Seventy-nine eyes (61 patients) with open-angle glaucoma and uncontrolled intraocular pressure (IOP) of 23 mmHg or more despite maximal tolerated medical therapy and prior argon laser trabeculoplasty (75 eyes) were treated with neodymium: YAG (Nd: YAG) laser angle surgery and followed for at least 1 year. Ten pulses of 10 mJ were applied to the midtrabecular meshwork over 40 degrees in the most visible portion of the angle. The IOP was controlled successfully (less than or equal to 22 mmHg) in 60 eyes (76%) 1 month after treatment and in 36 of 78 eyes (46%) 1 year after treatment. Long-term complications included two eyes with advanced glaucoma that lost central fixation despite good IOP control after treatment.