Клинические результаты лечения открытоугольной глаукомы микроимпульсной транссклеральной циклофотокоагуляцией

Abstract

Purpose. To evaluate treatment efficiency of open-angle glaucoma with micropulse transscleral cyclophotocoagulation, to determine the optimal total energy of laser exposure and to assess the stability of the glaucoma process after treatment. Material and methods. A prospective study was carried out. It included 34 (21 patients) with primary open-angle and pseudoexfoliative glaucoma of stages 1-3, which undergone micropulse transscleral cyclophotocoagulation. The patients were divided into subgroups 1 and 2, depending on the total amount of laser energy (100 J and 150 J, respectively). At different periods of observation, the intraocular pressure, best corrected visual acuity, visual fields, cup-to-disc ratio and the number of antiglaucoma drugs were determined. Results. In the general group, all operated patients achieved a decrease in IOP to a tolerant level, from a median value of 27 [25; 28] in the preoperative period, up to 17.5 [15; 20] at the end of the observation period. The number of used drugs decreased statistically significantly, from 3.0 [3.0; 3.0] to 2.0 [1.0; 2.0]. There was a statistically significant increase in the mean deviation of the retinal photosensitivity, from –4.85 [–8.25; –2.17] to –4.36 [–7.06; –2.37] after 18 months. Indicators of best corrected visual acuity and CDR remained stable throughout the observation period. In subgroup 2 (150J), a statistically more significant decrease in IOP level (p=0.033) and the number of used drugs (p=0.001) was achieved compared with subgroup 1 (100J). Conclusion. Micropulse transscleral cyclophotocoagulation is an effective and safe method of treating open-angle glaucoma in patients with early stages of the disease and high values of best corrected visual acuity. Using a total amount of energy in 150J contributes to a more pronounced decrease in IOP and a decrease in the number of applied drugs than an energy in 100J. Key words: open-angle glaucoma, pseudoexfoliative glaucoma, micropulse cyclophotocoagulation.