[Signs of proliferative process after laser treatment of advanced glaucoma].

Unlabelled: The universally established method for effective and less-invasive reduction of the intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG) is a two-step method consisting of non-penetrating deep sclerectomy (NDSE) followed by laser goniopuncture of the Descemet's membrane (Descemet's goniopuncture; DGP). However, the hypotensive effect can diminish at different times during the follow-up due to excessive scarring in surgically formed outflow tracts (SFOT).

Purpose: To evaluate the condition of SFOT in dynamics with Visante OCT after one-step combined laser technique consisting of modified selective laser activation of the trabecula (MSLAT) and DGP in advanced POAG patients with normalized IOP who have pronounced pigmentation of the trabecular meshwork and stage II pseudoexfoliation syndrome (PES).

Material And Methods: OCT scans of 117 patients (117 eyes) were analyzed before laser treatments and after 1, 3, 6, 12 and 24 months. The study included 62 patients (62 eyes) comprising the main group who underwent MSLAT + DGP, and the control group consisting of 55 patients (55 eyes) who only underwent DGP.

Results: Visante OCT scans revealed that parameters of the filtration bleb (FB) and intrascleral cavity (ISC) in the main study group were more stable than in the control group during the whole follow-up. In the main study group there were less incorporations in the ISC and they had lower optical density, compared with the control group where there were denser incorporations in the ISC which gradually increased in count.

Conclusion: According to Visante OCT, the growing count and the increase in density of incorporations in the ISC can be defined as adverse signs of an active proliferative process in SFOT. A one-step MSLAT with DGP help achieve both a long-lasting hypotensive effect, and decrease of active proliferative process signs in SFOT.