[The results of fistulizing glaucoma surgeries in pseudophackic patients].

Abstract

Purpose: This study evaluated the hypotensive efficacy of resorbable, slowly resorbable, and non-resorbable implants in the surgical treatment of primary open-angle glaucoma (POAG) in pseudophakic patients.

Material and methods: The study involved patients with pseudophakia and stage II-III POAG who underwent glaucoma surgeries using various types of implants. A total of 140 eyes were evaluated. Group 1 included patients with resorbable implants made of polylactide and polyethylene glycol (40 eyes, 28.3%); group 2 consisted of patients with partially resorbable hydrophilic collagen implants (40 eyes, 28.3%); group 3 comprised patients with non-resorbable collagen implants (40 eyes, 28.3%). The control group consisted of patients who underwent sinus trabeculectomy with basal iridectomy (STE+BI) without drainage implantation (20 eyes, 14.9%).

Results: After two years, intraocular pressure (IOP) decreased from 29.4±7.8 to 18.29±3.67 mm Hg in group 1, from 29.8±7.5 to 18.6±2.15 mm Hg in group 2, from 29.6±3.12 to 18.3±0.47 mm Hg in group 3, and from 31.6±4.8 to 20.6±3.95 mm Hg in the control group. These results correlated with hydrodynamic indicators assessed by tonography and examination of surgically created aqueous outflow pathways using ultrasound biomicroscopy (UBM) of the anterior segment and optical coherence tomography (OCT).

Conclusions: In the late postoperative period (24 months post-surgery), the complete success rate of the surgeries showed a decreasing trend. All groups eventually required the reintroduction of hypotensive therapy. The most sustained success was observed in groups with resorbable and non-resorbable implants. Further dynamic monitoring will determine which implant type is the most favorable for surgical treatment of glaucoma.