Отдаленные результаты селективной лазерной трабекулопластики при псевдоэксфолиативной глаукоме

PURPOSE: To assess the long-term efficacy of selective laser trabeculoplasty (SLT) in the treatment of pseudoexfoliative glaucoma (PEG) and primary open-angle glaucoma (POAG). METHODS: 75 patients with PEG (64 eyes) and 70 patients with POAG (63 eyes) were included in the study. The groups were homogeneous for age (69.67±0.93 years in PEG group and 65.63±0.33 years in POAG group, p = 0.09) and stages of glaucoma (MD -7.29±1.08 dB in PEG group and -5.95±1.12 dB in POAG group, p=0.39). Baseline IOP was 23.9±0.65 mm Hg in PEG patients and 21.4±0.44 mm Hg in POAG patients (p=0.002). The follow-up period was four years. RESULTS: There was a significant reduction of the IOP level in PEG patients after SLT as compared to the baseline at all stages of the study. By the end of the follow-up period the IOP was 19.00±0.97 mm Hg (p=0.023). A significant reduction of the IOP level in POAG patients occurred only during the first six months after surgery (IOP=18.92±0.46, p=0.000) and by the end of the follow-up period it was 20.8±1.13 (p=0.938). The amounts of topical ocular hypotensive drugs after SLT in the PEG group decreased from 1.69±0.107 to 1.45±0.092 (p=0.05), and in the POAG group - from 1.42±0.091 to 1.2±0.111 (p=0.137). There was no statistically significant progression of glaucomatous neuropathy in both groups: the MD index was not significantly changed in the PEG group during the follow-up period: -7.29±1.08 dB before SLT, and 7.6±1.36 dB in the late postoperative period (p=0.10), in the POAG group the index values were 5.95±1.12 dB and -6.63±1.28 (p=0.37) dB, respectively. CONCLUSION: SLT may be considered an effective and safe treatment for PEG patients, which not only significantly reduces the IOP level, but also helps preserve visual functions at least four years after the surgery.