J.ophthalmol.(Ukraine).2019;6:44-48.

http://doi.org/10.31288/oftalmolzh201964448

Received: 20 September 2019; Published: 06 January 2020

Stabilization of glaucoma after non-perforating deep sclerectomy with laser trabeculoplasty ab externo

L. Rudavska, MD; I. Novytskyy, Dr Sc (Med), Prof.

Danylo Halytsky Lviv National Medical University;  Lviv (Ukraine)

E-mail:  lidiarud91@gmail.com

 

Background: Non-perforating deep sclerectomy (NPDS) is an efficacious and safe procedure for the treatment of glaucoma.

Purpose: To examine the effect of NPDS alone vs NPDS with a simultaneous laser trabeculoplasty (LT) ab externo in patients with primary open-angle glaucoma (POAG).

Material and Methods: Patients of group 1 (94 patients; 94 eyes) underwent a combined procedure of NPDS and LT ab externo, whereas those of group 2 (control group; 80 patients; 80 eyes) underwent NPDS alone for POAG.

Results: In group 1, mean intraocular pressure (IOP) before surgery and at month 12 and month 24 was 27.1 ± 2.2 mm Hg, 19.1 ± 1.2 mm Hg and 19.8 ± 2.6 mm Hg, respectively, vs 26.9 ± 2.0 mm Hg, 20.6 ± 1.5 mm Hg, and 21.5 ± 1.2 mm Hg, respectively, in group 2. In addition, in the combination procedure group, mean Mean Deviation (MD) before surgery and at month 12 and month 24 was -8.1 ± 6.9 dB, -8.5 ± 6.9 dB, and -8.9 ± 7.0 dB, respectively, vs -8.8 ±7.6 dB, -9.2 ± 7.6 dB, and -9.7 ± 7.4 dB, respectively, in the control group. Moreover, in group 1, mean retinal nerve fiber layer (RNFL) thickness before surgery and at month 12 and month 24 was 65.3 ± 16.5 nm, 64.2 ± 16.3 nm and 63.6 ± 15.9 nm, respectively, in the combination procedure group, vs 67.1 ± 14.9 nm, 65.8 ± 15.2 nm and 62.3 ± 15.4 nm, respectively, in group 2.

Conclusion: NPDS with a simultaneous LT ab externo slows the progression of glaucomatous optic neuropathy.

Keywords: primary open-angle glaucoma, intraocular pressure, optic disc, non-perforating deep sclerectomy, laser trabeculoplasty, static automated perimetry, optical coherence tomography

References

1.Hodapp E, Parrish RK, Anderson DR. Clinical decisions in glaucoma. St. Louis: The CV Mosby Co; 1993. pp. 52–61. 

2.Rudavska LM. [Clinical efficacy of the combined non-penetrating deep sclerectomy with the simultaneous diod laser trabeculoplasty ab externo in patients with primary open-angle glaucoma.  Long-term results]. Oftalmokhirurgiia. 2016;2:35–40. Russian.

Crossref   

3.Bhardwaj N, Niles PI, Greenfield DS. The impact of surgical intraocular pressure reduction on visual function using various criteria to define visual field progression. J Glaucoma. 2013;22:632–7. 

Crossref   PubMed  

4.Pandey AN, Sujata S. Study of long term structural and functional changes in medically controlled glaucoma. Int J Opthalmol. 2014;7:128-32.

5.Koseki N, Araie M, Shirato S, Yamamoto S. Effect of trabeculectomy on visual field performance in central 30 degrees field in progressive normal-tension glaucoma. Ophthalmology. 1997 Feb;104(2):197-201.

Crossref   

6.Xin D, Greenstein VC, Ritch R, et al.  A comparison of Functional and Structural measures for identifying progression of glaucoma. Invest Ophthalmol Vis Sci. 2011 Jan 25;52(1):519-26. 

Crossref   PubMed  

7.Kotowski J, Wollstein G, Folio L, et al. Clinical use of OCT in assessing glaucoma progression. Ophthalmic Surg Lasers Imaging. 2011 Jul;42 Suppl:S6-S14. 

Crossref   PubMed 

8.Diniz-Filho A, Abe RY, Zangwill LM. Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography. Ophthalmology. 2016; 123: 2058-65.

Crossref   PubMed  

 

The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.