Laser Trabeculoplasty and the Glaucomas

A standard 100-spot laser trabeculoplasty was applied to 137 eyes of 109 presurgical patients with a variety of primary, secondary, and postsurgical glaucomas. Average follow-up was 15.3 months. Laser therapy was most successful in eyes without prior surgery (chronic open-angle glaucoma (COAG), pseudoexfoliation, pigmentary dispersion) or with only one prior operation (iridectomy, trabeculectomy, or intracapsular cataract extraction). The mean range for pressure reduction was 6 to 12 mmHg. Failures were frequently seen in eyes with angle recession, uveitis, or more than one operation. Visual field deterioration was seen in 11 % of successful COAG eyes. Asymmetric responses in bilaterally treated COAG patients were seen half the time. A drift downward of 5 mmHg or more at six months after laser reversed itself by 12 months in approximately one out of eight eyes from various categories.