A review of argon laser trabeculoplasty in treatment of open-angle glaucoma

Thesis (M.A.)--Boston UniversityDuring the past ten years argon laser trabeculoplasty (ALT) has evolved from a novel to a commonplace intervention in the management of open-angle glaucoma. Despite its widespread usage, the exact effect of ALT on the trabecular meshwork is only partially understood. Nonetheless, its effect of lowering intraocular pressure through enhancement of aqueous humor outflow is well documented. Laser photocoagulation of the trabecular meshwork focally destroys, but also diffusely stimulated trabecular meshwork cells. The laser induced shape alterations in the trabecular meshwork are thought to influence aqueous humor outflow only at very high intraocular pressure levels. It appears more probable that most of the aqueous humor outflow occurring after ALT results from laser induced metabolic changes within the cells of the trabecular meshwork. This review chronicles the history of the use of the laser in glaucoma management, the clinical experience and some of the experimental studies which have been conducted to answer the questions regarding the mechanism of action of ALT