Argon laser goniophotocoagulation of the trabecular meshwork in open-angle glaucoma

Argon laser goniophotocoagulation of the trabecular meshwork (ALGTM) after the method of Wise and Witter (1979) was performed on 66 eyes of 57 patients with phakic open-angle glaucoma. The duration of follow-up ranged from six to 21 months. The intraocular pressure decreased from a pre-treatment mean of 26.9 mm Hg to a post-treatment mean of 18.9 mm Hg and the mean number of medications used per eye decreased from 3.0 to 2.1 Of the 6 eyes, 54 (82%) were successfully controlled. The pressure-lowering effect was sustained rather than transient. The laser procedure was performed on an out-patient basis using only topical anesthesia. Complications were minimal in most cases. An early post-treatment rise in pressure greater than 6 mm Hg (range 7 mm Hg to 27 mm Hg) occurred in 14 eyes but two-thirds of this group were, nevertheless, successfully controlled. Failure did not adversely influence the outcome of subsequent glaucoma surgery.