Venger L. V., Yakymenko I. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Objective: to evaluate in the remote period the efficiency of the developed new method of surgical treatment of open-angle glaucoma with supraciliary drainage. Object and methods. The study included 100 patients with a diagnosis of primary open-angle glaucoma, which were divided into 50 patients in each. Each group was divided into 2 subgroups – with II and III stage glaucoma. Some patients had an anti-glaucomatous surgery, the other in combination with phacoemulsification. Patients in the main group were operated by the new supraciliary drainage method proposed by us. Patients of the control group performed classical sinusotrabeukulotomy. The data of intraocular pressure, hydrodynamics of the eye, visual acuity and static perimetry are analyzed for 5 days, one month and one year after surgery. Results. The hypotensive effect in both groups was sufficient, but in the control group there was a hyper effect of reducing intraocular pressure in the early postoperative period. The efficiency of increasing the coefficient easiness of outflow and decreasing the Becker coefficient in the main group were statistically significantly better compared to the control group. In the main group, one year after observations in patients with II and III stage glaucoma, which had a combined operation, the coefficient easiness of outflow improved by 200% and by 185%, and in patients who had only anti-glaucomatous surgery by 147% and by 150%. In the control group, the corresponding subgroups the coefficient easiness of outflow increased by 43% and by 13% in case of combined operation, 36% and 13% respectively. The decrease of the Becker coefficient in patients of the main group was also statistically significant compared with the control group. It was noted that the preservation of visual functions in patients operated by the proposed method, while in the control group, was statistically significant reduction. In the main group, stabilization of visual fields was noted, while in the control group, perimetry data deteriorated. The decrease in light sensitivity in patients with the second and third stage of glaucoma in the control group after the combined operation was 5% and 11%, and after only anti-glaucomatous operation by 16% and 22%, respectively. Conclusions. A new way of surgical treatment of open-angle glaucoma with drainage of supraciliary space allows to achieve a stable hypotensive effect, leads to an increase in the coefficient easiness of outflow by 2.5 times and a decrease in the Becker coefficient by 4.5 times compared with the tonography of the operation, contributes to stable stabilization of the peripheral vision in the remote postoperative period.

primary open-angle glaucoma, surgical treatment, supracіliary drainage, efficacy, uveoscleral outflow

1. Colin Cook, Paul Foster. Epidemiology of glaucoma: what’s new? Canadian Journal of Ophthalmology. 2012 June;47(3):223-6.
2. Nesterov AP. Glaukoma. M.: Medinformagenstvo; 2008. 360 s. [in Russiаn].
3. Koc YaI, Mitrofanova IS. Komplaentnost’ kak faktor povysheniya ehffektivnosti lecheniya bol’nyh s hronicheskoj serdechnoj nedostatochnost’yu. Rossijskij med. zhurn. 2007;4:4-7. [in Russiаn].
4. Stolyarov GM, Lebedev OI, Zolotarev AV. Uveoskleral’nyj ottok vnutriglaznoj zhidkosti: teoreticheskie aspekty i vozmozhnosti issledovaniya. Glaukoma. 2012;4:70-6. [in Russiаn].
5. Karlova EV, Zolotarev AV, Lebedev OI. Patogeneticheskoe obosnovanie hirurgicheskoj aktivacii uveoskleral’nogo ottoka pri pervichnoj otkrytougol’noj glaukome. Permskij medicinskij zhurnal. 2012;29(4):42-6. [in Russiаn].
6. Garway-Heath DF. Latanoprost for open-angle glaucoma (UKGTS): a randomised, multicentre, placebo-controlled trial. Lancet. 2015 Apr 4;385(9975):1295-304.

«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 127-132 pages, index UDK 617.7-007.681-07-08

10.29254/2077-4214-2018-4-2-147-127-132