[Influence of α2-adrenomimetics on incidence of choroidal effusion following laser trabeculoplasty in primary open angle glaucoma]. / Vliianie α2-adrenomimetikov na chastotu tsiliokhorioidal'noi otsloiki posle lazernoi trabekulopunktury pri pervichnoi otkrytougol'noi glaukome.

PURPOSE: To evaluate the influence of different topical hypotensive drugs on incidence of choroidal effusion (CE) following laser trabeculoplasty as the second stage of combined laser-surgical treatment plan in patients with primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 60 patients with previously operated stage I and II POAG who has 'b-c' intraocular pressure (IOP) on maximum hypotensive therapy. Fistulizing subscleral removal of the outer wall of Schlemm's canal (a.k.a. subscleral sinusotomy) was the first stage of treatment plan. The second stage took place 14 days later in the form of laser trabeculoplasty. In order to reduce the risk of IOP spikes, all patients were prescribed specific hypotensive therapy 5 days prior to the procedure. The 1st group included 30 patients (30 eyes) who were asked to use Brimonidine-Purite (0.15%). The 2nd group included 30 patients (30 eyes) who used either nonselective ß-blockers, or carbonic anhydrase inhibitors. IOP was measured on days 1, 5, 9, and 12 after stage 1, as well as after laser trabeculoplasty. Ophthalmic examination included ultrasound imaging and optical coherence tomography. RESULTS: After the combined laser-surgical treatment, the IOP reliably decreased in both groups. Choroidal effusion was observed in 7 cases in the 1st group and in 15 cases in the 2nd group. Change in IOP was less prominent in patients who had received instillations of α2-adrenomimetic (p<0.05). CONCLUSION: Patients who received Brimonidine-Purite 0.15% before laser trabeculoplasty had lower IOP drop than those on pre-surgical therapy with nonselective ß-blockers or carbonic anhydrase inhibitors. Topical application of 0.15% Brimonidine-Purite 5 days prior to laser trabeculoplasty as the second stage of combined laser-surgical treatment resulted in statistically significant reduction of the incidence of postoperative choroidal effusion, likely due to α2-adrenomimetics inhibiting the secretory function of the ciliary Body to the lesser extent than drugs of other groups that were tested.

[Long-term results of combined surgery for open-angle glaucoma]. / Otdalennye rezul'taty kombinirovannogo lazerno-khirurgicheskogo lecheniya otkrytougol'noi glaukomy.

AIM: to comparatively evaluate the hypotensive effect of minimally invasive (type 1) and basic (type 2) subscleral removing of the external wall of Schlemm's canal with subsequent laser trabeculopuncture in patients with open-angle glaucoma (POAG). MATERIAL AND METHODS: The main group included 60 patients (64 eyes) treated with the minimally invasive technique. The control group included 105 patients (105 eyes), who underwent the type 2 surgery. RESULTS: After sinusotomy, intraocular pressure (IOP) decreased by 25% of its preoperative values in most patients (in 90.6% of patients from the main group and 81.9% of the controls, p<0.05). After laser trabeculopuncture, IOP further decreased down to 15.6±0.4 mmHg in the main group and 17.4±0.3 mmHg in the control group (p<0.05). Twelve months after the combined treatment, the hypotensive effect was still present in 81.2% of patients from the main group and 90.5% of the controls. None of the patients required additional hypotensive therapy. CONCLUSION: In POAG patients, the effect of minimally invasive subscleral removal of the external wall of Schlemm's canal (microfistulazing procedure) followed by laser trabeculopuncture is no weaker than that of basic technique.