Abstract
Purpose . To study the clinical efficacy of phacoemulsification with YAG-laser activation of trabecula (YAG-LAT) in eyes with primary openangle glaucoma (POAG) and coexisting complicated cataract. Material and methods . The study included 70 patients (70 eyes) with initial and advanced stages of POAG and coexisting cataract. There were 42 women (60%) and 28 men (40%), the average age was 68.8±8.2 years. The follow-up period is 2 years after the treatment. The patients were divided into two groups: combined group – 36 patients (36 eyes) who underwent YAG-LAT and phacoemulsification and the control group – 34 patients (34 eyes) who underwent phacoemulsification alone. The baseline IOP by Maklakov in the combined and control groups was 24.1±2.52 and 23.0±2.41 mm Hg respectively. The mean medication use was 1.53±0.65 in the combined group and 1.44±0.50 in the control group. Results . There were no intraoperative complications. In the early postoperative period, reactive increase in IOP was noted in 8.3 and 32.4% of cases in the combined and control groups, respectively. By the end of the follow-up period, the mean IOP decreased by 21.1% after combined treatment (p<0.001) and in the control group, no statistically significant differences were revealed. The mean medication use decreased from 1.53±0.65 to 0.64±0.56 after combined treatment (p<0.05), and increased from 1.44±0.50 to 1.92±0.28 after phacoemulsification alone (p<0.05). Conclusion . In long-term follow-up after combined treatment (YAGLAT with phacoemulsification) normalization of IOP was achieved in 96.4% of cases, the mean medication use decreased significantly, stabilization of the glaucoma process was noted in 96.4% of cases. Increased visual acuity after treatment was observed in all patients in both groups. The developed method of treatment is safe, has a minimal risk of complications and can be used to treat patients with the initial stages of POAG and coexisting cataract.
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