METHOD FOR COMBINED LASER TREATMENT OF PRIMARY OPEN-ANGLE GLAUCOMA AFTER NON-PENETRATING DEEP SCLERECTOMY

摘要

FIELD: ophthalmology.;SUBSTANCE: invention relates to medicine, namely to ophthalmology. For combined laser treatment of primary open-angle glaucoma (POAG) after a non-penetrating deep sclerectomy (NPDS), a microfistula is formed in the trabeculodescemet membrane (TDM) and a basal coloboma of the iris by exposure to Nd-YAG laser pulses with a wavelength of 1064 nm through a gonioscopic lens. Before performing laser surgery, optical coherence tomography (OCT) of the NPDS zone is performed. The area with the thinnest TDM is determined, and in this area one microfistula is formed, applying 3-5 laser applications with pulse energy of 3.0-3.4 mJ. Next, a basal coloboma is formed near the root of the iris with pulse energy of 3.2-3.6 mJ, applying 6-8 applications directly under the previously formed microfistula. Then the lens is rotated and in the lower segment opposite to the NPDS zone, along an arc of a circle of 90 degrees, first in one direction, and then along the same arc in the opposite direction, the effect on the pigment cells of the trabecula of the eye with Nd-YAG laser radiation with a wavelength of 532 nm is performed, a spot diameter of 400 mcm and a radiation power of 1.0 mJ with a total number of pulses equal to 50.;EFFECT: invention stabilizes IOP in the early stages after NPDS due to the absence of a sharp discharge of IOP through the formed laser hole in the trabeculodescemet membrane (TDM), which prevents blockade of the operation zone by the iris root, and also prolongs the hypotensive effect due to additional activation of its own outflow pathways when performing selective trabeculoplasty.;1 cl, 3 ex