https://doi.org/10.30702/Ophthalmology.2019/105564

Novytskyy I.^{1, 2}, Rudavska L.³

¹Danylo Halytsky Lviv National Medical University, Lviv City Clinical Hospital No 8, Lviv, Ukraine
²Oculus Medical Center, Lviv, Ukraine
³Volyn Regional Clinical Hospital, Lutsk, Ukraine

Abstract

Introduction. The main criteria of the glaucomatous optic neuropathy stabilization are the level of the intraocular pressure (IOP), progression of the visual fields (VF) loss, morphometric data of the optic nerve head (ONH) and thickness of retinal nerve fiber layer (RNFL).

Purpose. To study the influence of the nonpenetrating deep sclerectomy with diod laser trabeculoplasty ab externo for glaucomatous optical neuropathy progression.

Methods. 94 patients (94 eyes) with primary open angle glaucoma (POAG) underwent nonpenetrating deep sclerectomy with diod laser trabeculoplasty ab externo. Maclakov’s tonometry was performed before the procedure, 7 days and every 3 months afterwards. Visual field testing was conducted before and every 4 months after the surgery. Optic coherence tomography (OCT) of the ONH and the thickness of the RNFL were analyzed twice a year.

Results. The mean IOP before the surgery was 27.1 ± 2.2 mm Hg. 1 and 2 years after the surgery IOP was 19.1 ± 1.2 mm Hg, and 19.8 ± 2.6 mm Hg accordingly. Mean defect VF before the surgery was -8.1 ± 6.9 dB, one year after the surgery -8.5 ± 6.9 dB, and -8.9 ± 7.0 dB two years after the surgery. Standard deviation of the stimulus was 6.5 ± 4.2, 6.7 ± 4.2 and 6.3 ± 4.1 dB accordingly. RNFL thickness during the first year declined from 65.3 ± 16.5 µm to 64.2 ± 16.3 µm, and during the second year – to 63.6 ± 15.9µm.

Conclusion. Nonperforatin deep sclerectomy with diod laser trabeculoplasty ab externo is an effective surgical procedure for IOP reduction for patients with POAG. VF testing and OCT of ONH and RNFL thickness have shown the slowing down the progression of the disease.

Keywords: primary open angle glaucoma, intraocular pressure, optic nerve head, nonperforating deep sclerectomy, laser trabeculoplasty, standard automated perimetry, optic coherence tomography.

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Received: 29 May 2019

Published: December 2019