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Br J Ophthalmol 2000;84:48-53 ( January )

Membrane formation in the chamber angle after failure of argon laser trabeculoplasty: analysis of risk factors

T Koller, J Stürmer, Ch Remé, B Gloor

Augenklinik, UniversitätsSpital, Zürich, Switzerland

Correspondence to: Dr J Stürmer, Augenklinik, Nordtrakt II, UniversitätsSpital, Frauenklinikstrasse 24, CH-8091 Zürich, Switzerland

Accepted for publication 18 August 1999

AIM---Membrane formation in the chamber angle induced by argon laser trabeculoplasty (ALT) can be a cause of treatment failure. Identification of risk factors for membrane formation was the primary aim of this retrospective study.
METHODS---Semithin sections of trabeculectomy specimens obtained in a 2 year period were examined by light microscopy. 122 eyes which were treated with one or more ALTs before trabeculectomy were identified. In 46 eyes, a sufficient amount of trabecular meshwork was obtained to permit morphological analysis.
RESULTS---Eyes treated with ALT had a significantly higher incidence of membrane formation (p=0.001). In 23/46 specimens a cellular and collagenous membrane was observed covering the entire trabecular meshwork. In 14/23 specimens (61%), this membrane was readily visible at low power magnification (×40). Comparison of these eyes with those without membrane formation revealed a significant difference in the number of ALTs (mean 2.07 (SD 0.73) v 1.48 (0.59); p=0.026) and in preoperative IOP (32.0 (9.7) v 26.2 (8.4) mm Hg; p=0.04).
CONCLUSIONS---Membrane formation in the chamber angle is a frequent cause of ALT failure. The major risk factor is the number of ALTs performed.

© 2000 by British Journal of Ophthalmology


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Membrane formation in the chamber angle after failure of argon laser trabeculoplasty
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