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First Author: O.Shunkevich RUSSIA
Co Author(s): S. Balalin B. Dghashi A. Maruhnenko
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to analyze results of comprehensive two-stage treatment of primary open-angle glaucoma, complicated with cataract, consisting of selective laser trabeculoplasty with subsequent cataract phacoemulsification with IOL implantation.
The S.N. Fyodorov Eye Microsurgery Federal State Institution, Volgograd Branch
32 patients with primary open-angle glaucoma and cataract (32 eyes) were examined. Mean age was 65,6ḟ1,2 years. Initial stage of POAG was registered in 21 patients (65,6%), a developed stage in 4 eyes (12,5%) and an advanced one in 7 eyes (21,9%). All patients have undergone a selective laser trabeculoplasty followed with cataract phacoemulsification 1-9 months later.
prior to SLT intraocular pressure was normalized by medication in all the patients, mean IOP value averaged 16,7ḟ0,27 mm Hg. One month after SLT mean IOP reduced to 14,6ḟ0,45 mm Hg (t=3,2; p <0,01). Mean readings of aqueous humor outflow coefficient increased to 0,19ḟ0,007 mm3/mm Hg*min. (t=6,2; p <0,001). One month after cataract phacoemulsification mean value of true IOP equaled 15,6ḟ0,6 mm Hg. In 20 patients (60,6 %) application of IOP-lowering agents was discontinued. In 11 eyes (33,3%) IOP was normalized by instillation of ?-adrenoreceptor blocking agents (Betaxolol Hydrochloride 0,5%, Timolol Maleate 0,5%) one drop per day, in 2 patients (6,1%) combination IOP-lowering solutions (COSOPT, AZARGA) were instilled one drop twice a day. In summary, SLT eliminates trabecular meshwork pigmentation due to photothermolysis, while phacoemulsification provides clearing of Schlemm canal from pseudoexfoliation residues.
selective laser trabeculoplasty can be applied as the first stage in comprehensive treatment of primary open-angle glaucoma complicated with cataract and pseudoexfoliation syndrome. It helps to normalize ocular hydrodynamics and to preserve aqueous humor outflow per vias naturales prior to cataract surgical treatment.