Saratov JOURNAL of Medical and Scientific Research

The new method for primary angle-closure glaucoma treatment: evolution of hypertensive efficacy in the long-term period

Year: 2019, volume 15 Issue: №4 Pages: 990-994
Heading: Тhematic supplement Article type: Original article
Authors: Kurysheva N.I., Lepeshkina L.V., Abdullova A.R., Plieva Kh.M.
Organization: State Research Center— Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency

Purpose: to work out a new algorithm of primary angle closure glaucoma (PACG) treatment based on the two steps of treatment: peripheral laser iridotomy (PUT) and selective laser trabeculoplasty (SLT)— and evaluate its hypotensive and functional effect over the long term period. Material and Methods. SLT hypotensive efficiency was evaluated on the sample of 70 eyes with the initial PACG after PI performed not earlier than one month before SLT and in 75 eyes with initial POAG. The quantities of hypotensive medication, necessary for decreasing IOP >20%, were also considered. Rate of progression (ROP) was assessed using MD index, RNFL and GCC thickness. The follow-up period was 6 years. Results. IOP decreased significantly after SLT in both groups over the long-term period. Hypotensive effect was more pronounced in PACG — 38.5% compared to POAG — 28%. After 6 years, less hypotensive eye drops were required for achieving the hypotensive efficacy in PACG than in POAG (p=0.035). There was no significant difference in ROP between PACG and POAG (p=0.461). Conclusion. The developed method of consequent laser treatment of PACG leads to effective IOP reduction and preserves glaucoma progression that does not differ from POAG.

1. Quigley HA, Broman AT. The number of persons with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006; 90 (3): 262-6.
2. Quigley HA. Angle-Closure Glaucoma Simpler Answers to Complex Mechanism: LXVI Edward Jackson Memorial Lecture. Am J Ophthalmol 2009; 148 (5): 657-69.
3. Ritch R. The treatment of chronic angle-closure glaucoma. Ann Ophthalmol 1981; 13 (1): 21 -3.
4. Marchenko AN, Sorokin EL, Danilov OV. Morphometric types of the lens and their significance in the formation of primary angle-closure glaucoma. In: Modern technologies of cataract and refractive surgery. Moscow, 2008; p. 189-93.
5. Но CL, Lai JS, Aquino MV, et al. Selective laser trabeculoplasty for primary angle closure with persistently elevated intraocular pressure after iridotomy. J Glaucoma 2009; 18 (7): 563-6.
6. Kozlov VI, Proshina Ol, Sokolovskaya TV, Kozlova TV. Method of treatment of angle-closure glaucoma: RF patent 2106128. Statement 01.11.1994; published 10.03.1998. Bulletin of ophthalmology 1998; (4): 6-10.
7. Nagar М, Ogunyomade A, O'Brart DP, et al. A randomised, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol 2005; 89: 1413-7.
8. Mills RP, Budenz DL, Lee PP, et al. Categorizing the stage of glaucoma from pre-diagnosis to end-stage disease. Am J Ophthalmol 2006; 141 (1): 24-30.
9. Chauhan ВС, Malik R, Shuba LM, et al. Rates of glaucomatous visual field change in a large clinical population. Invest Ophthalmol Vis Sci 2014; 55 (5): 2885-92.
10. Sung KR, Sun JH, Na JH, et al. Progression detection capability of macular thickness in advanced glaucomatous eyes. Ophthalmology 2012; 119: 308-13.
11. Sihota R, Goyal A, Kaur J, et al. Scanning electron-microscopy of the trabecular meshwork: understanding the pathogenesis of primary angle closure glaucoma. Indian J Ophthalmol 2012; 60 (3): 183-8.
12. Kurysheva Nl, Ryzhkov PK, Topolnik EV, Kapkova SG. Condition of corneal endothelium after selective laser trabeculoplasty. Glaucoma 2012; (2): 36-41.
13. Regina М, Bunya VY, Orlin SE, Ansari H. Corneal edema and haze after selective laser trabeculoplasty. Journal of Glaucoma 2011; 20 (5): 327-9.
14. Narayanaswamy A, Christopher K, Istiantoro DV, et al. Efficacy of Selective Laser Trabeculoplasty in Primary Angle-closure Glaucoma. JAMA Ophthalmol 2015; 133: 206-12.
15. Katz LJ, Steinmann WC, Kabir A, Molineaux J, et al. Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma: a prospective, randomized trial/SLT/Med Study Group. J Glaucoma 2012; 21 (7): 460-8.
16. AN Aljasim L, Owaidhah O, Edward DP. Selective Laser Trabeculoplasty in Primary Angle-closure Glaucoma after Laser Peripheral Iridotomy: A Case-control Study. J Glaucoma 2016; 25 (3): e253-8. DOI: 1097/1JG. 0000000000000282.

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