Oftalmol Zh.2015;1;19-23


Influence of the operation of endotrabecuoloectomy on glaucoma optical neuropathy course 

Novytskyy M. I. 

Lviv municipal medical center «Microsurgery of the eye», Lviv national medical university by Danylo Halytsky; Lviv (Ukraine)

Introduction. Compensation of IOP does not always lead to a stabilization of the glaucomatous process. Therefore, functional and morphometric studies to evaluate the effectiveness of glaucoma surgery are important and necessary. 

Purpose. To evaluate hypotensive effect of endotrabeculoectomy and influence of the operation on stabilization of glaucoma progressing. 

Material and methods. The investigation was done in two groups. The first group (22 patients, 23 eyes) was with open-angle glaucoma who underwent endotrabeculoectomy, and the second group (95 patients, 107 eyes) had open-angle glaucoma and cataract who underwent combined phacoemulsification and endotrabeculoectomy. 

Results. In the first group tonometric IOP decreased by 7.8+0.7 mm Hg and was 18.6+1.1 (p<0.05) in 6 months after the operation and in the second group IOP decreased by 5.2±0.6 mm Hg and was 18.9±1.2 mm Hg (p<0.05). In the follow up period IOP remained compensated and stable. 

Mean light sensitivity in patients with IOP<22 mm Hg decreased by 0.3±0.2 dB per year (p<0.05), and in patients with IOP over 22 mm Hg — by 0.6±0.4 dB per year (p<0.05). Pattern standard deviation in patients with IOP<22 mm Hg increased by 0.1±0.1 dB (p<0.05), and in patients with IOP over 22 mm Hg — by 0.4+0.3 dB (p<0.05) per year. Morphometric indices of the optic nerve disc during two years after the operation didn’t change significantly in the patients of both groups. 

Conclusion. Endotrabeculoectomy has an evident hypotensive effect. Results of standard automated perimetry, optical coherent tomography of the optic nerve disc, and measurement of thickness of the retinal nerve fiber layer confirmed stabilization of glaucoma progressing after the operation.

Key words: Endotrabecuoloectomy, intraocular pressure, field of vision, OCT, thickness of the retinal nerve fiber layer


1.Rudavska G. N., Gumenjuk O. V. Estimation of dynamics of visual functions in primery open angle glaucoma with compensated intraocular pressure. Oftalmol zh. 2007; 1: 62–64. Ukrainian. 

2.Serduk V. N. Neuromodulatory and neuroprotective agents in the treatment of various subtypes of glaucoma (clinical and neurophysiological research). Oftalmologiia. Vostochnaia Evropa. 2013; 3 (18): 5–12. Russian. 

3.Alencar L. M., Zangwill L. M., Weinreb R. N. et al. A  Comparison of Rates of Change in Neuroretinal Rim Area and Retinal Nerve Fiber Layer Thickness in Progressive Glaucoma. Invest Ophthalmol Vis Sci. 2010; July; 51(7): 3531–3539. 
Crossref   Pubmed

4.Artes P. H., Chauhan B. C. Longitudinal changes in the visual field and optic disc in glaucoma. Prog Retin Eye Res. 2005; Vol. 24: 333–354. 
Crossref   Pubmed

5.Chauhan B. C., Garway-Heath D. F., Goñi F. J. et al. Practical recommendations for measuring rates of visual field change in glaucoma. Br J Ophthalmol. 2008; April; 92(4): 569–573. 
Crossref   Pubmed

6.Heijl A., Buchholz P., Norrgren G., Bengtsson B. Rates of visual field progression in clinical glaucoma care. Acta Ophthalmol. 2012; August; 91(5): 406–412. 

7.Henson D. B., Thampy R. Preventing blindness from glaucoma. BMJ. 2005; 331(7509): 120–121.

8.Kerrigan-Baumrind L. A., Quigley H. A., Pease M. E. et al. Number of ganglion cells in glaucoma eyes compared with threshold visual field tests in the same persons. Invest Ophthalmol Vis Sci. 2000; 41: 741–748. 

9.Lisboa R., Weinreb R. N., Medeiros F. A. Combining Structure and Function to Evaluate Glaucomatous Progression: Implications for the Design of Clinical Trials. Curr Opin Pharmacol. 2013; February; 13(1): 115–122. 

10.Xin D., Greenstein V. C., Robert R. R. et al. A Comparison of Functional and Structural Measures for Identifying Progression of Glaucoma. Invest Ophthalmol Vis Sci. 2011; January; 52(1): 519–526.