Balalin AS¹, Fokin VP², Balalin SV³ and Dzhashi BG⁴

¹Ophthalmologist, Glaucoma Treatment Department, Volgograd Branch of the Federal State Autonomous Institution "National Medical Research Center "Intersectoral Scientific and Technical Complex "Eye Microsurgery" n. a. acad. S.N. Fyodorov" of the Ministry of Health, Russian Federation
²Professor, Head of the Volgograd Branch of the Federal State Autonomous Institution "National Medical Research Center "Intersectoral Scientific and Technical Complex "Eye Microsurgery" n. a. acad. S.N. Fyodorov" of the Ministry of Health, Russian Federation
³Head of the Scientific Department, Volgograd Branch of the Federal State Autonomous Institution "National Medical Research Center "Intersectoral Scientific and Technical Complex "Eye Microsurgery" n. a. acad. S.N. Fyodorov" of the Ministry of Health, Russian Federation
⁴Head of Glaucoma Treatment Department, Volgograd Branch of the Federal State Autonomous Institution "National Medical Research Center "Intersectoral Scientific and Technical Complex "Eye Microsurgery" n. a. acad. S.N. Fyodorov" of the Ministry of Health, Russian Federation

*Corresponding Author: Balalin AS, Ophthalmologist, Glaucoma Treatment Department, Volgograd Branch of the Federal State Autonomous Institution "National Medical Research Center "Intersectoral Scientific and Technical Complex "Eye Microsurgery" n. a. acad. S.N. Fyodorov" of the Ministry of Health, Russian Federation.

Received: August 13, 2023; Published: August 31, 2023

Abstract

Objective: To develop a combined technology of optimized YAG-laser trabeculostomy and evaluate its efficacy and safety in the treatment of primary open-angle glaucoma (POAG).

Methods: Three groups of patients were included in the study: 1^st main group (prospectively) - 87 patients (87 eyes) with POAG I and II stages before and after the optimized technology of YAG-laser trabeculostomy, 2^nd control group (prospectively) - 65 patients (65 eyes) with POAG I and II stages before and after SLT and 3^rd control group - 60 healthy individuals (60 eyes). For the application of YAG-laser trabeculostomy a technique of determining the collector channels topography and Schlemm's canal was developed. Using OCT of the eye anterior segment, the collector channels were localized relative to the Schlemm's canal. Postoperative monitoring was performed after a day, 1, 6, 12, 24 months.

Results: After optimized YAG-laser trabeculostomy a significant hypotensive effect was observed already on the first day post-op and amounted to 30.1%, whereas in case of SLT the maximum hypotensive effect was observed only 1 month after surgery (21.5%). Within 1 year there was a progressively decrease of hypotensive effect after SLT to 17.2%. Postoperatively the hypotensive effect remained - 30.1%, in 2 years it was 26.2% of the early level. When comparing the percentage of hypotensive therapy used in the main group after optimized YAG-laser trabeculostomy, there were 17.9% fewer cases of combined therapy and cancel of therapy in 18.4% in contrast to the 2^nd control group, where it was noted only in 10.7%.

Conclusion: YAG-laser and OCT data can optimize the trabeculostomy technique, providing an alternative non-invasive laser treatment for patients with early and moderate stages of POAG. Combination technology of optimized YAG-laser trabeculostomy in comparison with SLT allows to reduce IOP more quickly to individual values, has a more significant and persistent hypotensive effect, allows to perform the operation more precisely in the projection of collector channels, using acceptable values of laser energy.

 Keywords: Glaucoma; Trabeculostomy; Selective Laser Trabeculoplasty; Primary Open-Angle Glaucoma

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Citation

Citation: Balalin AS., et al. “Long-Term Results of Combined Technology of Optimized YAG-Laser Trabeculostomy in the Treatment of Primary Open-Angle Glaucoma".Acta Scientific Ophthalmology 6.9 (2023): 45-54.

Copyright

Copyright: © 2023 Balalin AS., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.