ND-YAG LASER TRABECULOPUNCTURE (YLT) FOR GLAUCOMA WITH TRAUMATIC ANGLE-RECESSION

Traumatic angle recession caused by blunt trauma often induces uncontr ollable glaucoma despite the maximum medical therapy tolerated, such a s argon laser trabeculoplasty (ALT), with no or little benefit. Theref ore, instead of ALT, we tried Nd:YAG laser trabeculopuncture (YLT) on 11 patients with this type of glaucoma. The intraocular pressure of th ese patients was followed up for 15 +/- 7 months (average +/- SD). In 6 of 7 eyes treated initially with YLT, the IOP was significantly redu ced, so medication was discontinued. Four other cases with uncontrolla ble IOP after failed ALT were treated with YLT. The IOP of 3 cases was successfully controlled by medication after YLT. These YLT results we re then compared with those of ALT in 11 glaucoma patients with trauma tic angle recession. Seven of 11 cases treated initially with ALT fail ed in less than 3 months, and surgical intervention or additional lase r treatments were required. The probability of success from the time-s eries analysis at 12 months after each laser application was 0.909 in YLT, 0.273 in ALT. YLT offers significant advantages over ALT for the treatment of glaucoma with traumatic angle recession after blunt traum a and thus merits further study.