Complex use of energetic surgery in treatment of patients with primary open-angle glaucoma and cataract on the background of pseudoexfoliative syndrome
- Authors: Dzhashi B.G.1, Balalin S.V.1
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Affiliations:
- S.N. Fyodorov Eye Microsurgery Federal State Institution
- Issue: Vol 14, No 3 (2021)
- Pages: 25-34
- Section: Original researches
- URL: https://journals.rcsi.science/ov/article/view/70269
- DOI: https://doi.org/10.17816/OV70269
- ID: 70269
Cite item
Abstract
BACKGROUND: Glaucoma remains one of the current problems of modern ophthalmology. The combination of glaucoma and cataract is observed in 17–38.6% of cases, and glaucoma with pseudoexfoliative syndrome – in 20–50% of primary open-angle glaucoma cases.
AIM: The aim of this work is to develop an effective and safe technology of complex energetic surgical treatment of the incipient primary open-angle glaucoma stage and cataract on the background of pseudoexfoliation syndrome on the basis of modified laser, hydrodynamic and ultrasound methods’ use.
MATERIALS AND METHODS: 187 patients (187 eyes) with the incipient stage of primary open-angle glaucoma, cataract and pseudoexfoliation syndrome were examined. In the main group (111 eyes), selective laser trabeculoplasty followed by femtosecond laser-assisted cataract surgery with hydrodynamic trabeculocleaning was performed. Patients in the control group (76 eyes), after selective laser trabeculoplasty, underwent phacoemulsification according to the standard technique.
RESULTS: The developed technology allowed to reach the hypotensive effect in 35.2% (t = 23.0; p < 0.001) of baseline intraocular pressure values, of individual intraocular pressure level without adding IOP-lowering medications in 27% of cases, stabilization of visual functions and morphometric indices of the optic disc during 2 years of follow-up in 97.3% of cases unlike the selective laser trabeculoplasty with subsequent phacoemulsification (21.2, 5.3 and 81.6% respectively). The patients of the main group had significantly lower energy expenditure during the stage of phacoemulsification, a lower percentage of postoperative inflammatory reaction was noted, and a persistent hypotensive effect with stabilization of visual functions was achieved based on the results of a two-year follow-up.
CONCLUSIONS: Femtosecond laser-assisted phacoemulsification, performed as part of complex treatment in patients with cataract and incipient stage of primary open-angle glaucoma, is a sparing method that minimizes surgical trauma and achieves a persistent hypotensive effect, reduces intraocular pressure to an individual level and stabilizes visual functions in 97.3% of cases.
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##article.viewOnOriginalSite##About the authors
Benta G. Dzhashi
S.N. Fyodorov Eye Microsurgery Federal State Institution
Email: benta1@eandex.ru
ORCID iD: 0000-0001-5763-888X
SPIN-code: 9487-2798
Ophthalmologist
Russian Federation, 80 Zemljachki str., Volgograd, 400138Sergei V. Balalin
S.N. Fyodorov Eye Microsurgery Federal State Institution
Author for correspondence.
Email: s.v.balalin@gmail.com
ORCID iD: 0000-0002-5250-3692
SPIN-code: 5561-2173
Scopus Author ID: 6504016538
ResearcherId: AAL-3746-2021
Doctor of Medical Sciences, Head of the Scientific Department Fedorov Eye Microsurgery Federal State Institution, Volgograd Branch
Russian Federation, 80 Zemljachki str., Volgograd, 400138References
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