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). CONCLUSION: 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.
RCT Entities:
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). CONCLUSION: 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.