The options of an individual approach to the modification of sinustrabeculectomy for hypotensive effect prolongation

Abstract

BACKGROUND: Reducing scarring in the postoperative period is one of the main tasks of glaucoma surgery. AIM: To develop new modifications of sinustrabeculectomy in the surgical treatment of primary open-angle glaucoma normalizing and prolonging the outflow of aqueous humor along newly formed pathways. MATERIALS AND METHODS: Surgical procedures were performed in 106 patients (109 eyes) with primary open-angle glaucoma of moderate and advanced stages, without any history of previous surgeries. Patients were divided into groups: 1a 25 patients (25 eyes) who underwent sinustrabeculectomy with the formation of grooves for the intramuscular fluid outflow, 1b 26 patients (28 eyes) who underwent of sinustrabeculectomy with scleral flap twisting, 1c 28 patients(29 eyes) who underwent sinustrabeculectomy with scleral flap stitching, and the control group 27 patients (27 eyes) who underwent routine sinustrabeculectomy. The follow-up duration was up to 24 months. RESULTS: In 1 month after surgery, the average level of intramuscular pressure was comparable and remained low in all groups. Complete compensation of intramuscular pressure in groups 1a, 1b and 1c was observed in 80%, 75% and 76% of cases; partial in 16%, 18% and 21% of cases; failure in 4%, 7% and 3% of cases, respectively. In the control group (2), complete hypotensive success was noted in 55% of cases; partial in 30% of cases; failure in 15% of cases. CONCLUSIONS: Developed new methods of sinustrabeculectomy allow to obtain a prolonged hypotensive effect.