Сравнительная оценка клинико-функциональных результатов непроникающей глубокой склерэктомии и каналопластики при первичной открытоугольной глаукоме

Abstract

Purpose. To carry out a comparative evaluation of clinical and functional results of non-penetrating deep sclerectomy and canaloplasty in patients with primary open-angle glaucoma within the 12 month follow-up. Material and methods. The study included 93 patients (151 eyes) with non-compensated primary open-angle glaucoma (POAG) (67 female and 26 male), the mean age 66.5±10.8 years, who were divided into 2 groups: the main group consisted of 51 patients (84 eyes) where was scheduled the canaloplasty and in the control group of 42 patients (67 eyes) the non-penetrating deep sclerectomy (NPDS) was scheduled. Each group was additionally divided into 2 subgroups according to POAG stages (initial and advanced B – far-advanced). The follow-up was 12 months. Results . The successful micro-catheter implantation into the lumen of Schlemm’s canal was achieved in 63 cases (75%). In the early postoperative period, the most frequent complications in the group 1 were micro-hyphema and hyphema in 49 cases (77.7%) and elevated intraocular pressure was in 16 cases (25.4%). In the second group the most frequent complications were choroid detachment in 14 cases (20.9%) and elevated intraocular pressure in 8 cases (11.9%). In the late postoperative period, the elevated intraocular pressure (IOP) was the most common complication in all groups: 27 cases (42.8%) in the group 1 and 17 cases (25.4%) in the group 2. At 12 months the mean IOP was 21.9±4.2mmHg in the group 1 and 20.6±2.85mmHg in the group 2, respectively. The quantity of glaucoma medications by the end of follow-up in the group 1 decreased on average from 1.8±0.8 to 1.3±0.8; in the second group the IOP decreased from 1.9±0.65 to 0.7±0.65, respectively. Conclusions. Canaloplasty and non-penetrating deep sclerectomy are safe and effective in the surgical management of open-angle glaucoma. Canaloplasty procedures showed comparable efficacy to non-penetrating deep sclerectomy in the IOP reduction in patients with initial and advanced stages of glaucoma.