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Abstract #79321 Published in IGR 20-2
Influence of α2-adrenomimetics on incidence of choroidal effusion following laser trabeculoplasty in primary open angle glaucoma
Baranov IY; Shiryaev IV; Molodkina NA; Efimov OA; Mitrofanova NVVestnik Oftalmologii 2018; 134: 26-31
PURPOSE: To evaluate the influence of different topical hypotensive drugs on incidence of choroidal effusion (CE) following laser trabeculoplasty as the second stage of combined laser-surgical treatment plan in patients with primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 60 patients with previously operated stage I and II POAG who has 'b-c' intraocular pressure (IOP) on maximum hypotensive therapy. Fistulizing subscleral removal of the outer wall of Schlemm's canal (a.k.a. subscleral sinusotomy) was the first stage of treatment plan. The second stage took place 14 days later in the form of laser trabeculoplasty. In order to reduce the risk of IOP spikes, all patients were prescribed specific hypotensive therapy 5 days prior to the procedure. The 1 group included 30 patients (30 eyes) who were asked to use Brimonidine-Purite (0.15%). The 2 group included 30 patients (30 eyes) who used either nonselective β-blockers, or carbonic anhydrase inhibitors. IOP was measured on days 1, 5, 9, and 12 after stage 1, as well as after laser trabeculoplasty. Ophthalmic examination included ultrasound imaging and optical coherence tomography. RESULTS: After the combined laser-surgical treatment, the IOP reliably decreased in both groups. Choroidal effusion was observed in 7 cases in the 1 group and in 15 cases in the 2 group. Change in IOP was less prominent in patients who had received instillations of α-adrenomimetic (p<0.05). CONCLUSION: Patients who received Brimonidine-Purite 0.15% before laser trabeculoplasty had lower IOP drop than those on pre-surgical therapy with nonselective β-blockers or carbonic anhydrase inhibitors. Topical application of 0.15% Brimonidine-Purite 5 days prior to laser trabeculoplasty as the second stage of combined laser-surgical treatment resulted in statistically significant reduction of the incidence of postoperative choroidal effusion, likely due to α-adrenomimetics inhibiting the secretory function of the ciliary Body to the lesser extent than drugs of other groups that were tested.
Saint Petersburg branch of S. Fyodorov Eye Microsurgery Federal State Institution, 21 Yaroslava Gasheka St., Saint Petersburg, Russian Federation, 192283.
Full articleClassification:
9.4.5.5 Other (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
