39% required less; however, 28% of persons who were poorly controlled before treatment required the same regimen to maintain control after laser trabeculoplasty. Six out of nine persons no longer required a carbonic anhydrase inhibitor while six out of eight persons no longer required a miotic. Laser trabeculoplasty failed to produce a sufficiently large fall in IOP in most persons on maximal medication to permit discontinuation of all medication; but it produced its most satisfying response in persons whose glaucoma was less difficult to control.