scholarly journals Laser trabeculoplasty - the first choice surgery for treatment of primary open angle glaucoma

2012 ◽  
Vol 93 (6) ◽  
pp. 939-941
Author(s):  
R F Akhmetshin ◽  
S N Bulgar
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Hypotensive Effect ◽  
Beam Diameter ◽  
Open Angle ◽  
Second Stage ◽  
Laser Trabeculoplasty ◽  
First Choice

Aim. To analyze the results of laser trabeculoplasty in patients with first and second stage of primary open angle glaucoma with the disease duration over 6 years depending on nature of sclera sinus blockade. Methods. 251 patients aged 38 to 78 years (121 female, 130 males, 285 eyes) with primary open angle glaucoma were observed. The early stage of the disease was observed in 188 eyes, promoted stage of the disease - in 97 eyes. Hypertension, atherosclerosis, diabetes mellitus were among the comorbidities. Visual acuity testing, visual field testing, ocular tonometry and tonography, ophthalmoscopy were performed, sclera sinus blockade features were defined. Laser trabeculoplasty was performed with an argon laser using the universal three mirror lens (600 to 1000 mW, laser beam diameter 50 μm, exposure time 0.1 sec, average number of iterations - 100). Laser linear trabeculoplasty by Wise modified by Mamedov was performed. In case of narrow anterior chamber angle an additional laser gonioplasty by Krasnov and laser peripheral iridotomy were performed prior to trabeculoplasty. Results. In patients with the first stage of the disease in case of a functional blockade the remote hypotensive effect was reached in 81.7% of cases, in case of organic blockade - in 46.7% of cases. In the second stage of an open angle glaucoma decrease in intraocular pressure in functional blockade was reached in 65% of cases, in organic blockade - in 33.3% of cases. Visual acuity decreased in 22.1% of cases. In patients with sclera sinus functional blockade the remote hypotensive effect was twice as better compared to patients with organic blockade. Visual field stabilization in patients with organic blockade was achieved 5.5 times rarely compared to patients with functional blockade. Conclusion. Laser linear trabeculoplasty is still the first choice surgery for primary open angle glaucoma treatment. Defining the nature of sclera sinus blockade allows to predict the laser trabeculoplasty results.

scholarly journals Efficacy of Microwave Pulse Diode Laser and Argon Laser Trabeculoplasty in Patients with Primary Open Angle Glaucoma

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Asma Shams ◽  
Narain Das ◽  
Noman Rashid ◽  
M. Nasir Bhatti ◽  
Beenish Khan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diode Laser ◽  
Microwave Pulse ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Argon Laser ◽  
Open Angle ◽  
Argon Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Group B

Purpose:  To compare the efficacy of the microwave pulse diode laser and argon laser trabeculoplasty in primary open angle glaucoma. Study Design:  Quasi experimental study. Place and Duration of Study:  Shaheed Mohtarma Benazir Bhutto Medical College Lyari and Sindh Government Lyari General Hospital, Karachi, from October, 2017 to March, 2018. Material and Methods:  One hundred and sixty patients, between 42 to 61 years with visual acuity of perception of light to 6/36 were enrolled. Patients diagnosed with POAG were included and patients with intraocular pressure of more than 40 mm Hg, previous glaucoma surgery or laser treatment and narrow angle on gonioscopy were excluded. Ophthalmic examination included visual acuity, slit lamp examination, fundus examination and visual field status using Humphrey perimeter. Patients were divided into two groups. Group A received microwave pulse diode laser (810) and Group B received argon laser trabeculoplasty. Average follow up period was 6 months. Success was assessed objectively by measuring intra ocular pressure and subjectively by visual acuity. Results:  The average time-period for each procedure was 15 ± 5 minutes. In Group A, mean IOP at first week, first month, third month and sixth month was 20.79, 16.34, 16.21and 16.09 mm Hg respectively. While in Group B, IOP at first week, first, third and sixth month was 16.52, 15.76, 13.62, and 12.54 mm Hg at (P < 0.001 in both groups). Conclusion:  Both microwave pulse diode laser and argon laser trabeculoplasty are effective in lowering intra ocular pressures in patients with primary open angle glaucoma.

scholarly journals Complex use of energetic surgery in treatment of patients with primary open-angle glaucoma and cataract on the background of pseudoexfoliative syndrome

2021 ◽  
Vol 14 (3) ◽  
pp. 25-34
Author(s):  
Benta G. Dzhashi ◽  
Sergei V. Balalin
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Visual Functions ◽  
Incipient Stage ◽  
Laser Trabeculoplasty

BACKGROUND: Glaucoma remains one of the current problems of modern ophthalmology. The combination of glaucoma and cataract is observed in 1738.6% of cases, and glaucoma with pseudoexfoliative syndrome in 2050% 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; р 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.

GERIATRIC STATUS OF GLAUCOMA PATIENTS

2021 ◽  
pp. 56-61
Author(s):  
Виктор Афанасьевич Иванов ◽  
Борис Дмитриевич Жидких ◽  
Татьяна Игоревна Субботина ◽  
Дарья Николаевна Бельчикова ◽  
Александр Викторович Иванов ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Visual Deficit ◽  
Quality Of Life Index

Во многих странах продолжается увеличение заболеваемости первичной открытоугольной глаукомой, а гериатрический статус пациентов ухудшается. В связи с этим актуальным является коррекция гериатрического статуса. Цель исследования - изучение гериатрического статуса пациентов, страдающих ПОУГ, после проведения селективной лазерной трабекулопластики. Результаты исследования базируются на комплексном офтальмологическом и гериатрическом обследовании до и после проведения селективной лазерной трабекулопластики. При изучении гериатрического статуса проведен анализ изменений таких гериатрических синдромов как зрительный дефицит, индекс качества жизни, депрессивный синдром. В ходе исследования установлено позитивное влияние селективной лазерной трабекулопластики на величину снижения зрительного дефицита. Так, острота зрения без коррекции и максимальная корригированная острота зрения после проведенного оперативного вмешательства повысились соответственно с 0,51±0,02 до 0,6±0,01 и с 0,62±0,02 до 0,68±0,01. Однако селективная лазерная трабекулопластика не изменила уровень депрессии, а интегральный показатель качества жизни имел тенденцию к снижению с 438,6±3,9 баллов до 429,4±3,8 баллов. Это указывает на необходимость коррекции гериатрического статуса больных с первичной открытоугольной глаукомой In many countries, the incidence of primary open-angle glaucoma continues to increase, and the geriatric status of patients is deteriorating. In this regard, the correction of geriatric status is relevant. The aim of the study was to study the geriatric status of patients suffering from POAG after selective laser trabeculoplasty. The results of the study are based on a comprehensive ophthalmological and geriatric examination before and after selective laser trabeculoplasty. When studying the geriatric status, the analysis of changes in such geriatric syndromes as visual deficit, quality of life index, and depressive syndrome was carried out. The study found a positive effect of selective laser trabeculoplasty on the reduction of visual deficit. Thus, the visual acuity without correction and the maximum corrected visual acuity after the surgical intervention increased, respectively, from 0.51±0.02 to 0.6±0.01 and from 0.62±0.02 to 0.68±0.01. However, selective laser trabeculoplasty did not change the level of depression, and the integral indicator of quality of life tended to decrease from 438.6±3.9 points to 429.4±3.8 points. This indicates the need to correct the geriatric status of patients with primary open-angle glaucoma

Comparison of Hypotensive Effect of Endotrabeculoectomy and Selective Laser Trabeculoplasty

2021 ◽  
pp. 19-25
Author(s):  
Olha V. Levytska ◽  
Igor Ya. Novytskyy
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Significant Difference ◽  
The Difference

Hypotensive effect of endotrabeculectomy was compared with that of selective laser trabeculoplasty in patients with primary open-angle glaucoma (POAG). We evaluated 44 patients (44 eyes) with POAG. In the first group (23 patients), endotrabeculectomy (trabecular ablation through the angle of anterior chamber) was performed, and in the second group (21 patients) the patients underwent selective laser trabeculoplasty. When comparing the intraocular pressure (IOP), it was found that the difference between preoperative and postoperative IOP was significant up to 6 months of follow-up in both groups (p < 0.05), however, hypotensive effect in the first group was more pronounced (7.58 vs. 1.55 mmHg, respectively). When comparing the number of hypotensive medications used before and after glaucoma surgery, it was found that the difference in patients of the first group was significant throughout the observation period (p = 0.028), while in patients of the second group there was no significant difference from the 3rd month of observation. The number of topical drugs to reduce IOP decreased by 1.44 in the first group (p < 0.05) and by 0.33 in the second group (p = 0.109). Endotrabeculectomy, as well as selective laser trabeculoplasty, showed significant hypotensive effect in patients with POAG within 6 months of observation, however, hypotensive effect of endotrabeculectomy significantly overweighted that of SLT. Keywords: endotrabeculectomy, selective laser trabeculoplasty, intraocular pressure, primary open-angle glaucoma.

Results of a new modification of anti-glaucoma surgery in the treatment of primary open-angle glaucoma in combination with cataract

2021 ◽  
pp. 67-70
Author(s):  
M.M. Bikbov ◽  
◽  
O.I. Orenburgkina ◽  
A.E. Babushkin ◽  
G.Z. Israfilova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Visual Functions ◽  
Group 2 ◽  
Group 1

Purpose. To study the effectiveness of the developed partially fistulizing glaucoma surgery in the treatment of primary open-angle glaucoma (POAG) in combination with complicated cataract. Material and methods. 28 patients (28 eyes) were examined, including 13 patients (13 eyes) with I–III stages of POAG, operated according to the method of glaucoma surgery developed by us (group 1), and 15 patients (15 eyes) with a combination of previously unoperated glaucoma with incomplete complicated cataracts, who underwent a combined intervention – simultaneous phacoemulsification of cataracts with the specified variant of partially fistulizing glaucoma intervention (group 2). The analysis of the frequency of complications, the dynamics of visual functions, visual acuity and ophthalmotonus before surgery, at the time of discharge from the hospital, and in the longterm (6–9 months) after surgery was carried out. Results. In group 1, in the long term, the absolute hypotensive effect was recorded in 81.8% of cases, visual functions remained the same – in 90.9%. In group 2, by the end of follow – up, the level of normalized intraocular pressure was recorded in all patients, while in 78.6% of cases without drug correction and in 21.4% – with the help of antihypertensive drugs. Visual acuity in group 2, after a single-stage combined operation by the day of discharge from the hospital, averaged 0.53±0.05, in the long-term – 0.77±0.06, while the stabilization of glaucoma optic neuropathy after surgery occurred in 92.9%. Conclusion. Glaucoma surgery according to the proposed method in the studied long-term periods in patients with POAG provided a sufficiently high hypotensive effect and the preservation of visual functions. Combined single-stage intervention was an effective way to increase visual acuity, normalize ophthalmotonus and stabilize glaucoma optic neuropathy, as well as reduce drug load. Key words: primary open-angle glaucoma, cataract, partially fistulizing glaucoma surgery, cataract phacoemulsification.

scholarly journals Immediate Manifestation of Ocular Decompression Retinopathy following Anterior Chamber Paracentesis

2019 ◽  
Vol 10 (2) ◽  
pp. 287-291 ◽  
Author(s):  
Jamie Prince ◽  
David Fleischman
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Light Perception ◽  
Laser Trabeculoplasty ◽  
Anterior Chamber Paracentesis ◽  
The Right ◽  
Decompression Retinopathy

Ocular decompression retinopathy (ODR) is a complication of rapid lowering of intraocular pressure (IOP) resulting in hemorrhages in multiple retinal layers. We report a case of ODR that developed within minutes following anterior chamber paracentesis in an adult female with primary open-angle glaucoma. A 61-year-old Black woman with primary open-angle glaucoma presented with marked elevation of IOP (46 mm Hg in the right eye and 30 mm Hg in the left) despite maximal medical therapy and bilateral selective laser trabeculoplasty. Vision in the right eye decreased from counting fingers at 3 feet 1 week earlier to no light perception at the time of presentation. Anterior chamber paracentesis was performed on the right eye to reduce IOP and stabilize the eye until further surgical intervention could be performed. IOP in the right eye decreased to 6 mm Hg postoperatively. Within minutes of the procedure, several intraretinal blot hemorrhages appeared in the periphery of the right eye. During this time, visual acuity remained at no light perception. The findings were consistent with decompression retinopathy. By 12 weeks postoperatively, the ODR had resolved with visual acuity of light perception and normal fundoscopy except for profound cupping. Our case demonstrates how rapidly ocular decompression can form following IOP reduction.

Experience in the management of patients with cataract-associated glaucoma

2021 ◽  
pp. 25-29
Author(s):  
B.G. Dzhashi ◽  
◽  
T.N. Zhdanova ◽  
S.V. Balalin ◽  
A.R. Vinogradov ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Surgical Intervention ◽  
Open Angle Glaucoma ◽  
Hypotensive Effect ◽  
Main Group ◽  
Control Group ◽  
Deep Sclerectomy ◽  
Open Angle ◽  
Second Stage

Purpose. Analysis of the effectiveness of surgical treatment of patients with primary open-angle glaucoma associated with cataract the first stage realization of cataract phacoemulsification with IOL implantation (PHACO), and the second stage - microinvasive nonpenetrating deep sclerectomy (MNPDS). Material and methods. The results of 234 cases of performing PHACO and MNPDS at various stages have been analyzed. The main group included patients who underwent PHACO, followed by MNPDS – 39 persons, 40 eyes. The group was divided into a subgroup based on the date of the second intervention. 1 subgroup – patients who underwent MNPDS 1 month after PHACO (11 cases); 2 subgroup – 3 months after PHACO (29 cases). The control group included patients who underwent MNPDS followed by PHACO – 180 persons, 195 eyes. Also, subgroups of patients were identified for whom PHACO + IOL was performed in the second stage after 1 month – 1 subgroup (99 cases) and after 3 months – 2 subgroup (96 cases). Results. Patients of the main group showed a significant decrease in intraocular pressure after each stage of treatment. in the control group, intraocular pressure decreased after the first stage of treatment, but increased 6 months after surgery. Conclusions. According to the study, in primary open-angle glaucoma associated with cataract, the most persistent hypotensive effect is observed when the first stage of cataract phacoemulsification is performed, and the second stage is antiglaucoma surgical intervention. Key words: glaucoma, cataract, cataract phacoemulsification, microinvasive nonpenetrating deep sclerectomy.

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