S.Yu. ANISIMOVA¹, S.I. ANISIMOV², L.L. ARUTYUNYAN¹, I.V. NOVAK¹

¹Eye Center «Vostok-Prozreniye», 38 Bolshoy Tishinskiy pereulok, Moscow, Russian Federation, 123557

²A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., building 1, Moscow, Russian Federation, 127473

Anisimova S.Yu. ― D. Med. Sc., Professor, Director General, tel. (495) 223-32-75, e-mail: vostok-prozrenie@yandex.ru

Anisimov S.I. ― D. Med. Sc., Professor of the Ophthalmology Department, tel. (495) 223-32-75, e-mail: xen3744@yandex.ru

Arutyunyan L.L. ― D. Med. Sc., Head of the Diagnostic Department, tel. (495) 223-32-75, e-mail: luslev@yandex.ru

Novak I.V. ― doctor-ophthalmologist, tel. (495) 223-32-75, e-mail: baushkabatman@gmail.com

The article presents clinical and functional results of femto-assisted phacoemulsification of cataract combined with non-penetrating deep sclerectomy with Xenoplast drainage implantation. The procedure was performed on 45 eyes (42 patients) 65-85 years of age with different stages of POAG. In all cases the following examinations were performed: computer perimetry, optic disk retinal tomography, corneal-compensated pressure (IOP CC), pressure equal to Goldman IOP (IOP G) and corneal hysteresis (CH) with the ORA device (Reichert). All examinations were performed before operation and 1, 3, 6 months, 1, 2, 3, and 4 years after the operation. By the end of the 4^th year, the level of normalized IOP without hypotensive medication was observed in 40.9% of all cases. 58.1% patients had to use 1.7±0.8 medications. Statistically significant increase of CH was 8.8±1.7 mm Hg compared with the same parameter before operation. These data indicate normalization of biomechanical parameters of cornea-scleral capsule of the eye in the long-term post-operation period. Stabilization of glaucoma process according to perimetry and structural parameters was observed in 34 patients, 35 eyes (77.8%, p=0,001). These results show that femto-assisted phacoemulsification combined with non-penetrating deep sclerectomy with Xenoplast drainage implantation is statistically effective method of IOP normalization and stabilization of glaucoma process, decreasing the medication load compared with pre-operation level.

Key words: femtolaser, cataract, glaucoma, phacoemulsification, non-penetrating deep sclerectomy.

References

1. Anisimova S.Yu., Anisimov S.I. Zagrebelnaya L.V. The influence of operation techniques on intraocular pressure decrease level and eye functions in combined cataract and glaucoma surgery, 2003, pp. 31-37.
2. Janovskaya N.P., Frankovska-Gerlak M. The efectiveness of one-stage combined surgical treatment of patients with cataract and pseudoexfoliative glaucoma. Scientific-practical conference Fyodorov reading, 2007, pp. 88-89.
3. Anisimova S.Yu., Anisimov S., Zagrebelnaya L. Selection of technique of operation and intraocular lens in comdined glaucoma and cataract surgery. Journal Francais d’Ophthalmologie, 203 p.
4. Anisimova S.Yu., Anisimov S.I., Novak I.V., Polyakova K.M., Trubilin A.V., Anisimova N.S. Comparative evaluation of clinical results in cases of standard phacoemulsification and femtoassisted phacoemulsification in out-patient clinic. Cataract and refractive surgery, no. 13(2), pp. 17-21.
5. Anisimova S.Yu., Anisimov S.I. Zagrebelnaya L.V. The results of combined non-penetrating sclerotomy and cataract extraction with IOL implantation. Glaucoma, 2003, no. 2, pp. 15-19.
6. Malyugin B.E. Modern aspects of surgical treatment in cases of glaucoma and cataract combination. Glaucoma, problems and solutions, 2004, pp. 373-377.
7. Malyugin B.E. Long-term results of one-stage phacoemulsification and non-penetrating tunel sclerectomy. Modern technologies of cataract surgery, 2000, pp. 109-115.
8. Gimbel H.V., Meyer D. Small incision trabeculotomy combined with phacoemulsification and IOL implantation. J Cataract Refract Surg, 1993, no. 19, pp. 92-96.