Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma
<p> A.S. Balalin, V.P. Fokin, S.V. Balalin, B.G. Dzhashi </p> <p> Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd, Russian Federation </p> <p> <b>Aim: </b>to develop a combined technology of optimized YAG-laser...
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| Format: | Article |
| Language: | Russian |
| Published: |
Prime-Media
2023-11-01
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| Series: | РМЖ "Клиническая офтальмология" |
| Online Access: | http://clinopht.com/upload/iblock/f2f/58akut15r2e0iwpv3datgo07sx4xjmg3.pdf |
| _version_ | 1797294996663042048 |
|---|---|
| author | A.S. Balalin V.P. Fokin S.V. Balalin B.G. Dzhashi |
| author_facet | A.S. Balalin V.P. Fokin S.V. Balalin B.G. Dzhashi |
| author_sort | A.S. Balalin |
| collection | DOAJ |
| description | <p>
A.S. Balalin, V.P. Fokin, S.V. Balalin, B.G. Dzhashi
</p>
<p>
Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd, Russian Federation
</p>
<p>
<b>Aim: </b>to develop a combined technology of optimized YAG-laser trabeculostomy and selective laser trabeculoplasty and to evaluate its efficacy and safety in the treatment for primary open-angle glaucoma (POAG).
</p>
<p>
<b>Patients and Methods: </b>this study enrolled three groups of patients. Group 1 (study group, prospective) included 87 patients (87 eyes) with early and moderate POAG before and after optimized YAG-laser trabeculostomy. Group 2 (control, prospective) included 78 patients (78 eyes) with early and moderate POAG before and after selective laser trabeculoplasty (SLT). Group 3 (control) included 60 healthy individuals (60 eyes). A technique to determine the topography of the collector channels and Schlemm's canal was developed to perform YAG-laser trabeculostomy. The location of the collector channels was determined with regard to Schlemm's canal using anterior segment optical coherence tomography (OCT). Patients were followed up after 1 day, 1, 6, 12, and 24 months.
</p>
<p>
<b>Results:</b> after combined optimized YAG-laser trabeculostomy and SLT, a significant IOP-lowering effect (reduction in IOP level by 30.1%) was reported as early as day 1 after surgery. Meanwhile, after SLT, the maximum IOP-lowering effect (by 21.5%) was observed only 1 month after surgery. Over a year, a gradual decrease in the IOP-lowering effect (17.2%) was reported after SLT. After optimized YAG-laser trabeculostomy, the IOP-lowering effect was stable (by 30.1%) being 26.2% after 2 years. When comparing the percentage of IOP-lowering regimen, group 1 (after optimized YAG-laser trabeculostomy) patients used less combined medications (by 27.7%) than group 2 (after SLT) patients. Moreover, IOP-lowering therapy was canceled in 18.4% and 10.3% of patients, respectively.
</p>
<p>
<b>Conclusion: </b>YAG-laser and OCT optimize trabeculostomy by providing an alternative non-invasive laser treatment for patients with early and advanced POAG. Optimized YAG-laser trabeculostomy along with SLT (in contrast to SLT alone) reduces IOP faster, provides a more significant and stable IOP-lowering effect, and allows the surgery to be performed in the projection of the collector channels more accurately using acceptable laser energy values.
</p>
<p>
<b>Keywords: </b>glaucoma, trabeculostomy, selective laser trabeculoplasty, primary open angle glaucoma.
</p>
<p>
<b>For citation:</b> Balalin A.S., Fokin V.P., Balalin S.V., Dzhashi B.G. Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma. Russian Journal of Clinical Ophthalmology. 2023;23(4):181–191 (in Russ.). DOI: 10.32364/2311-7729-2023-23-4-2.
</p> |
| first_indexed | 2024-03-07T21:40:13Z |
| format | Article |
| id | doaj.art-29c59bd63024403ca4a73a95f6b88c40 |
| institution | Directory Open Access Journal |
| issn | 2311-7729 2619-1571 |
| language | Russian |
| last_indexed | 2024-03-07T21:40:13Z |
| publishDate | 2023-11-01 |
| publisher | Prime-Media |
| record_format | Article |
| series | РМЖ "Клиническая офтальмология" |
| spelling | doaj.art-29c59bd63024403ca4a73a95f6b88c402024-02-26T10:12:10ZrusPrime-MediaРМЖ "Клиническая офтальмология"2311-77292619-15712023-11-0123431647Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucomaA.S. Balalin0V.P. Fokin1S.V. Balalin2B.G. Dzhashi3Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399<p> A.S. Balalin, V.P. Fokin, S.V. Balalin, B.G. Dzhashi </p> <p> Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd, Russian Federation </p> <p> <b>Aim: </b>to develop a combined technology of optimized YAG-laser trabeculostomy and selective laser trabeculoplasty and to evaluate its efficacy and safety in the treatment for primary open-angle glaucoma (POAG). </p> <p> <b>Patients and Methods: </b>this study enrolled three groups of patients. Group 1 (study group, prospective) included 87 patients (87 eyes) with early and moderate POAG before and after optimized YAG-laser trabeculostomy. Group 2 (control, prospective) included 78 patients (78 eyes) with early and moderate POAG before and after selective laser trabeculoplasty (SLT). Group 3 (control) included 60 healthy individuals (60 eyes). A technique to determine the topography of the collector channels and Schlemm's canal was developed to perform YAG-laser trabeculostomy. The location of the collector channels was determined with regard to Schlemm's canal using anterior segment optical coherence tomography (OCT). Patients were followed up after 1 day, 1, 6, 12, and 24 months. </p> <p> <b>Results:</b> after combined optimized YAG-laser trabeculostomy and SLT, a significant IOP-lowering effect (reduction in IOP level by 30.1%) was reported as early as day 1 after surgery. Meanwhile, after SLT, the maximum IOP-lowering effect (by 21.5%) was observed only 1 month after surgery. Over a year, a gradual decrease in the IOP-lowering effect (17.2%) was reported after SLT. After optimized YAG-laser trabeculostomy, the IOP-lowering effect was stable (by 30.1%) being 26.2% after 2 years. When comparing the percentage of IOP-lowering regimen, group 1 (after optimized YAG-laser trabeculostomy) patients used less combined medications (by 27.7%) than group 2 (after SLT) patients. Moreover, IOP-lowering therapy was canceled in 18.4% and 10.3% of patients, respectively. </p> <p> <b>Conclusion: </b>YAG-laser and OCT optimize trabeculostomy by providing an alternative non-invasive laser treatment for patients with early and advanced POAG. Optimized YAG-laser trabeculostomy along with SLT (in contrast to SLT alone) reduces IOP faster, provides a more significant and stable IOP-lowering effect, and allows the surgery to be performed in the projection of the collector channels more accurately using acceptable laser energy values. </p> <p> <b>Keywords: </b>glaucoma, trabeculostomy, selective laser trabeculoplasty, primary open angle glaucoma. </p> <p> <b>For citation:</b> Balalin A.S., Fokin V.P., Balalin S.V., Dzhashi B.G. Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma. Russian Journal of Clinical Ophthalmology. 2023;23(4):181–191 (in Russ.). DOI: 10.32364/2311-7729-2023-23-4-2. </p>http://clinopht.com/upload/iblock/f2f/58akut15r2e0iwpv3datgo07sx4xjmg3.pdf |
| spellingShingle | A.S. Balalin V.P. Fokin S.V. Balalin B.G. Dzhashi Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma РМЖ "Клиническая офтальмология" |
| title | Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma |
| title_full | Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma |
| title_fullStr | Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma |
| title_full_unstemmed | Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma |
| title_short | Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma |
| title_sort | long term outcomes of combined optimized yag laser trabeculostomy and selective laser trabeculoplasty for primary open angle glaucoma |
| url | http://clinopht.com/upload/iblock/f2f/58akut15r2e0iwpv3datgo07sx4xjmg3.pdf |
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