Эффективность и безопасность надпороговой селективной лазерной трабекулопластики как первого этапа лечения начальной стадии первичной открытоугольной глаукомы у пациентов с катарактой на фоне псевдоэксфолиативного синдрома

Abstract

Suprathreshold selective laser trabeculoplasty (SLT) is a modification of the classical subthreshold SLT. Purpose . To study the clinical efficacy and safety of suprathreshold SLT as the first stage of combined surgical treatment of the early primary open-angle glaucoma in patients with cataract against the background of pseudoexfoliation syndrome. Material and methods . The study of 48 suprathreshold SLT cases (48 eyes) was performed in patients with early primary open-angle glaucoma (POAG) with cataract against the background of pseudoexfoliation syndrome. Results . The drug therapy led to IOP decrease from 22.1±3.2 to 16.3±2.6 mm Hg (-26.3%). An additional IOP decrease to 14.3±1.8 mm Hg was determined 1 month after suprathreshold SLT (-34.8%). A significant improvement in the coefficient of intraocular fluid easiness outflow was noted from 0.12±0.03 to 0.16±0.03 mm3 /mm Hg·min. The decrease in IOP was accompanied by a significant improvement in MD and PSD indicators according to static perimetry and a decrease in the area of the optic disc excavation. Colorimetric analysis showed a decrease in pigmentation of the trabecular meshwork. The density of corneal endothelial cells has not changed: PEC – 2204±392 cells/mm2 . There wasn’t any clinical case of reactive hypertension, pain by palpation in the ciliary body projection, precipitates or Tyndall phenomenon during the study. Conclusion . According to the study, suprathreshold SLT is an effective and safe method of the early primary open-angle glaucoma treatment in patients with cataract against the background of pseudoexfoliation syndrome.