EC Ophthalmology

Purpose: To analyze the efficacy of a complex technology of laser surgery for pigmentary glaucoma which consists of YAG-laser iridectomy in the first stage followed by multistage selective laser trabeculoplasty to achieve a mild pigmentation degree of the trabecula in 360⁰.

Materials and Methods: Laser iridectomy was performed in 19 patients (38 eyes) aged 18 to 54 years old with pigmentary glaucoma after achieving the values of the individual IOP level using drug therapy. Then after 4 weeks SLT was carried out. If an exogenous pigmentation was ≥ 2 st., SLT has been repeated several times every 4 - 6 months. Observation period: from 4 to 15 years.

Results: The glaucoma process stabilization was achieved in all cases. The level of true IOP decreased by 6.6 ± 0.3 mm Hg (-30%, p < 0.05), Becker’s coefficient by 121 ± 4.3 (-60%, p < 0.001), the instillations number by 0.57 ± 0.09 (-70%, p < 0.001). The indicators increased: the average value of the total retinal photosensitivity by 381 ± 4.3 dB (15%, p < 0.001), the average threshold of the retinal photosensitivity by 2.6 ± 0.1 dB (10%, p < 0.001), the intraocular liquid outflow by 0.08 ± 0.013 (72%, p < 0.001). Drug hypotensive therapy was canceled at 16 eyes (42.1%).

Conclusion: The complex method of pigmentary glaucoma laser surgery in the form of YAG-laser iridectomy and the multistep SLT is effective and safe. It may be performed for a decrease of increased ophthalmotonus level to the individual IOP against the background of drug treatment.

Keywords: Pigmentary Glaucoma; YAG-Laser Iridectomy; Selective Laser Trabeculoplasty

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