[Changes in retinal light sensitivity and morphometry during surgical treatment of primary glaucoma with physiotherapeutic stimulation].

Abstract

Surgery for advanced stages of primary open-angle glaucoma (POAG) aims to normalize intraocular pressure (IOP). A course of physiotherapy during subsequent stages of surgical treatment may have an additional beneficial effect.

Objective: The study evaluated the effect of physiotherapy in patients with glaucomatous optic neuropathy and surgically compensated IOP.

Material and methods: This prospective cohort study included 50 patients (64 eyes) with stage II-III POAG and indications for glaucoma surgery - nonpenetrating deep sclerectomy (NPDS). IOP, mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI), average retinal nerve fiber layer thickness (AvgRNFL), and ganglion cell complex (GCC) parameters were assessed before NPDS and at 1, 3, and 6 months after surgery. In the study group, 1 month after NPDS, patients received a 2-week course of adjunctive physiotherapy consisting of three procedures - transcranial magnetic and electrical stimulation, endonasal electrophoresis with the 0.1% retinoprotective agent Semax, and heliox (21/79) inhalation. The control group received 0.1% Semax nasal drops twice daily for 10 days.

Results: One month after NPDS, corneal-compensated IOP (IOPcc) decreased significantly (p<0.001), with no subsequent increase. In the study group, MD improved from -8.62±1.86 dB to -7.03±1.36 dB (p<0.01), while adjunctive physiotherapy produced a further improvement to -4.33±0.98 dB (p<0.0001), which persisted for up to 6 months after surgery. In the control group, MD returned to baseline values by month 3. Analysis of VFI, AvgRNFL, and GCC revealed no statistically significant differences.

Conclusion: The findings indicate that comprehensive physiotherapy potentiates improvement in retinal function after surgery in patients with advanced POAG, with the effect lasting for up to 6 months.