Laser trabeculoplasty as a primary treatment of primary open angel glaucoma

ABSTRACT

To evaluate the efficacy of laser trabeculoplasty as a primary procedure in the treatment of eyes with primary open angle glaucoma. The patients included in this study were required to have an age 50 years or older, phakic eyes, cup/disc ratio of 0.5 or more, polar notching or narrowing of the neuroretinal rim, and asymmetry of cup! ratio of cup/disc ratio>0.2 between the two eyes, glaucomatous visual field defects, open angle on gonioscopy, basal IOP >/-18 mmHg, and a best corrected visual acuity of more than 20/80. Those patients underwent laser trabeculoplasty in one eye as primary treatment. The IOP was measured 1,2 hours, 1 day, 1 week, 1, 2, and 3 months postoperatively. Twenty eyes of 20 patients with primary open angel glaucoma were included in the study. The mean pre-laser lop was 24.7 +/- 2.7 mmHg, which was increased one hour after treatment to 27.6 +/- 2.3 mmHg. After the 3 months, the mean IOP was 17.1 +/- 3.2 mmHg with a mean reduction of lop of about 7.6 mmHg which represent a 30.8% reduction from the initial IOP. No patient developed significant complications. Laser trabeculoplasty is considered a save, and effective procedure as a primary treatment of patients complaining of primary open angle glaucoma. It can be performed as an outpatient procedure without admission of the patient. The patients should be followed-up closely within the first hour of the procedure for any episodes of rise of IOP. Long term follow-up is recommended as there may be late rise of IOP that necessitate either repetition of the procedure or addition of topical pressure lowering drugs