Эффективность селективной лазерной трабекулопластики у больных с первичной закрытоугольной глаукомой после периферической лазерной иридотомии в отдаленном периоде

摘要

Purpose . To evaluate an efficiency of selective laser trabeculoplasty?(SLT) in treatment of patients with primary angle closure glaucoma (PACG)?following a YAG laser peripheral iridotomy (PI) compared with primary?open angle glaucoma (POAG) in long-term follow-up period. Material and methods . The SLT hypotensive efficiency was evaluated?in 68 eyes with the initial PACG after PI performed not earlier than one?month before SLT and in 74 eyes with initial POAG. The quantity of necessary?hypotensive medication to decrease IOP ≤21 mm was also considered. Rate?of progression (ROP) of glaucoma optic neuropathy was assessed using?the MD index, RNFL and GCC thickness. Follow-up period lasted 6 years. Results . The IOP was decreased significantly after SLT in both?groups in long-term period. However, hypotensive effect was more?pronounced in PACG – 41.18% compared to POAG – 28.38%. After 6?years, a significantly less quantity of hypotensive eye drops was required?to achieve a hypotensive efficacy in PACG than in POAG: 0.68±0.92 and?1.18±0.75, respectively (р=0.035). There was no significant difference in?ROP between PACG and POAG: -0.06±0.65 dB/year and -0.14±0.48 dB/year, respectively for MD (р=0.461); -0.57±1.82 μm/year and -0.62±1.59?μm/year for RNFL (р=0.372); -0.60±2.36 μm/year and -0.71±1.98 μm/?year for GCC (р=0.292). Conclusion . The SLT is a safe and effective laser treatment method?for the initial stage of PACG after peripheral laser iridotomy. Hypotensive?effect of SLT in case of PACG is higher than in POAG, especially 2 and 6?years after the procedure. The SLT in the initial stages of POAG and PACG?allows to stabilize glaucoma optic neuropathy.