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The hypotensive effect of dosed endotrabeculoectomy in combination with non-penetrating deep sclerectomy in patients with primary open-angle glaucoma

Aim. To analyze the effect of dosed endotrabeculectomy in combination with non-penetrating deep sclerectomy on the level of intraocular pressure (IOP) and aqueous humor outflow from the anterior chamber.
Materials and methods. The study involved 12 patients (12 eyes) who underwent dosed endotrabeculectomy with ab interno approach in combination with non-penetrating deep sclerectomy surgery. All the patients had moderate or severe trabecular pigmentation by gonioscopy. The follow-up period was 12 months. Measurement of IOP was performed according to Maklakov before and after surgery (on the 7th day, 1st, 3rd, 6th and 12th month). Tonography was performed according to Nesterov (using the simplified method) at the same time periods. The outflow facility coefficient and Becker’s coefficient were determined. The number of local antihypertensive agents used within that period was also observed. A combined drug was counted as two – according to the number of active substances.
Results. The difference between preoperative and postoperative IOP was found to be significant up to and including the 12th month. IOP at the 6th month after surgery was 8.67 mm Hg lower and at the 12th month – 7.83 mm Hg lower. The outflow facility coefficient was significantly increased from 0.14 ± 0.06 mm3/mm Hg/min up to 0.32 ± 0.03 mm3/mm Hg/min (P < 0.05). Becker’s coefficient was significantly decreased from 157.80 ± 8.04 to 42.2 ± 3.6 (P < 0.05).
Conclusions. Dosed endotrabeculoectomy in combination with non-penetrating deep sclerectomy has shown the significant hypotensive effect, as well as the increase in outflow facility coefficient and the decrease in Becker’s coefficient during the postoperative period among patients with primary open-angle glaucoma within the 12-month follow-up.
 