Клиническая оценка эффективности алгоритма прогнозирования повышения уровня внутриглазного давления после факоэмульсификации у пациентов с первичной открытоугольной глаукомой

Abstract

Purpose. To evaluate the clinical effectiveness of the algorithm for predicting the risk of increased intraocular pressure (IOP) after phacoemulsification (PE) in patients with primary pen-angle glaucoma (POAG). Material and methods. 103 patients (103 eyes) with POAG who underwent PE were studied. The level of IOP according to Maklakov before the operation was 18.7±1.9 mm Hg. To identify the risk of an increase in IOP after PE, a prediction algorithm was used, with the help of which significant predictors were selected, logistic regression coefficients were determined, and the cut-off point for making prediction decisions was determined using ROC analysis. A favorable prognosis (without an increase in IOP) was given to 81 patients, an unfavorable prognosis (an increase in IOP to intolerant values) was given to 22 patients. Results. In the course of dynamic observation for 24 months, 20 cases of an increase in the level of IOP to intolerant values were identified. In 2 patients with a poor prognosis, there was no increase in IOP during the entire follow-up period. The specificity of the forecast was 90 % (20 out of 22). Conclusion. The developed predictive algorithm is reasonable and effective, its specificity is 90 %. When predicting the risk of an increase in IOP in the postoperative period of PE, patients with POAG should be carefully monitored postoperatively. This will provide an individual strategy for managing the patient to preserve visual functions. Keywords: primary open-angle glaucoma, phacoemulsification, intraocular pressure, prediction algorithm.