Офтальмохирургия (Aug 2020)

YAG-laser Activation of Trabecula in Combined Treatment of Primary Open-Angle Glaucoma and Coexisting Complicated Cataract

  • B. E. Maluygin,
  • T. V. Sokolovskaya,
  • D. A. Magaramov,
  • P. L. Volodin,
  • V. N. Yashina,
  • V. V. Teplovodskaya

DOI
https://doi.org/10.25276/0235-4160-2020-2-85-92
Journal volume & issue
Vol. 0, no. 2
pp. 85 – 92

Abstract

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Purpose. To study the clinical efficacy of phacoemulsification with YAG-laser activation of trabecula (YAG-LAT) in eyes with primary openangle glaucoma (POAG) and coexisting complicated cataract.Material and methods. The study included 70 patients (70 eyes) with initial and advanced stages of POAG and coexisting cataract. There were 42 women (60%) and 28 men (40%), the average age was 68.8±8.2 years. The follow-up period is 2 years after the treatment. The patients were divided into two groups: combined group – 36 patients (36 eyes) who underwent YAG-LAT and phacoemulsification and the control group – 34 patients (34 eyes) who underwent phacoemulsification alone. The baseline IOP by Maklakov in the combined and control groups was 24.1±2.52 and 23.0±2.41 mm Hg respectively. The mean medication use was 1.53±0.65 in the combined group and 1.44±0.50 in the control group.Results. There were no intraoperative complications. In the early postoperative period, reactive increase in IOP was noted in 8.3 and 32.4% of cases in the combined and control groups, respectively. By the end of the follow-up period, the mean IOP decreased by 21.1% after combined treatment (p<0.001) and in the control group, no statistically significant differences were revealed. The mean medication use decreased from 1.53±0.65 to 0.64±0.56 after combined treatment (p<0.05), and increased from 1.44±0.50 to 1.92±0.28 after phacoemulsification alone (p<0.05).Conclusion. In long-term follow-up after combined treatment (YAGLAT with phacoemulsification) normalization of IOP was achieved in 96.4% of cases, the mean medication use decreased significantly, stabilization of the glaucoma process was noted in 96.4% of cases. Increased visual acuity after treatment was observed in all patients in both groups. The developed method of treatment is safe, has a minimal risk of complications and can be used to treat patients with the initial stages of POAG and coexisting cataract.

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