Micropulse cyclophotocoagulation in combined treatments of neovascular glaucoma

Purpose. To evulate the efficiency of micropulse cyclophotocoagulation (MP-CPC) in the combined treatment of patients with secondary refractory neovascular glaucoma with object vision. Material and methods. The study involved 30 patients (30 eyes) with neovascular glaucoma (NVG) in the stage of part...

Full description

Saved in:
Bibliographic Details
Main Authors: I.V. Shiryaev, S.V. Sosnovskii, M.M. Pravosudova, I.E. Panova
Format: Article
Language:Russian
Published: Publishing house "Ophthalmology" 2023-12-01
Series:Офтальмохирургия
Subjects:
Online Access:https://ophthalmosurgery.ru/index.php/ophthalmosurgery/article/view/568/843
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850203143455899648
author I.V. Shiryaev
S.V. Sosnovskii
M.M. Pravosudova
I.E. Panova
author_facet I.V. Shiryaev
S.V. Sosnovskii
M.M. Pravosudova
I.E. Panova
author_sort I.V. Shiryaev
collection DOAJ
description Purpose. To evulate the efficiency of micropulse cyclophotocoagulation (MP-CPC) in the combined treatment of patients with secondary refractory neovascular glaucoma with object vision. Material and methods. The study involved 30 patients (30 eyes) with neovascular glaucoma (NVG) in the stage of partial or complete blockade of the iridocorneal angle with decompensated intraocular pressure (IOP) resistant to drug therapy, who had object vision. Two study groups were formed, 15 eyes each. The first main group is represented by patients whom performed MP-CPC (Cyclo G6 Glaucoma Laser System by IRIDEX), as a stage of combined treatment before implantation of Ahmed glaucoma valve (IAGV). The second control group included patients who initially were treated by this type of drainage surgery without preliminary micropulse laser exposure. The follow-up period was 18 months. Results. The implementation of MP-CPC in the main group led to a significant decrease in IOP on the 1st day after treatment from 27.5±6.1 to 23.6±4.6 mm Hg, with the maximum attainment of normal values on the 3rd day of observation, which averaged 20.3±4.4 mm Hg. (p<0.05). By the end of the 1st month, an increase in mean IOP values to subcompensated values was recorded – 24.4±6.3 mm Hg. After valve drainage implantation, by the end of the 1st month of observation, IOP in the main group was 19 (16.5; 22.0) mm Hg, and in the control group it was 24.5 (20.5; 25.8) mm Hg. (p<0.05). After 18 months of the postoperative period, the level of ophthalmotonus in the main group is 15.5 (15.0; 18.2), and in the control group – 16.5 (15.0; 19.5) mm Hg. (p>0.05). A significant decrease in the amounts of hypotensive drugs in the main group was revealed: 1 (0; 2) versus 2 (1; 3) in the control group (p=0.03). In both groups, there was no significant deterioration in visual functions during the entire observation period. Conclusions. MP-CPC can be considered as a preliminary stage in the combined treatment of neovascular refractory glaucoma, as it reduces the risk of preoperative ophthalmohypertension before valve surgery, leads to a significant decrease in the amounts of hypotensive drugs in the late postoperative period, thereby improving the effectiveness treatment of patients with neovascular refractory glaucoma who have object vision.
format Article
id doaj-art-71ea0a0d1c5c4031b6b4d78299fc543d
institution OA Journals
issn 0235-4160
2312-4970
language Russian
publishDate 2023-12-01
publisher Publishing house "Ophthalmology"
record_format Article
series Офтальмохирургия
spelling doaj-art-71ea0a0d1c5c4031b6b4d78299fc543d2025-08-20T02:11:35ZrusPublishing house "Ophthalmology"Офтальмохирургия0235-41602312-49702023-12-011374546110.25276/0235-4160-2023-4-54-61Micropulse cyclophotocoagulation in combined treatments of neovascular glaucomaI.V. Shiryaev0https://orcid.org/0000-0003-3621-1507S.V. Sosnovskii1https://orcid.org/0000-0001-8969-6240M.M. Pravosudova2https://orcid.org/0009-0003-8322-579XI.E. Panova3https://orcid.org/0000-0001-7443-4555S. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Brunch, St. Petersburg, Russian FederationS. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Brunch, St. Petersburg, Russian FederationS. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Brunch, St. Petersburg, Russian FederationS. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Brunch, St. Petersburg, Russian FederationPurpose. To evulate the efficiency of micropulse cyclophotocoagulation (MP-CPC) in the combined treatment of patients with secondary refractory neovascular glaucoma with object vision. Material and methods. The study involved 30 patients (30 eyes) with neovascular glaucoma (NVG) in the stage of partial or complete blockade of the iridocorneal angle with decompensated intraocular pressure (IOP) resistant to drug therapy, who had object vision. Two study groups were formed, 15 eyes each. The first main group is represented by patients whom performed MP-CPC (Cyclo G6 Glaucoma Laser System by IRIDEX), as a stage of combined treatment before implantation of Ahmed glaucoma valve (IAGV). The second control group included patients who initially were treated by this type of drainage surgery without preliminary micropulse laser exposure. The follow-up period was 18 months. Results. The implementation of MP-CPC in the main group led to a significant decrease in IOP on the 1st day after treatment from 27.5±6.1 to 23.6±4.6 mm Hg, with the maximum attainment of normal values on the 3rd day of observation, which averaged 20.3±4.4 mm Hg. (p<0.05). By the end of the 1st month, an increase in mean IOP values to subcompensated values was recorded – 24.4±6.3 mm Hg. After valve drainage implantation, by the end of the 1st month of observation, IOP in the main group was 19 (16.5; 22.0) mm Hg, and in the control group it was 24.5 (20.5; 25.8) mm Hg. (p<0.05). After 18 months of the postoperative period, the level of ophthalmotonus in the main group is 15.5 (15.0; 18.2), and in the control group – 16.5 (15.0; 19.5) mm Hg. (p>0.05). A significant decrease in the amounts of hypotensive drugs in the main group was revealed: 1 (0; 2) versus 2 (1; 3) in the control group (p=0.03). In both groups, there was no significant deterioration in visual functions during the entire observation period. Conclusions. MP-CPC can be considered as a preliminary stage in the combined treatment of neovascular refractory glaucoma, as it reduces the risk of preoperative ophthalmohypertension before valve surgery, leads to a significant decrease in the amounts of hypotensive drugs in the late postoperative period, thereby improving the effectiveness treatment of patients with neovascular refractory glaucoma who have object vision.https://ophthalmosurgery.ru/index.php/ophthalmosurgery/article/view/568/843micropulse cyclophotocoagulationneovascular glaucomavalve’s ahmed
spellingShingle I.V. Shiryaev
S.V. Sosnovskii
M.M. Pravosudova
I.E. Panova
Micropulse cyclophotocoagulation in combined treatments of neovascular glaucoma
Офтальмохирургия
micropulse cyclophotocoagulation
neovascular glaucoma
valve’s ahmed
title Micropulse cyclophotocoagulation in combined treatments of neovascular glaucoma
title_full Micropulse cyclophotocoagulation in combined treatments of neovascular glaucoma
title_fullStr Micropulse cyclophotocoagulation in combined treatments of neovascular glaucoma
title_full_unstemmed Micropulse cyclophotocoagulation in combined treatments of neovascular glaucoma
title_short Micropulse cyclophotocoagulation in combined treatments of neovascular glaucoma
title_sort micropulse cyclophotocoagulation in combined treatments of neovascular glaucoma
topic micropulse cyclophotocoagulation
neovascular glaucoma
valve’s ahmed
url https://ophthalmosurgery.ru/index.php/ophthalmosurgery/article/view/568/843
work_keys_str_mv AT ivshiryaev micropulsecyclophotocoagulationincombinedtreatmentsofneovascularglaucoma
AT svsosnovskii micropulsecyclophotocoagulationincombinedtreatmentsofneovascularglaucoma
AT mmpravosudova micropulsecyclophotocoagulationincombinedtreatmentsofneovascularglaucoma
AT iepanova micropulsecyclophotocoagulationincombinedtreatmentsofneovascularglaucoma