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Laser therapy for glaucoma.

Three laser techniques for the treatment of glaucoma are described. The short-burn technique of argon laser iridotomy permitted perforation of the peripheral iris in one session without serious complications, thereby alleviating pupillary block in angle-closure glaucoma. The rates of successful intraocular pressure (IOP) control and visual acuity loss due to cataract progression were similar in laser iridotomy and surgical iridectomy. The tonographic outflow facility remained unchanged after argon laser iridotomy. Techniques of argon laser trabeculoplasty (ALT) to the anterior and posterior aspects of the trabecular band were evaluated. The anterior ALT gave fewer complications, but a lower IOP control rate than the posterior ALT. Posterior ALT over 180 degrees with about 50 burns gave fewer complications than treatment over 360 degrees with about 100 burns, yet the final effects in IOP control were better after the 180 degrees than after the 360 degrees treatment. Nd-YAG laser irradiation can separate dysgenetic iris insertion from the trabecular band in developmental glaucoma without serious complications. This Nd-YAG laser goniotomy may be useful for the treatment of juvenile primary developmental glaucoma.