NON-PENETRATING SURGERY OF OPEN ANGLE GLAUCOMA: 10-YEAR EXPERIENCE AND PROSPECTIVE STUDIES

T.V. Sokolovskaya, N.T.Timoshkina, E.S.Ivanova, N.N.Yereskin

The Svyatoslav Fyodorov Eye Mikrosurgery Complex, Department of Glaucoma Surgery, Moscow, Russia

There have been performed over 50 thousand procedures of non-penetrating deep sclerectomy (NDSE) in our clinic. This experience allows to precisely determine indications and contraindications to NDSE. The analysis of the achieved results showed that an ophthalmotonus normalization after NDSE has been obtained in 92% of cases. The risk of complications is minimum: choroid detachment is 2% of cases, hyphema - 0.6%, cataractogenic effect is practically absent, there were no infectious complications.

There have been determined main causes of NDSE inefficacy. They are as follows: non-observation of indications to the operation; breaking of the surgical intervention technology; excessive scarring at the operation area. So that to prolong a hypotensive effect of NDSE we have developed and improved new types of drains. There has been studied a possibility of cytostatics application. There has been widely introduced a method of laser descemetogoniopuncture at the NDSE area. There has been worked out a new technology of excimer laser of NDSE. The ablation of the external wall of the canal of Schlemm and corneal tissue up to Descemet's membrane is being performed with the help of excimer laser. During an operation there were no perforations of trabecula and Descemet's membrane. An hypotensive effect makes up over 90%.