glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2023-22-4-80-88glaucoma-492Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSПовторная хирургия глаукомы: современный взгляд на проблемуRepeat glaucoma surgery: modern view of the problemhttps://orcid.org/0000-0001-7735-9650ВитковА. А.VitkovA. A.

Витков Александр Александрович, мл. науч. сотрудник отдела глаукомы

119021, Москва, ул. Россолимо, 11А

Junior Researcher at the Glaucoma Department

11A Rossolimo St., Moscow, 119021

avitkov.niigb@gmail.comhttps://orcid.org/0000-0001-9606-0566КуроедовА. В.KuroyedovA. V.

д.м.н., профессор кафедры офтальмологии, ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России; начальник офтальмологического центра, ФКУ «ЦВКГ им. П.В. Мандрыка» Минобороны России

117997, Москва, ул. Островитянова, 1

107014, Москва, ул. Б. Оленья, 8А

Dr. Sci. (Med.), Professor at the Academic Department of Ophthalmology, Pirogov Russian National Research Medical University; Head of the Ophthalmology Center, Mandryka Military Clinical Hospital

1 Ostrovityanova St., Moscow, 117997

8A Bolshaya Olenya St., Moscow, 107014

https://orcid.org/0000-0003-0521-2750МакароваА. С.MakarovaA. S.

к.м.н., научный сотрудник отдела глаукомы

119021, Москва, ул. Россолимо, 11А

Cand. Sci. (Med.), Researcher at the Glaucoma Department

11A Rossolimo St., Moscow, 119021

https://orcid.org/0000-0003-3421-1298ПолеваР. П.PolevaR. P.

к.м.н., старший научный сотрудник отдела глаукомы

119021, Москва, ул. Россолимо, 11А

Cand. Sci. (Med.), Senior Researcher at the Glaucoma Department

11A Rossolimo St., Moscow, 119021

https://orcid.org/0000-0003-3352-8170ДорофеевД. А.DorofeevD. A.

врач-офтальмолог

454090, Челябинск, ул. Российская, 200

ophthalmologist

200 Rossiyskaya St., Chelyabinsk, 454090

https://orcid.org/0000-0003-2893-0173АсиновсковаИ. И.AsinovskovaI. I.

ординатор

119021,Москва, ул. Россолимо, 11А

clinical resident

11A Rossolimo St., Moscow, 119021

ФГБНУ «НИИГБ им. М.М. Краснова»РоссияKrasnov Research Institute of Eye DiseasesRussian FederationФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России; ФКУ «ЦВКГ им. П.В. Мандрыка» Минобороны РоссииРоссияPirogov Russian National Research Medical University; Mandryka Military Clinical HospitalRussian FederationГАУЗ ГКБ №2, поликлиника №1РоссияChelyabinsk Public Clinical Hospital No. 2, Polyclinic No. 1Russian Federation2023071220232248088Copyright © Витков А.А., Куроедов А.В., Макарова А.С., Полева Р.П., Дорофеев Д.А., Асиновскова И.И., 20232023Витков А.А., Куроедов А.В., Макарова А.С., Полева Р.П., Дорофеев Д.А., Асиновскова И.И.Vitkov A.A., Kuroyedov A.V., Makarova A.S., Poleva R.P., Dorofeev D.A., Asinovskova I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.glaucomajournal.ru/jour/article/view/492

Хирургическое лечение глаукомы является наиболее эффективным способом достижения целевых значений уровня ВГД. Однако этот метод обладает как существенными преимуществами, так и недостатками. Основным недостатком является временность гипотензивного эф фекта. Хирургическая неудача может произойти в различные сроки после самого вмешательства. Правильная оценка сроков проведения операции и факторов риска избыточного рубцевания, которое является основной причиной неудачного исхода антиглаукомной операции, а также корректная периоперационная терапия позволяют продлить эффективность операции и сократить число повторных вмешательств.

При большом выборе методов хирургического лечения синусотрабекулэктомия остается наиболее часто проводимым вмешательством. Ее эффект лучше изучен и может считаться более контролируемым. При неэффективности хирургического лечения глаукомы возможно назначение терапии «рестарта», активации сформированных путей оттока и проведение повторного вмешательства. Развитие технологии нидлинга позволяет отсрочить проведение повторных вмешательств, продлевая гипотензивный эффект стартовой операции.

Glaucoma surgery is the most effective way to achieve target levels of intraocular pressure. However, it has significant advantages and disadvantages. The main disadvantage is the temporary nature of its hypotensive effect. The onset of surgical failure can occur at various times after the intervention. A correct assessment of the operation timing and risk factors for excessive scarring, as well as correct perioperative therapy, can prolong the effectiveness of the surgery and reduce the number of repeat operations.

With a wide choice of surgical treatment methods, trabeculectomy remains the most frequently performed intervention. Its effect is better understood and can be considered more controllable. If the surgical treatment of glaucoma is ineffective, it is possible to prescribe a "restart" therapy, activate previously formed outflow tracts, and perform a second intervention. The development of needling technology makes it possible to delay repeat interventions, prolonging the hypotensive effect of the initial operation.

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