Сравнительные результаты микроимпульсной циклофотокоагуляции с учетом различных уровней энергии у пациентов с первичной открытоугольной глаукомой

Abstract

Purpose. To evaluate the safety and efficacy of different laser energy parameters when performing micropulse transscleral cyclophotocoagulation (MP-TSCPC) in patients with different stages of primary open-angle glaucoma (POAG). Material and methods. 177 patients with moderate (47) and advanced (130) stages of primary open-angle glaucoma were under observation. All patients underwent repeated laser (mean 1,3±0,6) and surgical (mean 1,78±0,7) penetrating and nonpenetrating antiglaucoma surgeries. According to the amount of total energy during MP-TSCPC, patients were divided into 2 groups. The protocol of the first group (117 patients) included a total energy of 125J, fluence of 121,8 J/cm² . The protocol of the second group included increased energy (60 patients) where the total energy was 150 J, fluence 152 J/cm² . Results. Surgery and postoperative period in all patients were areactive. According to the data obtained when comparing the two groups on Kaplan – Meier chart, after 12 months of observation the group of patients with the fluence of 152J/cm² showed better results. A positive result was achieved in 95% of cases, compared to 87,1% in patients in the first group with an fluence of 121,8 J/cm². Conclusion. MP-TSCPC in patients with POAG with a fluence of 121,8 J/сm² and a total energy of 125 J and a fluence of 152 J/сm² and a total energy of 150 J is an effective and safe treatment method. The success parameters evaluated according to the Kaplan – Meier criterion showed that performing MP-TSCPC with 150 J energy was more effective than with 125 J. In the first group, 87,1% (102 out of 117 patients) success was achieved in up to 12 months of follow-up. In 60 patients with a higher energy (150 J), MP-TSCPC resulted in a long-term hypotensive effect in 95% (57 out of 60 patients) in the same period of observation. Key words: open angle glaucoma, intraocular pressure, micropulse cyclophotocoagulation, fluence