Our First Experience of Combined Treatment of Primary Open-Angle Glaucoma and Complicated Cataract, Using Yag-Laser Activation of the Trabecula and Phacoemulsification of the Cataract With Iol Implantation

Abstract

The combination of cataract and glaucoma is observed in approximately 76 % of cases, and in the presence of pseudoexfoliative syndrome - in 85 %. In order to optimize the surgical treatment of this combined pathology, various methods of combined intervention have been developed and applied. One of them is combination of YAG-laser activation of the trabecula (YAG-LAT), followed by cataract phacoemulsification and implantation of an intraocular lens (IOL). We observed 78 patients (78 eyes) with primary open-angle glaucoma with varying degrees of pigmentation of the anterior chamber angle structures in combination with complicated cataract. All patients underwent surgical intervention, which included YAG-laser activation of the trabecula 30 minutes after which, the stage of cataract phacoemulsification with IOL implantation was performed. After the treatment, in all cases, there was a significant increase in visual acuity in comparison with the preoperative values, on average, the best corrected visual acuity (BCVA) was 0.91 ± 0.09 and a decrease in the level of intraocular pressure by 16 % from the initial value after 12 months after treatment. According to computer perimetry data, no negative dynamics was observed in any patient in the long-term follow-up period to 12 months, which may indicate the stabilization of the glaucoma process. Suggested method provides stable normalization of intraocular pressure, improvement of visual functions and stabilization of the glaucoma process.