Efficacy of argon laser trabeculoplasty: 3-year preliminary results of a prospective placebo-controlled study.
BACKGROUND
It was the purpose of this study to evaluate the efficacy of argon laser trabeculoplasty (ALT) in controlling intraocular pressure (IOP) and avoiding surgical intervention. We also investigated whether topically applied diclofenac sodium eye drops had an influence on the success rate of ALT compared with placebo eye drops.


METHODS
The indication for ALT was progressive glaucoma uncontrolled by maximal tolerated medical therapy. Thirty-nine of 41 patients were available for follow-up after 1122 +/- 239 days.


RESULTS
Twenty-one of 39 eyes failed during the first 3 years of follow-up for one or more reasons: 11 eyes required additional laser treatment and/or filtration surgery because of progressive visual field loss or unacceptably high IOP, 9 eyes failed to have a final IOP > or = 21 mmHg, and 7 eyes failed because of an increase in the number of the medications. This yields a success rate for ALT of 46% for 3-year follow-up. There was no significant difference between diclofenac sodium- and placebo-treated eyes concerning the success rate after 3 years (P > 0.05).


CONCLUSIONS
We conclude that the use of ALT for the treatment of glaucoma is best reserved for cases in which medical avenues of treatment have been exhausted.
Ustundag
C
C
Department of Ophthalmology, University of Cologne, Germany.
Diestelhorst
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use; D018450:Disease Progression; D017889:Exfoliation Syndrome / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
D016861:Cyclooxygenase Inhibitors; D009883:Ophthalmic Solutions; D004008:Diclofenac