Efficiency and safety of the suprathreshold selective laser trebeculoplasty as the first stage of the early primary open-angle glaucoma treatment in patients with cateract against the background of pseudoexfoliation syndrome

Abstract

Suprathreshold selective laser trabeculoplasty (SLT) is a modification of the classical subthreshold SLT.Purpose. To study the clinical efficacy and safety of suprathreshold SLT as the first stage of combined surgical treatment of the early primary open-angle glaucoma in patients with cataract against the background of pseudoexfoliation syndrome.Material and methods. The study of 48 suprathreshold SLT cases (48 eyes) was performed in patients with early primary open-angle glaucoma (POAG) with cataract against the background of pseudoexfoliation syndrome.Results. The drug therapy led to IOP decrease from 22.1±3.2 to 16.3±2.6 mm Hg (-26.3%). An additional IOP decrease to 14.3±1.8 mm Hg was determined 1 month after suprathreshold SLT (-34.8%). A significant improvement in the coefficient of intraocular fluid easiness outflow was noted from 0.12±0.03 to 0.16±0.03 mm3 /mm Hg·min. The decrease in IOP was accompanied by a significant improvement in MD and PSD indicators according to static perimetry and a decrease in the area of the optic disc excavation. Colorimetric analysis showed a decrease in pigmentation of the trabecular meshwork. The density of corneal endothelial cells has not changed: PEC – 2204±392 cells/mm2 . There wasn’t any clinical case of reactive hypertension, pain by palpation in the ciliary body projection, precipitates or Tyndall phenomenon during the study.Conclusion. According to the study, suprathreshold SLT is an effective and safe method of the early primary open-angle glaucoma treatment in patients with cataract against the background of pseudoexfoliation syndrome.

Keywords

• suprathreshold selective trabeculoplasty
• primary openangle glaucoma