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Abstract #3630 Published in IGR 4-2
Role of argon laser trabeculoplasty as primary and secondary therapy in open angle glaucoma in Indian patients
Agarwal HC; Sihota R; Das C; Dada TBritish Journal of Ophthalmology 2002; 86: 733-736
AIMS: To study the efficacy of argon laser trabeculoplasty (ALT) as a primary and secondary therapy in Indian patients with primary open-angle glaucoma (POAG). METHODS: ALT was performed as a primary therapy in 40 eyes of 21 patients newly diagnosed with POAG (group 1) and as a secondary therapy in 39 eyes of 21 patients who had been taking topical antiglaucoma medications for more than one year. Best-corrected visual acuity, baseline intraocular pressure (IOP), diurnal variation of IOP, anterior chamber angles, and visual fields were the various parameters evaluated before and after performing ALT. Follow up visits were scheduled at 24 hours, one week, one, three and six months, and one year after surgery. Patients were recalled at the end of five years for the final follow-up examination. Success of ALT was defined as IOP ≤ 21 mmHg without any medication with no progression of disc or visual field changes. RESULTS: The prelaser mean IOP was 25.8 (SD 3.4) mmHg in group 1 and 26.1 (3.2) mmHg in group 2. The mean post-laser IOP at the five-year follow-up was 18.1 (3.2) mmHg in group 1 and 22.7 (3.9) mmHg in group 2 (p = 0.002), while the mean reduction in IOP was 5.7 (1.8) mmHg in group 1 and 3.2 (0.8) mmHg in group 2 (p < 0.001). The diurnal variation reduced from a preoperative value of 7.9 (1.4) to 3.6 (1.3) mmHg in group 1, and from 7.7 (1.4) to 5.8 (1.8) mmHg in group 2 (p < 0.001). The success rate of ALT was 75% at one year and 65% at five years in group 1, and 35% at one year and 10% at five years in group 2. CONCLUSIONS: ALT can be used as a primary therapy in pigmented eyes with POAG. ALT is less effective as a secondary therapy in controlling the IOP in eyes of patients on long-term topical antiglaucoma treatment.
Classification:
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)