[Trabeculectomy and trabeculo-retraction in the treatment of chronic primary open-angle glaucoma. Long-term tonometric results].

The long term tonometric results of laser (Argon Laser Trabeculoplasty) and surgical (Trabeculectomy and combined-surgery) treatment in Primitive Chronic Open Angle Glaucoma are analysed on 184 eyes by a retrospective study. Three groups of patients are compared: group I: 81 trabeculoplasties followed 4 years, group II: 75 trabeculectomies followed 5 years, group III: 28 combined-surgery (intra-capsular cataract extraction without implantation combined with a trabeculectomy) followed 5 years. For the three groups, reduce of IOP is noted after 6 months but seems less important after 30 months. Instantaneous results curves show a success rate of 80 to 100% (of which 10 to 20% with additional medical treatment). But cumulative failures rates are higher: more than 50% at 4 years for group I and group II, and only 29% at 5 years for group III. These results are confirmed by actuarial curves: group I: probability success rate of 65% at 4 years group II: probability success rate of 49% at 5 years group III: probability success rate of 73% at 5 years. The comparison of group I and II by actuarial curves is not statistically significant (Logrank test: chi 2 = 0.05). We had discussed the advantage of a new prospective randomised study.