Neodymium: YAG laser trabeculopuncture in open-angle glaucoma.


Journal Article

Ten eyes of eight patients with open-angle glaucoma (OAG) had neodymium (Nd):YAG trabeculopuncture performed in an investigational protocol as an alternative to surgical intervention. In each, at four to six sites in the mid-trabecular meshwork, three to six superimposed applications were made (2 to 6 mJ). In four of six patients with adult OAG, a small decrease in intraocular pressure (IOP) was noted (from a mean of 25.5 to 20.0 mmHg after 3-4 weeks in the treated eyes, compared to no change at 21 mmHg in the fellow eyes). There appeared to be further attenuation of this IOP effect over the subsequent 2 to 11 months, and all patients demonstrated gonioscopic closure of all the puncture sites with time. One patient demonstrated an acute IOP elevation to 58 mmHg after the procedure, necessitating emergency filtration surgery. In contrast, in four eyes of two patients with juvenile open angle glaucoma, a dramatic lowering of IOP and improvement in tonographic outflow facility was demonstrated, although the effects were only temporary in one patient. YAG laser treatment to the trabecular meshwork may have its greatest potential usefulness when abnormalities in the uveal meshwork are involved, such as in certain cases of juvenile or congenital glaucoma, and may help identify the need for a surgical goniotomy. With more usual forms of OAG, however, widespread use of this technique should be avoided until greater efficacy can be achieved.

Full Text

Cited Authors

  • Epstein, DL; Melamed, S; Puliafto, CA; Steinert, RF

Published Date

  • July 1, 1985

Published In

Volume / Issue

  • 92 / 7

Start / End Page

  • 931 - 937

PubMed ID

  • 4022580

Pubmed Central ID

  • 4022580

Electronic International Standard Serial Number (EISSN)

  • 1549-4713

International Standard Serial Number (ISSN)

  • 0161-6420

Digital Object Identifier (DOI)

  • 10.1016/s0161-6420(85)33932-5


  • eng