Analysis Of Factors That Nullify The Effect Of Surgical Intervention In Glaucoma Patients

To identify the factors that influence the decompensation of intraocular pressure following minimally invasive glaucoma surgery.

The pathogenetic mechanisms that lead to the overgrowth of channels responsible for the outflow of intraocular fluid following anti-glaucoma surgery have not yet been fully elucidated. Furthermore, the use of valves does not solve the problem.

The study included a primary group of 56 patients (112 eyes) diagnosed with primary open-angle glaucoma who underwent minimally invasive glaucoma surgery, specifically tunnel trabeculopuncture. The comparison group comprised 32 patients (64 eyes) without glaucoma. All procedures were conducted following the same protocol and performed by the same surgeon. Patients in the primary group underwent a comprehensive ophthalmological examination, which included assessments of disease duration and biochemical markers in blood plasma. The biochemical markers LOX1, TGFb2, and pNF-H were measured in all patients. The results were statistically processed using the licensed software package EZR (R-statistics).

The outcomes indicate that the most significant factors influencing the incidence of intraocular pressure decompensation include: the level of intraocular pressure before surgery (greater than 21 mm Hg), the duration of the disease (exceeding 5 years), and the level of LOX1 in blood plasma among patients with primary open-angle glaucoma (cut-off value ≥ 131.408 ± 27.8 pg/ml) (p < 0.05). In our opinion, LOX1 serves as a marker of chronic inflammation, which contributes to the overgrowth of the channels formed during surgery.

The determination of LOX1 levels in the blood plasma of patients with primary open-angle glaucoma can be considered for personalized management and the selection of optimal treatment strategies for these patients.