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Argon laser trabeculoplasty in open-angle glaucoma

S Shirato, T Yamamoto, Y Kitazawa

    Japanese Journal of Ophthalmology
    |January 1, 1982
    PubMed
    Summary
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    Argon laser trabeculoplasty (LTP) for open-angle glaucoma shows that treating half the circumference (HC-LTP) leads to fewer complications and a shorter intraocular pressure (IOP) rise compared to whole circumference (WC-LTP). Long-term HC-LTP efficacy requires further study.

    Area of Science:

    • Ophthalmology
    • Glaucoma Research
    • Surgical Interventions

    Background:

    • Open-angle glaucoma (OAG) management often involves procedures to lower intraocular pressure (IOP).
    • Argon laser trabeculoplasty (LTP) is a common surgical option for OAG.
    • Different techniques of LTP exist, varying in the extent of the trabecular band treated.

    Purpose of the Study:

    • To compare the immediate and long-term efficacy and safety of whole-circumference LTP (WC-LTP) versus half-circumference LTP (HC-LTP) in open-angle glaucoma patients.
    • To evaluate the impact of LTP extent on intraocular pressure (IOP) fluctuations and control.
    • To assess the failure rates and long-term outcomes of WC-LTP and preliminary outcomes of HC-LTP.

    Main Methods:

    • Argon laser trabeculoplasty was performed on 45 eyes using WC-LTP and 20 eyes using HC-LTP for open-angle glaucoma.

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  • Intraocular pressure (IOP) was monitored closely in the immediate post-operative period (within 6 and 2 hours, respectively).
  • Long-term follow-up (7-38 months) was conducted for WC-LTP eyes, with failure defined as IOP control below 21 mmHg. Life-table analysis was used.

    • Main Results:

    • A significant IOP rise occurred in 74% of WC-LTP eyes and 64% of HC-LTP eyes, with shorter duration in HC-LTP.
    • Post-operative IOP at 24 hours was ≥25 mmHg in 42% of WC-LTP cases versus 10% of HC-LTP cases.
    • WC-LTP showed a 48% probability of IOP control after 38 months, with most failures occurring within the first week. HC-LTP results appeared promising despite shorter follow-up.

    Conclusions:

    • HC-LTP demonstrates a potentially more favorable short-term IOP response and fewer complications compared to WC-LTP.
    • While WC-LTP shows moderate long-term success, a significant portion of patients experience early failure.
    • Further evaluation of long-term outcomes for HC-LTP is warranted to consider its routine use in open-angle glaucoma management.