Modern possibilities of laser surgery in the treatment of primary open-angle pigmentary glaucoma
https://doi.org/10.53432/2078-4104-2023-22-1-67-75
Abstract
PURPOSE. To analyze the effectiveness of the complex method of pigmentary glaucoma laser surgery: YAG-laser iridectomy and multistep selective laser trabeculoplasty (SLT).
METHODS. We examined 18 patients (36 eyes) between 13 and 54 years old with primary open-angle pigmentary glaucoma: initial stage was detected in 13 patients (26 eyes), moderate stage — in 4 patients (8 eyes), advanced stage — in 1 patient (2 eyes). Laser iridectomy was performed as the first stage after individual IOP level was reached by drug therapy. SLT was performed 4 weeks later and was repeated around the trabecula every 4–6 months if exogenous pigmentation exceeded grade II. The observation period lasted 4 to 15 years.
RESULTS. The glaucoma process was stabilized successfully in all cases. True IOP decreased by 6.6±0.3 mm Hg (-30%, p<0.05), Becker’s coefficient — by 121±4.3 (-60%, p<0.001), the number of drug instillations — by 1.32±0.06 (-70%, p<0.001). The following indicators increased: mean total retinal photosensitivity — by 381±4.3 dB (15%, p<0.001), mean threshold of retinal photosensitivity — by 2.6±0.1 dB (10%, p<0.001), ease of intraocular liquid outflow — by 0.08±0.013 (72%, p<0.001). Hypotensive drug therapy was canceled in 15 cases (41.7%).
CONCLUSION. Laser surgery of pigmentary glaucoma consisting of YAG-laser iridectomy combined with multistep SLT is an effective and safe method. It can be performed if the elevated IOP is normalized to the individual norm by drug therapy.
About the Authors
V. P. Fokin
Volgograd Branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery"
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor, Director.
80 Zemljachki St., Volgograd, Russian Federation, 400138
S. V. Balalin
Volgograd Branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery"; Volgograd State Medical University
Russian Federation
Russian Federation
Dr. Sci. (Med.), Head of the Scientific Department; Professor at the Academic Department of Eye Disease
80 Zemljachki St., Volgograd, Russian Federation, 400138
1 Pavshikh Bortsov Sq., Volgograd, Russian Federation, 400000
A. S. Sarkisyan
Volgograd Branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery"
Russian Federation
Russian Federation
Ophthalmologist.
80 Zemljachki St., Volgograd, Russian Federation, 400138
A. S. Balalin
Volgograd Branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery"
Russian Federation
Russian Federation
Ophthalmologist.
80 Zemljachki St., Volgograd, Russian Federation, 400138
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Review
For citations:
Fokin V.P., Balalin S.V., Sarkisyan A.S., Balalin A.S. Modern possibilities of laser surgery in the treatment of primary open-angle pigmentary glaucoma. National Journal glaucoma. 2023;22(1):67-75. (In Russ.) https://doi.org/10.53432/2078-4104-2023-22-1-67-75
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