glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”glaucoma-3Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESОтдаленные результаты селективной лазерной трабекулопластики при псевдоэксфолиативной глаукомеLong-term results of selective laser trabeculoplasty in the treatment of pseudoexfoliative glaucomaКурышеваНаталия ИвановнаKuryshevaN. I.e-natalia@list.ruАпостоловаА. С.ApostolovaA. A.noemail@neicon.ruШаталоваЕ. О.ShatalovaE. O.noemail@neicon.ruСеменистаяА. А.SemenistayaA. A.noemail@neicon.ruЦентр офтальмологии ФМБА России, Клиническая больница № 86РоссияThe Ophthalmological Center of the Federal Medical and Biological Agency, Clinical Hospital № 86Russian FederationМБУЗ «Городская поликлиника № 3»РоссияMoscow city clinic № 3Russian Federation2014170120171311320Copyright © Курышева Н.И., Апостолова А.С., Шаталова Е.О., Семенистая А.А., 20172017Курышева Н.И., Апостолова А.С., Шаталова Е.О., Семенистая А.А.Kurysheva N.I., Apostolova A.A., Shatalova E.O., Semenistaya A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.glaucomajournal.ru/jour/article/view/3

ЦЕЛЬ. Сравнить эффективность селективной лазерной трабекулопластики (СЛТ) в лечении псевдоэксфолиативной глаукомы (ПЭГ) и первичной открытоугольной глаукомы (ПОУГ) в отдаленном периоде. МЕТОДЫ. Под наблюдением находились 75 больных с ПЭГ (64 глаза) и 70 больных ПОУГ (63 глаза). Группы были однородны по возрасту (69,67±0,93 года при ПЭГ и 65,63±0,33 года при ПОУГ, р=0,09) и стадиям глаукомы (MD -7,29±1,08 дБ при ПЭГ и -5,95±1,12 дБ при ПОУГ, р=0,39). При ПЭГ исходное внутриглазное давление (ВГД) составило 23,9±0,65 мм рт.ст., при ПОУГ 21,4±0,44 мм рт.ст. (р=0,002). Отдаленный период наблюдения составил 4 года. РЕЗУЛЬТАТЫ. Достоверное снижение ВГД после СЛТ наблюдалось на всех этапах по сравнению с исходным у больных ПЭГ и к концу срока наблюдения составило 19,00±0,97 мм рт.ст. (р=0,023). При ПОУГ достоверное снижение офтальмотонуса происходило только в первые полгода после операции до 18,92±0,46 мм рт.ст. (р=0,000) и к концу срока наблюдения составило 20,8±1,13 мм рт.ст. (p=0,938). Количество применяемых гипотензивных капель после СЛТ при ПЭГ снизилось с 1,69±0,107 до 1,45±0,092 (р=0,05), а при ПОУГ - от 1,42±0,091 до 1,2±0,111 (р=0,137). В обеих группах больных не отмечалось прогрессирования ГОН: за период наблюдения в группе ПЭГ индекс MD достоверно не изменился: -7,29±1,08 дБ до СЛТ и -7,6±1,36 дБ - в отдаленном периоде после СЛТ (р=0,10); при ПОУГ: -5,95±1,12 и -6,63±1,28 дБ (р=0,37) соответственно. ЗАКЛЮЧЕНИЕ. СЛТ - эффективный и безопасный метод лечения ПЭГ, позволяющий не только снизить ВГД, но и сохранить зрительные функции в течение 4 лет после операции.

PURPOSE: To assess the long-term efficacy of selective laser trabeculoplasty (SLT) in the treatment of pseudoexfoliative glaucoma (PEG) and primary open-angle glaucoma (POAG). METHODS: 75 patients with PEG (64 eyes) and 70 patients with POAG (63 eyes) were included in the study. The groups were homogeneous for age (69.67±0.93 years in PEG group and 65.63±0.33 years in POAG group, p = 0.09) and stages of glaucoma (MD -7.29±1.08 dB in PEG group and -5.95±1.12 dB in POAG group, p=0.39). Baseline IOP was 23.9±0.65 mm Hg in PEG patients and 21.4±0.44 mm Hg in POAG patients (p=0.002). The follow-up period was four years. RESULTS: There was a significant reduction of the IOP level in PEG patients after SLT as compared to the baseline at all stages of the study. By the end of the follow-up period the IOP was 19.00±0.97 mm Hg (p=0.023). A significant reduction of the IOP level in POAG patients occurred only during the first six months after surgery (IOP=18.92±0.46, p=0.000) and by the end of the follow-up period it was 20.8±1.13 (p=0.938). The amounts of topical ocular hypotensive drugs after SLT in the PEG group decreased from 1.69±0.107 to 1.45±0.092 (p=0.05), and in the POAG group - from 1.42±0.091 to 1.2±0.111 (p=0.137). There was no statistically significant progression of glaucomatous neuropathy in both groups: the MD index was not significantly changed in the PEG group during the follow-up period: -7.29±1.08 dB before SLT, and 7.6±1.36 dB in the late postoperative period (p=0.10), in the POAG group the index values were 5.95±1.12 dB and -6.63±1.28 (p=0.37) dB, respectively. CONCLUSION: SLT may be considered an effective and safe treatment for PEG patients, which not only significantly reduces the IOP level, but also helps preserve visual functions at least four years after the surgery.

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The authors declare that there are no conflicts of interest present.