MICROINVASIVE DRAINAGE TECHNOLOGIES ENHANCE UVEOSCLERAL OUTFLOW IN THE TREATMENT OF VARIOUS FORMS OF PRIMARY OPEN-ANGLE GLAUCOMA

Kasimov E. M., Ibadova N. T.

METHODS AND METHODOLOGIES

Scentific article

Glaucoma remains one of the major causes of blindness, low vision and visual disability in developed countries and is currently one of the most actual problems of ophthalmology. According to who, the number of patients with glaucoma in the world ranges from 60.5 to 105 million people, and in the next 10 years it could increase by another 10 million More than 15% of the total number of blind in the world lost his sight from glaucoma. Despite advances in medical and laser treatment of primary open-angle glaucoma, according to most researchers, surgery is the main approach and highly effective way to reach target pressure and stabilization of visual functions. The main indication for surgical treatment of patients with POAG is the progression of glaucomatous process, which is most often observed in the fluctuations of the intraocular pressure above the pressure tolerant, it is impossible to reach the target pressure on the background of drug therapy or laser surgery, and when patient compliance with the doctor's recommendations. The choice of operative measure based on effectiveness, safety and minimal complications during surgical treatment. In this approach, the advantage belongs to non-invasive operations, namely microinvasive non-penetrating deep sclerectomy (MNPDS). This is because the reduction of elevated IOP to target pressure is achieved without opening the anterior chamber of the eye, provides controlled reduction of the intraocular pressure with minimal surgical intervention and significantly reduces the risk of intra — and postoperative complications. Long-term results of the use of minimally invasive surgical technology MNDPS show its high efficiency in normalization of intraocular pressure and stabilization of visual functions. Preserving the integrity of the outer membranes of the eyes, no sudden drop in intraocular pressure, avoids the characteristic of penetrating surgeries complications. However, the lack of effectiveness of the proposed methods of treatment, a significant number of patients with refractory glaucoma, which is characterized by persistent, are not amenable to traditional methods of therapeutic and surgical treatment of the increased IOP, has led to the search and development of new technologies and devices for surgical treatment of glaucoma. Another approach, which has long attracted ophthalmologists, was an attempt to create drainage systems that provide directional outflow of aqueous humor under the conjunctiva to reduce IOP. According to experts of the centre for evidence-based medicine (Johns Hopkins University, USA), while it is impossible to make an opinion on the effectiveness of new treatments for glaucoma, as researchers have not provided sufficient data regarding changes of the optic nerve and the visual fields of the studied patients. Not all available methods can be compared with the «gold standards» of traditional surgery in terms of hypotensive effect and frequency of complications.

open-angle glaucoma, drainage ways of treating glaucoma

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«Bulletin of problems biology and medicine» Issue 1 part 1 (126), 2016 year, 232-238 pages, index UDK 617.7-007.681