[Technique for laser activation of scleral hydropermeability in the treatment of patients with refractory forms of glaucoma]. / Tekhnologiya lazernoi aktivatsii gidropronitsaemosti sklery pri refrakternykh formakh glaukomy.

Laser cyclodestructive interventions are considered the method of choice in the treatment of refractory glaucoma. However, the traumatic nature of cyclocoagulation makes it necessary to search for more gentle methods of laser treatment. One of the possible directions is the development of laser transscleral technologies that mainly affect the uveoscleral outflow. This article presents a new technique for laser activation of scleral hydropermeability (LASH) using pulse-periodic erbium glass (Er-glass) fiber-optics laser with wave length of 1.56 µm. The article describes the parameters of laser emission and the technique of LASH, and presents the mechanism of reducing intraocular pressure associated with increased transcleral drainage of intraocular fluid by forming new pores in the sclera. The effectiveness and safety of LASH is supported by a detailed example from clinical practice. This technology has proven itself as a possible alternative to the conventional contact transcleral cyclocoagulation.

[Current trends in studying pathogenesis of glaucoma]. / Sovremennye napravleniya v izuchenii patogeneza pervichnoi glaukomy.

Glaucoma is a group of neurodegenerative disorders comprising one of the main causes of irreversible blindness. Glaucoma-related blindness is a globally relevant problem. By now, many aspects of glaucoma pathogenesis have been studied: impact of increased intraocular pressure (IOP) on the development of optic neuropathy, ischemia and reperfusion of the retina, most of the direct mechanisms of neuronal death (excitotoxicity, oxidative stress, etc). However, the only effective glaucoma treatment is lowering the IOP, while early glaucoma diagnosis is based on determining structural and functional retinal defects. Therefore, it is important to emphasize further research on the insufficiently studied aspects of glaucoma pathogenesis - such as neuroinflammation, translaminar pressure, genetic factors, association of glaucomatous damage with changes in the brain, mitochondrial pathologies, and others. The article reviews the most perspective directions in research of the pathogenesis of glaucomatous optic neuropathy.

[Transscleral laser therapy in the treatment of glaucoma]. / Lazernye transskleral'nye tekhnologii v lechenii glaukomy.

Nowadays glaucoma is one of the leading causes of irreversible blindness worldwide. The main goal in preservation of vision in glaucoma patients is reducing intraocular pressure (IOP), which is considered the main controlled risk factor for progression of glaucomatous optic neuropathy. The article discusses the effectiveness and safety of various transscleral laser technologies in the treatment of glaucoma. Modern transscleral laser technologies that affect the uveoscleral drainage and scleral hydro-permeability are less traumatic and more gentle making them promising in the treatment of patients with early stages of glaucoma, and not only in terminal glaucoma with pain syndrome resistant to conventional treatment ("last resort surgery").

[The study of opportunity of aqueous humor filtration increase after nondestructive laser exposure of sclera in the site of pars plana projection (experimental study)].

Increase of scleral water permeability due to formation of porous structure after exposure of pulsed periodic radiation of erbium-glass optical fiber laser with wave length 1,56 pm was demonstrated in experimental study of cadaver human eyes in vitro and eyes of experimental animals (rabbits) in vivo. Simultaneous complex laser exposure of pars plana and ciliary processes results in summation of morphological changes that provide decrease of aqueous humor secretion, uveal drainage and extension of suprachoroid space. A base for new noninvasive technology of nondestructive laser exposure in glaucoma treatment is established.

[Laser cyclodestructive procedures in glaucoma treatment].

The history of development of cyclodestructive procedures is given, their advantages and disadvantages are discussed. Different techniques of laser use, relative and absolute contraindications to various laser cyclophotodestructive procedures are considered. Their potential complications and effecting mechanisms are discussed.