Alʹmanah Kliničeskoj Mediciny (Feb 2016)
ANALYSIS OF EFFECTIVENESS OF DIFFERENT SURGICAL METHODS AND EARLY POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH PSEUDOEXFOLIATION GLAUCOMA
Abstract
Aim: To study the effectiveness of several surgical methods in patients with pseudoexfoliation glaucoma (PEG); to assess frequency of early postoperative complications. Materials and methods: We analyzed hospital medical records of 554 patients with verified diagnosis of PEG; the patients underwent surgical treatment in the State-Financed Health Institution of the Tyumen Region “Regional Clinical Hospital No. 1”. Results: The majority of patients were > 70 years old (mean age was 67.5 ± 21.5 years old). Types of surgical treatment were as follows: sinus trabeculectomy (STE) with posterior scleral trepanation in 73.1% of the cases (n = 405), non-penetrating deep sclerectomy (NPDS) – in 23.8% (n = 132); STE + posterior scleral trepanation and use of silicone drainage Repegel-1 (STE + drainage) – in 3.1% (n = 17). After primary STE, postoperative complications were found in 20% (n = 31) of the patients; after repeated STE – in 76.8% (n = 119); after STE + drainage – in 3.2% (n = 5). Early postoperative complications of STE were diagnosed in 28% (n = 155) of the patients including hyphema in 45% (n = 70) of cases, postoperative hypertension in 31% (n = 48), absence of filtering bleb in 20% (n = 31) and others in 4% (n = 6) of cases. After repeated STE, early postoperative hypertensionwas found only in patients with hyphema (in 99.2% (n = 118) of cases, p < 0,05). Сonclusion: Analysis of the results of several surgical methods of treatment for pseudoexfoliation glaucoma demonstrated inefficiency of NPDS; on the contrary, STE and STE + drainage are regarded as methods of choice. Concomitant cardiovascular diseases contribute to the progression of PEG and increase the risk of early postoperative complications.
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