Kanyukova Yu.V., Kadnikova O.V.
SELECTIVE LASER TRABECULOPLASTY AS A TREATMENT MODE FOR PRIMARY OPEN-ANGLE GLAUCOMA (THE RESULTS OF 6 MONTHS FOLLOW UP) ^{[№ 12 ' 2015]}
Glaucoma is one of the most common eye diseases, often resulting in low vision, blindness and disability. Among the clinical forms of the disease the primary open angle glaucoma (POAG) accounts for 72 % of all glaucoma cases. According to some researchers, selective laser trabeculoplasty (SLT) is a safe alternative for anti-glaucoma medications in the treatment of POAG. SLT was performed in 90 patients (125 eyes) aged 18 to 85 years (48 males and 52 females). The first stage of glaucoma was registered on 49 eyes (39.2 %), the second stage — 46 eyes (36.8 %) and the third one — 30 eyes (24.0 %). IOP was 20 to 35 mm Hg. The patients underwent surgery had the following comorbidities: cataract — 34 eyes (27.2 %), myopia — 35 eyes (28.0 %), hyperopia — 23 eyes (18.4 %), pseudophakia — 9 eyes (7.2 %), presbyopia — 11 eyes (8.8 %), pseudoexfoliation syndrome — 13 eyes (10.4 %). The laser parameters were adapted for the selective impact on the trabecular pigmented cells, without coagulate damage of structure of trabecular meshwork or non-pigmented cells. All patients were examined at 1 day, 1, 3 and 6 months after surgery. SLT is an effective and safe laser surgery in patients with early stage of POAG. Using SLT the target pressure has been achieved in 88 % of cases. IOP compensation was noticed by the end of the first day after surgery and was stable, while maintaining therapeutic regimen or its weakening during follow up period (6 months). An important indicator of SLT efficacy is improvement of visual acuity and widening of limits of field of view. Selective laser trabeculoplasty may be inappropriate for patients with previously operated far-advanced glaucoma and on the background of diabetic retinopathy due to the presence of goniosynechia, neovascularization and high proliferative activity.