| Abstrakt: |
Forty-five phakic eyes of 36 patients with open-angle glaucoma and uncontrolled intraocular pressure despite maximally tolerated medication underwent initial argon laser trabeculoplasty (ALT) in 1981 and 1982 as part of a prospective, randomized study to evaluate the effectiveness of different treatment standards. Each eye had been randomly assigned to receive either 100 laser applications over 360° of trabecular meshwork, 50 applications over 180°, or 50 applications over 360° in a single session. Further treatment in each group was based on clinical standards prevailing at the time. The long-term results were analyzed using Kaplan-Meier survival analyses. By 4 years after initial ALT, six of the 15 remaining eyes in group 1 (40), one of 14 eyes in group 2 (7), and two of 13 eyes in group 3 (15) had undergone filtration surgery, and one eye in group 1 (7), three eyes in group 2 (21), and three eyes in group 3 (23) had received further ALT. By 7 years after initial ALT, seven of the nine remaining eyes in group 1 (78), one of 12 eyes in group 2 (8), and four of 12 eyes in group 3 (33) received filtration surgery, and two eyes in group 1 (22), three eyes in group 2 (25), and four eyes in group 3 (33) had received further ALT. Kaplan-Meier survival curves predict the following probabilities of avoiding either repeat ALT or filtration surgery at 4 years after an initial ALT: group 1, 54 ± 12; group 2, 76 ± 12; and group 3, 62 ± 11. Our results suggest that performing 50 rather than 100 burns at initial ALT may significantly delay the need for additional surgical or repeat laser intervention. |
