Argon laser gonioplasty for synechial angle closure.

Six eyes of five patients with synechial angle closure were treated with argon laser gonioplasty. The angle closure had persisted for weeks to many years. In each eye, most of the synechial angle closure (60% to 100%) was anatomically opened. The mean decrease in intraocular pressure was 5.5 mm Hg (range, 2 to 12 mm Hg). Previous reports have suggested that argon laser gonioplasty is successful only if the angle closure is of recent onset. I believe that argon laser gonioplasty can be attempted in virtually all cases of synechial angle closure regardless of its duration. I found the single-mirrored goniolens to be the most useful lens for this procedure. It permitted visualization of the angle, direct application of the laser burns on the synechial closure, and simultaneous compression gonioscopy if necessary.