Secondary glaucoma is a risk with any form of corticosteroid therapy. Only 3 previous studies have reported secondary open-angle glaucoma uncontrollable by topical medication following IVTA, requiring trabeculectomy alone3,4 or removal of the depot corticosteroid by pars plana vitrectomy combined with trabeculectomy.5 To our knowledge, this is the first reported case of argon laser trabeculoplasty for intractable secondary glaucoma following IVTA. We decided to perform argon laser trabeculoplasty because of the intractable steroid-induced glaucoma, the still detectable presence of triamcinolone crystals in the vitreous cavity after 5 months, and pharmacokinetics of this drug after high-dose injections.4 The IOP-lowering effect caused by the natural absorption of the intravitreal triamcinolone could not be ruled out in our cases but seems unlikely, because triamcinolone crystals can be present in the vitreous and soluble triamcinolone can be detected in the aqueous humor for 9 months or longer after a single high-dose injection of IVTA, as previously described by Jonas et al.4,6 Additionally, 8 patients with secondary ocular hypertension (IOP range, 26-35 mm Hg; mean, 30 mm Hg) but without diagnosis of glaucoma at baseline, have been followed up since the high-dose IVTA for the eventual development of glaucomatous changes in the appearance of the optic nerve head. For 12 months after IVTA, triamcinolone crystals were still detectable in the vitreous cavity, the IOP was still elevated despite maximally tolerable antiglaucomatous topical treatment (range, 25-32 mm Hg; mean, 29 mm Hg), but the cup-disc ratio was apparently unaffected in all the patients. This small control group suggests that all patients with IOP elevation despite maximal medical therapy after high-dose IVTA need to be strictly observed; in some cases the drug effect seems to persist for more than 1 year. This long intraocular presence of triamcinolone may not only lead to secondary hypertension but also to steroid-induced secondary open-angle glaucoma necessitating more invasive laser or surgical procedures. The advantages of argon laser trabeculoplasty are numerous when considering the possible hazards of trabeculectomy, including anaesthesia, hypotony, cataract, and endophthalmitis. It is also a time-efficient and cost-effective procedure when compared with filtering surgery. The clinical course of these patients sug gests that argon laser trabeculoplasty may be considered as a primary option for secondary glaucoma following IVTA if medical therapy is unsuccessful. However, longer follow-up with a larger number of treated patients will be needed to assess whether argon laser trabeculoplasty permanently reduces the IOP, and if other medications could eventually be stopped as the steroid effect lessens.