glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2024-23-2-79-94glaucoma-528Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSАнализ эффективности и безопасности имплантации дренажных устройств в хирургии глаукомыAnalysis of the effectiveness and safety of implantation of drainage devices in glaucoma surgeryhttps://orcid.org/0000-0002-5170-2462ВолковаН. В.VolkovaN. V.

Волкова Наталья Васильевна, к.м.н., доцент, врач-офтальмолог, заведующая научно-образовательным отделом; доцент кафедры офтальмологии; доцент кафедры глазных болезней

664033, Иркутск, ул. Лермонтова 337

664079, Иркутск, м/р Юбилейный, 100

664003, Иркутск, ул. Красного Восстания, 1

Cand. Sci. (Med.), ophthalmologist, Associate Professor, Head of the Scientefic Academic Department; Associate Professor at the Academic Department of Ophthalmology; Associate Professor  at the Academic Department of Eye Diseases

337 Lermontova St., Irkutsk, 664033

100 Ubileiny m/d, Irkutsk, 664049

1 Krasnogo Vosstania St., Irkutsk, 664003

vnv-mntk@mail.ruhttps://orcid.org/0000-0003-0547-7521ЮрьеваТ. Н.IurevaT. N.

д.м.н., профессор, врач-офтальмолог, заместитель директора по научной работе; профессор кафедры офтальмологии; профессор кафедры глазных болезней

664033, Иркутск, ул. Лермонтова 337

664079, Иркутск, м/р Юбилейный, 100

664003, Иркутск, ул. Красного Восстания, 1

Dr. Sci. (Med.), ophthalmologist, Professor, Deputy Directory for Scientific Work; Professor at the Academic Department of Ophthalmology; Professor at the Academic Department of Eye Diseases

337 Lermontova St., Irkutsk, 664033

100 Ubileiny m/d, Irkutsk, 664049

1 Krasnogo Vosstania St., Irkutsk, 664003

https://orcid.org/0000-0001-9606-0566КуроедовА. В.KuroyedovA. V.

д.м.н., начальник офтальмологического центра; профессор кафедры офтальмологии

107014, Москва, ул. Большая Оленья, 8А

117997, Москва, ул. Островитянова, 1

Dr. Sci. (Med.), Head of the Ophthalmology Department; Professor at the Academic Department of Ophthalmology

8A Bolshaya Olenya St., Moscow, 107014

1 Ostrovityanova St., Moscow, 117997

ИФ ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова Минздрава России; Иркутская государственная медицинская академия последипломного образования – филиал ФГБОУ ДПО РМАНПО Минздрава России; ФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава РоссииРоссияIrkutsk Branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery"; Irkutsk State Medical Academy of Postgraduate Education — branch of Russian Medical Academy of Continuous Professional Education; Irkutsk State Medical UniversityRussian FederationФКУ ЦВКГ им. П.В. Мандрыка Минобороны России; ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияMandryka Central Military Clinical Hospital; Pirogov Russian National Research Medical UniversityRussian Federation2024260620242327994Copyright © Волкова Н.В., Юрьева Т.Н., Куроедов А.В., 20242024Волкова Н.В., Юрьева Т.Н., Куроедов А.В.Volkova N.V., Iureva T.N., Kuroyedov A.V.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/528

В настоящее время операцией выбора в лечении как первичных, так и вторичных форм глаукомы, несмотря на доказанные побочные эффекты и противоречивость отдаленных гипотензивных результатов, остается трабекулэктомия в сочетании с антиметаболитами. С другой стороны, методы и технологии антиглаукомных вмешательств постоянно совершенствуются, а с появлением дренажных устройств (ДУ) возможности достижения необходимого гипотензивного эффекта и сохранения зрительных функций, даже в прогностически «неблагоприятных» клинических ситуациях, существенно возросли. Дренажные устройства направлены на улучшение оттока внутриглазной жидкости, снижение уровня внутриглазного давления (ВГД) и стабилизацию глаукомной оптической нейропатии. С расширением в клинической практике показаний к имплантации ДУ, специалистам важно знать все преимущества и недостатки различных видов дренажей, возможные осложнения и способы их профилактики. Целью настоящего обзора явилась систематизация литературных данных о видах ДУ, показаниях и нюансах имплантации, послеоперационном уровне ВГД и длительности гипотензивного эффекта, сравнительной эффективности, характерных осложнениях раннего и отдаленного послеоперационных периодов (гиперфильтрация, гипотония, экструзия и обнажение трубки, трофические дефекты, рубцовые трансформации тканей вокруг платформы дренажа, дисфункция эндотелия роговой оболочки), а также способах их профилактики и лечения.

Currently, trabeculectomy in combination with antimetabolites remains the operation of choice in the treatment of both primary and secondary forms of glaucoma, despite the proven side effects and contradictory long-term hypotensive results. At the same time, methods and technologies of glaucoma surgeries are constantly developing, and with the advent of drainage devices (DD), the possibilities for achieving the necessary hypotensive effect and preserving visual functions have significantly improved, even in prognostically unfavorable clinical situations. Drainage devices are used to improve the outflow of intraocular fluid, reduce intraocular pressure and stabilize glaucomatous optic neuropathy. With the expansion of indications for DD implantation in clinical practice, it is important for specialists to know all the advantages and disadvantages of different types of drainage systems, possible complications and methods of their prevention. This review systematizes literature data on the types of DD, indications and nuances of implantation, postoperative IOP level and duration of hypotensive effect, comparative effectiveness, characteristic complications of early and late postoperative periods (hyperfiltration, hypotension, tube extrusion and exposure, trophic defects, cicatricial transformations of tissues around the drainage platform, endothelial dysfunction of the cornea), as well as methods of their prevention and treatment.

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