Argon laser trabeculoplasty or trabeculectomy a prospective randomised block study.

A prospective randomised block study of treatment by either argon laser trabeculoplasty or trabeculectomy was undertaken in patients with chronic open angle glaucoma not controlled by medication. The study was undertaken in two centres in the United Kingdom where the regimes of medical treatment prior to interference were different. Regression analysis showed that in both populations laser trabeculoplasty was effective in reducing the intraocular pressure but it was less effective than trabeculectomy in permanently reducing the intraocular pressure to within normal limits. Laser trabeculoplasty was most effective in those patients whose intraocular pressure was initially high but many of these required post-operative medication or surgery. Laser trabeculoplasty is a useful adjunct to the therapy of open angle glaucoma but it is not a substitute for trabeculectomy as a method of permanently reducing the intraocular pressure to normal. Because of the effectiveness of both these methods of treatment we feel it no longer justified to use anything other than simple local medication to control the intraocular pressure before proceeding to active therapy.