Коррекция вторичной глаукомы с применением гониоассоциированной трансиллюминальной трабекулотомии у пациентов после витреоретинальной хирургии

Abstract

Purpose. To study the efficacy and safety of gonio-associated transluminal trabeculotomy (GATT) in patients who developed secondary glaucoma after vitreoretinal surgery (VRS) see Silicone Oil Removal (SO) 1300. Material and methods. The analysis of surgical treatment of 12 patients (12 eyes) with a history of vitreoretinal intervention with silicone oil (SO) 1300 tamponade, the average age of patients was 53.6 ± 11.8 years, who underwent surgery according to the GATT method, was performed. Results. Before surgery, the mean IOP was 31.0 ± 4.1 mmHg; at the last postoperative visit, the mean IOP was 15.6 ± 4.6 mmHg (p = 0.033 compared to preoperative data). In the postoperative period, IOP values were significantly lower than in the preoperative period. Before surgery, the average number of antiglaucoma drugs used was 4.8 ±0.9; after surgery, the mean value of antiglaucoma drugs used was 1.6 ± 1.4 (p = 0.025 compared to preoperative data). The most common complication was hyphema, it was observed in 4 patients, which accounted for 33.3 %. Hyphema resolved within 1–3 days. In the postoperative period, jumps in IOP, detachment of the Descemet's membrane, detachment of the choroid, corneal edema and iridodialysis were not observed. The success of surgery was achieved in 11 (91.6 %) patients, while complete success without the use of antiglaucoma drops was achieved in 3 (25.0 %) patients (p = 0.024). Conclusion. The main goal of glaucoma treatment is to preserve the visual function and quality of life of patients. In recent years, in connection with the development of vitreoretinal surgery, a number of complications have appeared, one of which is ophthalmohypertension and progressive glaucomatous damage to the optic disc. There is a need for methods of surgical treatment with minimal trauma to the conjunctiva and sclera, for the possibility of future operations. Based on this study, it can be concluded that GATT is a safe and effective method in the treatment of patients with secondary glaucoma after VRS with CM 1300 removed. However, most patients may require antiglaucoma drugs in the postoperative period. Keywords: glaucoma, secondary glaucoma, gonioassociated trabeculotomy, minimally invasive glaucoma surgery, surgical treatment of glaucoma, silicone oil.