СРАВНИТЕЛЬНЫЙ АНАЛИЗ РЕЗУЛЬТАТОВ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ОТКРЫТОУГОЛЬНОЙ ГЛАУКОМЫ МЕТОДАМИ МИКРОИМПУЛЬСНОЙ ТРАНССКЛЕРАЛЬНОЙ ЦИКЛОФОТОКОАГУЛЯЦИИ И СИНУСТРАБЕКЛЭКТОМИЕЙ

Abstract

Purpose of the study: Evaluate the efficiency and compare results of micropulse transscleral cyclophotocoagulation(mCPC) and trabeculectomy in treatment of patients with open-angle glaucoma of stages 1—3. Materials and methods: In our study 67 surgical interventions were performed to reduce the level of IOP. The patients were divided into two groups depending on the used surgical technique: group I (study) — 34 eyes (21 patients) which underwent micropulse transscleral cyclophotocoagula- tion, group II (comparison) — 33 eyes (33 patients), trabeculectomy was performed. The groups were comparable in terms of the main indicators affecting the final treatment outcome. During the period of observation the level of intraocular pressure, the best corrected visual acuity, visual fields, cup-to-disc ratio and the amount of antiglaucoma drugs used were determinated. Results: In both groups, a statistically significant decrease in IOP was achieved at the end of the observation period (p < 0.001), the groups were comparable in terms of this indicator (p = 0.61). There was a statistically significant decrease in the number of drugs taken (p < 0.001) in both groups. Comparison of groups I and II showed a statistically significant difference in terms of the indicator at the observation periods of 3, 6 and 12 months, and the absence thereof after 18 months (p = 0.072). BCVA in group I was stable (p = 0.53 after 18m.), In group II, statistically insignificant positive dynamics in BCVA were observed (p = 0.046 at pcrit. = 0.125 after 18m). Both groups were comparable throughout the observation period in terms of CDR and the MD of the retina light sensitivity. Group I patients did not require additional surgical treatment, 9 patients of group II underwent 12 additional interventions aimed at treating complications. Conclusion: Micropulse transscleral cyclophotocoagulation allows to achieve a pronounced decrease in the IOP level and a decrease in the number of the applied drugs. MCPC is comparable in efficiency with trabeculectomy, in the absence of complications that require additional surgical treatment and affect the success of treatment, which is typical for trabeculectomy. The use of mCPC provides a stable course glaucomatous neuroopticopathy comparable to trabeculectomy.