The effect of argon laser trabeculoplasty on the blood-aqueous barrier and intraocular pressure in human glaucomatous eyes treated with diclofenac 0.1%

Abstract

We studied the effect of argon laser trabeculoplasty (ALT) on the blood-aqueous barrier (BAB) in 41 eyes of 41 patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, or pigment dispersion glaucoma using the Fluorotron Master II. Fluorophotometry was performed the day before ALT and on the 3rd day after surgery at 30 and 60 min after intravenous injection of 7 mg/kg body weight sodium fluorescein 10%. Intraocular pressure (IOP) was measured using Goldmann applanation tonometry on the day before surgery and at 3rd days and 1 year (mean) after ALT. Patients were treated with argon laser by one surgeon (180 degrees, 0.1 s, 50 microns 0.6-1.0 W, 56 laser burns). Eyes were randomly assigned to either diclofenac-sodium 0.1% eye drops or vehicle. Eye drops were applied six times 1 h before ALT into the operated eyes and five times daily for 3 days postoperatively. On the 3rd day after ALT there was significant disruption of the BAB in the placebo-treated eyes compared to the diclofenac 0.1%-treated eyes. In the placebo-treated eyes as well as in diclofenac-sodium 0.1%-treated eyes there was a significant decrease of IOP postoperatively for up to 1 year. There was no significant difference concerning the IOP reduction after 1 year. Diclofenac-sodium 0.1% eye drops significantly stabilized the BAB on the 3rd day after ALT, compared to placebo, in this model. Diclofenac-sodium 0.1% significantly stabilized the disruption of the blood-aqueous barrier on the 3rd day after ALT. Concerning the IOP-lowering effect of ALT, the postoperative application of steroids should be avoided.