Analysis of Cases of Decompensation of Intraocular Pressure in Patients after Antiglaucoma Surgery

Objective. Evaluation of the effectiveness of reducing intraocular pressure (IOP) in patients after antiglaucoma surgeries (AGO) using the Healaflow viscodrainage device based on a retrospective analysis of the timing and frequency of IOP decompensation.

Material and methods. A retrospective analysis of 438 medical records of patients with primary open-angle glaucoma (POAG) who underwent glaucoma surgery using micro-non-penetrating deep sclerectomy (NPDS) technology was performed at the Yekaterinburg Center of the Scientific and Technical Complex “Eye Microsurgery”. The patients were divided into 2 groups: with primary antiglaucoma surgery — 315 and 123 with repeated surgery. In each group, 2 subgroups were identified: 285 patients using Healaflow viscodrainage and 153 patients without Healaflow. Achievement of target IOP in the early and late postoperative periods was assessed. The observation period was 5 years.

Results. The absolute success in IOP compensation after primary micro-NPDS in patients using Healaflow was 59.7 % and 54.2 % without it. Repeated micro-NPDS resulted in a lower frequency of absolute success in IOP compensation — 31.5 % in patients using Healaflow and 24 % without it, with an observation period of 40 months. The relative failure in IOP compensation after micro-NPDS was 40.3 % in patients using Healaflow and 45.8 % without it, with an observation period of 40 months. The frequency of absolute failure (AF) did not depend on the stage of glaucomatous optic neuropathy (GON). In patients after primary micro-NPDS, the incidence of AF was 36.2 % in patients using Healaflow and 57.1 % without it, and 34.1 and 53.1 % after repeated AGO, with an average decompensation period of 19.3 ± 12.6 months and 13.5 ± 11.2 months, respectively. The use of Healaflow viscodrainage increased the time to repeated surgery by 26.8 % in the primary AGO group and by 37 % in the repeated AGO group.

Conclusion. The effectiveness of AGO decreases over time, despite the use of minimally invasive surgical treatment technologies and the use of modern anti-scarring agents. A retrospective comparative study conducted to evaluate the long-term results of intraocular pressure (IOP) reduction after micro-NPDS using Healaflow viscodrainage revealed a longer period of achieving target IOP values both during primary and repeated surgical intervention.

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