A new approach to treatment of glaucoma has been tried, in which Q-switched laser bursts are delivered to the anterior chamber angle. Nonthermal effects emerge as an important factor in the biological action of such laser impulses. Laser-induced defects in the filtering zone produced by Q-switched impulses have been traced histologically.
Fifty patients (all of them awaiting glaucoma surgery) were treated by the method described above. The maximum follow-up study was three years. The average drop in the intraocular tension was 8.3 mm Hg. Improvement in the outflow facility was also characteristic. No appreciable adverse effects have been traced.
The controlled state of the intraocular pressure was maintained by repeated laser goniopuncture sessions on the eyes of 46 patients (in four cases the tension was not controlled).
Q-switched laser goniopuncture seems to offer a new aspect in the treatment of glaucoma, but further extensive studies and several years of follow-up study are certainly needed.