E u ropean Journal of Ophthalmology / Vol. 16 no. 5, 2006 / pp. 7 5 6- 7 5 7 1 1 2 0 - 6 7 2 1 /7 5 6- 0 2 $ 1 5 . 0 0 / 0 © Wichtig Editore, 2006 A rgon laser trabeculoplasty in triamcinolone acetonide induced ocular hypertension refractory to maximal medical tre a t m e n t F. RICCI 1 , F. MISSIROLI 1 , M. PA R R AVA N O 2 1 Department of Ophthalmology, University of Roma “Tor Ve rg a t a ” 2 Fondazione G.B. Bietti per lo studio e la ricerca in Oftalmologia–IRCCS, Roma - Italy INTRODUCTION S t e roid-induced elevation of intraocular pre s s u re (IOP) is one of the two most common side effects of intravitreal injection of triamcinolone acetonide (iTAA). After intravitreal administration of 20 mg of triamcinolone acetonide, an IOP elevation can develop in about 50% of eyes, starting about 1 to 2 months after the injection (1, 2). In the vast majority, IOP can be normalized by topical med- ication and re t u rns to normal values without further medica- tion within 6 to 9 months after the injection. In few cases (1.0%) filtering surgery is necessary in eyes that show an el- evation of IOP to values up to 35 mmHg despite maximal topical and systemic antiglaucoma therapy (1-3). Argon laser trabeculoplasty (ALT) is an additional therapeutic op- tion for the treatment of open-angle glaucoma and it is often recommended when medical therapy alone is insufficient in controlling pressure and the progression of glaucoma (4, 5). We report two cases in which elevation of IOP after iTAA in- jection did not respond to topical and systemic antiglauco- ma medications and was successfully treated by ALT. Case 1 A 77-year-old man with primary open angle glaucoma (POAG) was on topical medication with latanoprost with a well-controlled IOP of 18 mmHg in both eyes. Four weeks PU R P O S E. To report two cases of intraocular hypertension after intravitreal injection of tri- amcinolone acetonide (iTAA) that were re f r a c t o ry to maximal medical therapy and were suc- cessfully treated with argon laser trabeculoplasty (ALT ) . ME T H O D S. Two patients with history of primary open angle glaucoma were treated with in- t r a v i t real injection of triamcinolone acetonide for chronic macular edema secondary to branch retinal vein occlusion. Both patients (Case 1 after 2 months and Case 2 after 5 days) de- veloped intraocular hypertension that did not respond to maximal medical therapy. Despite medical therapy, intraocular pre s s u re (IOP) was 45 mmHg in Case 1 and between 34 and 37 mmHg in Case 2. ALT was performed in the inferior 180° angle using the following pa- rameters: 50 μm size, 700 mW, 0.50 sec, 100 spots. R E S U LT S. In both patients IOP re t u rned to normal level a few days after ALT. CO N C L U S I O N S . ALT seems to be effective at reducing IOP in patients with intraocular hyper- tension secondary to iTAA that does not respond to maximal medical treatment. (Eur J Oph- thalmol 2006; 16: 756-7) KE Y WO R D S. Argon laser trabeculoplasty, Inraocular hypertension, Tr i a m c i n o l o n e Accepted: May 7, 2006 S H O RT COMMUNICAT I O N