What is the role of argon laser trabeculoplasty (ALT) in the treatment of penetrating keratoplasty and glaucoma (PKPG)?

Updated: Dec 30, 2020
  • Author: Shibandri Das, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Answer

Argon laser trabeculoplasty (ALT) is no longer in common use, but it was historically reported to result in a 10 to 40% reduction in IOP in primary open-angle glaucoma in the short term. The efficacy of ALT depends on the clinical characteristics of the patients and the type of glaucoma treated. The IOP-lowering effect tends to diminish between 1.5 and 4 years postoperatively with only a 40 to 50% success rate at 5 years. [50]  Because the beneficial effects appear to decrease over time, ALT may be tried as a short-term measure in patients with open angles and clear grafts with moderately elevated IOP (ie, 20-25 mm Hg) who are receiving glaucoma medications. [51]  Possible complications include pressure spikes and iritis, both of which can trigger graft rejection.


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