Betamethasone-loaded bioresorbable drainage in primary open-angle glaucoma surgery
https://doi.org/10.53432/2078-4104-2025-24-2-41-52
Abstract
PURPOSE. To investigate the use of betamethasoneloaded bioresorbable drainage in patients with primary open-angle glaucoma undergoing fistulizing surgery to increase the stability of its hypotensive effect.
METHODS. The study included two groups of 50 patients (50 eyes): the main group underwent surgery using a bioresorbable polylactic acid drainage device loaded with betamethasone solution, while the control group received the same drainage device without betamethasone. Patients were examined at baseline, postoperatively, then at 1 and 2 weeks, as well as at 1, 3, 6, and 12 months. Interleukin-6 (IL-6) and interleukin-10 (IL-10) levels in tear fluid were assessed before and after surgery using enzyme-linked immunosorbent assay (ELISA).
RESULTS. At 1 year postoperatively, intraocular pressure (IOP) was significantly lower in the main group compared to the control group (15.48±1.74 vs. 17.52±2.25 mm Hg; p <0.05).
In the main group, IL-6 levels in tear fluid decreased postoperatively from 32.7 [0.0; 784.2] to 8.15 [0.0; 1031.2] pg/ml, remaining significantly lower than in the control group (p=0.026), whereas IL-10 levels remained unchanged. IL-6 levels in the control group did not change postoperatively. No significant differences were observed between the groups in IL-10 levels preoperatively (p=0.817) or postoperatively (p=0.029).
The superior hypotensive effect of the novel surgical approach was associated with greater filtration bleb height compared to the control group (0.71±0.20 vs. 0.57±0.13 mm; p=0.002), scleral cavity height (0.47±0.16 vs. 0.39±0.14 mm; p=0.015), and intrascleral cavity volume (3.58±1.51 vs. 2.07± 0.82 mm³; p < 0.001). The incidence and severity of postoperative complications did not differ between groups (6.8%).
CONCLUSION. The findings confirm the high efficacy and safety of glaucoma surgery using a bioresorbable polylactic acid drainage device loaded with betamethasone for primary open-angle glaucoma. ELISA results indicate that the use of this drainage method is associated with reduced postoperative inflammation.
Supporting agencies: the authors received no specific funding for this work
About the Authors
I. B. Alekseev
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Dr, Sci. (Med.), Professor at the Academic Department of Ophthalmology
2/1 Barrikadnaya St., Moscow, 123995
A. R. Isaev
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
ophthalmologist, postgraduate student at the Academic Department of Ophthalmology
2/1 Barrikadnaya St., Moscow, 123995
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For citations:
Alekseev I.B., Isaev A.R. Betamethasone-loaded bioresorbable drainage in primary open-angle glaucoma surgery. National Journal glaucoma. 2025;24(2):41-52. (In Russ.) https://doi.org/10.53432/2078-4104-2025-24-2-41-52
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