Single step laser procedures combined technology in the treatment algorithm of advanced primary open-angle glaucoma stage after surgery

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Abstract

Results are presented of a combined laser treatment method of advanced primary open-angle glaucoma stagewith high trabecular meshwork pigmentation in anterior chamber angle and pseudoexfoliation syndrome stage 2, after non-penetrating deep sclerectomy at recurrent IOP increase in the post-op period. The laser treatment included a single-step modified selective laser activation of the trabeculum and a laser Descemet’s goniopuncture. The study results demonstrated more significant IOP-lowering effect as well as the integrity of surgically-formed aqueous humor outflow pathways during a follow-up period of 24 months compared with controls, in whom only classical Descemet’s goniopuncture (DGP) method was used.

About the authors

Eleonora R. Tumanyan

S. Fyodorov Eye Microsurgery Federal State Institution

Author for correspondence.
Email: ivashchenko.ekaterina@gmail.com

MD, DMedSc, Нead of the Scientific and Educational Center

Russian Federation, Moscow

Tatyana S. Lyubimova

S. Fyodorov Eye Microsurgery Federal State Institution

Email: ivashchenko.ekaterina@gmail.com

MD, PhD, Department of Surgical Treatment of Glaucoma

Russian Federation, Moscow

Elena E. Kozlova

S. Fyodorov Eye Microsurgery Federal State Institution

Email: ivashchenko.ekaterina@gmail.com

Ophthalmologist, Department of Surgical Treatment of Glaucoma

Russian Federation, Moscow

Irina N. Shormaz

S. Fyodorov Eye Microsurgery Federal State Institution

Email: ivashchenko.ekaterina@gmail.com

MD, Ophthalmologist

Russian Federation, Moscow, Russia

Ekaterina V. Ivashchenko

S. Fyodorov Eye Microsurgery Federal State Institution

Email: ivashchenko.ekaterina@gmail.com

MD, Ophthalmologist, Postgraduate Student

Russian Federation, Moscow, Russia

References

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2. Fig. 1. Gonioscopic view before laser surgery: An anterior chamber angle is open, has an average width, intense trabecular meshwork pigmentation, pseudoexfoliation material concretion can be noted at every structure of an anterior chamber angle. A trabeculo-Descemet's membrane is visualisable at 12 o’clock, shaped as semi-transparent rectangle overlaid by pigment granules and pseudoexfoliation material

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3. Fig. 2. Gonioscopic view 2 years after laser surgery: а – the main group demonstrates sharply defined borders of the modified selective laser activation of the trabecular shaped as an anterior chamber angle structure paleness; b – the control group demonstrates a significant pigmentation of an anterior chamber angle structure with remained overlays of pseudoexfoliation material

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4. Fig. 3. OCT Visantae 2 years after the laser surgery: а – patient M. from the main group. Law optical density filtering bleb with a height of 0.43 mm, significant intrascleral cavity with a height of 0,37 mm, a few incorporations with a low optical density located mural; b – patient K. from the control group. Average optical density filtering bleb with a height of 0.33 mm, slit-like intrascleral cavity, fully filled with a high optical density overlays

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Copyright (c) 2018 Tumanyan E.R., Lyubimova T.S., Kozlova E.E., Shormaz I.N., Ivashchenko E.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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