A NEW APPROACH TO LASER TREATMENT OF OPEN-ANGLE GLAUCOMAJournal: International bilingual medical journal "MEDICUS" (Vol.1, No. 22)
Publication Date: 2018-07-06
Authors : Khomyakova E.N. Sergushev S.G.;
Page : 38-43
Keywords : glaucoma; laser hypotensive nonpenetrating sclerotomy; trabeculoplasty.;
Relevance. Multivariate analysis showed that in nosological structure of disability-free in Russia takes leading place 41 % of glaucoma. The basis of glaucoma treatment is to normalize intraocular pressure and prevent further progression of glaucomatous optic neuropathy. Currently, there are three methods available to achieve these goals: medical, laser and surgical. Goal. To study the efficacy of Nonpenetrating Hypotensive Laser Sclerotomy (NGLS) in front of the previously held laser trabeculoplasty (LTP 270 °) are on drug therapy. Material and methods. The subjects were operated and 54 patients (102 eyes) with initial -38 eyes developed – 46 -18 eyes and far-advanced eye stages of glaucoma. 23 patients (46 eyes) instilled β- blockers, 28 (56 eyes) of prostaglandin analogues. Intraocular pressure was in the range of 27 ± 2,4 mm Hg. A standard eye examination, including optical coherence tomography (OCT), computerized perimetry. Results. Reduction of intraocular pressure was observed in 89 % of patients after 2 weeks. After NGLS and reached 19,5 ± 2,2 mm Hg, 1 month- 19,8 ± 2,1 mmHg, 3 months -16,7 ± 1,4 mm Hg, 6 months18,2 ± 3,6 mm Hg, after 9 months of 19,7 ± 3,5 mm Hg. By the end of the observation period parameters IOP remained within the normal range in 16 patients (21 eyes 20.6 %) drug therapy has not been used in 32 patients (67 eyes, 65.7 %) achieved normalization of intraocular pressure in combination with antihypertensive therapy, 9 patients (9 Eye 8.8 %) focused on surgical treatment. Decrease in visual acuity was found in (29 % -30 eye) to 0.18 ± 0.12, as a result of the development or progression of cataract. Conclusion. Nonpenetrating hypotensive laser sclerotomy (NGLS) allows metered, lower IOP at various stages of glaucoma to achieve controlled and persistent hypotensive effect.
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