LONG-TERM EFFICACY OF ARGON-LASER TRABECULOPLASTY - A 10-YEAR FOLLOW-UP-STUDY

Purpose: Argon laser trabeculoplasty (ALT) is commonly used in the tre atment of open-angle glaucoma. Varying success rates in lowering intra ocular pressure (IOP) and controlling glaucoma are reported in studies with follow-up periods from 1 to 5 years, and few reports are availab le with follow-up to 10 years. The authors retrospectively reviewed th e efficacy of ALT in patients followed up to 10 years. Methods: Ninety -three patients with open-angle glaucoma underwent 360-degrees ALT. Me an follow-up was 52 +/- 43 months (mean +/- standard deviation; range, 1-132 months). Successful treatment at the time of final follow-up wa s defined as a decrease in IOP of 3 mmHg or greater from pretreatment level, IOP of 19 mmHg or less, stable visual field, stable optic nerve , and no further laser or surgical intervention. Results: The decrease in IOP was 8.9 +/- 5.4 mmHg at 1 year, 10.0 +/- 4.2 mmHg at 5 years, and 8.9 +/- 5.2 mmHg at 10 years. The probability of success at 1 year was 77%, at 5 years 49%, and at 10 years 32%. Failure was most common in the first year after treatment (23%), and thereafter failure occur red at a rate of 5% to 9% per year. The mean decrease in IOP for all 9 3 eyes at time of maximum follow-up was 6.1 +/- 7.1 mmHg. Conclusion: Argon laser trabeculoplasty is an effective means for reducing IOP in many patients followed for an extended time. However, up to one half o f eyes within 5 years of ALT and two thirds of eyes within 10 years ma y require additional laser or surgical intervention for glaucoma contr ol.