Clinical results of surgical resection of the sclera in patients with primary glaucoma
Korchuganova E.A., Rumyantseva O.А., Egorov E.А., Kazantseva А.Yu.

Russian National Research Medical University named after N.I. Pirogov, Moscow 

Glaucoma continues to lead among diseases causing the loss of visual functions. Most surgical operations are carried out on patients with advanced glaucoma stages. Especially high risks of postoperative complications are observed in patients with high vision and residual field of vision. Surgical treatment of glaucoma is mainly aimed at creating or stimulating the ways of intraocular fluid outflow from the eye. A non-penetrating non-invasive operation has been developed to increase uveoscleral outflow by improving scleral permeability.
The aim of this research is to study the clinical efficacy of surgical resection of the sclera.
Patients and Methods: 79 patients (79 eyes) have been operated, most of patients (77%) had an advanced glaucoma, 19% had a developed glaucoma and 4% (3 eyes) had glaucoma stage IV. In 23 cases, 1 resection was performed, in 56 patients (56 eyes) - 2 resections were performed in the projection between the rectus muscles. Technique of the operation: after the conjunctiva is cut off from the limbus, the sclera is excised in the projection between the rectus muscles in the upper half of the eyeball with a size of 7.0x5.0 mm to a depth of 2/3 - 4/5 of its thickness in the projection of the ciliary body and the intrascleral collector canals. After hemostasis, 1-2 nodal seams are applied to the conjunctiva 8/00. Objective studies included: determination of visual acuity, level of intraocular pressure (IOP), outflow index (OI). Evaluation of the results was carried out 6 months after the operation.
Results: in all cases there were no sudden changes in IOP, it was normalized against the background of a weakening of the drug regimen.
Conclusion: The high efficiency of the developed method for the surgical treatment of glaucoma was noted by activating an additional path of outflow through the suprachoroidal space and the sclera. Complications in the early and late operating period were absent.

Key words: glaucoma, sclera, uveoscleral outflow, surgical treatment of glaucoma.
For citation: Korchuganova E.A., Rumyantseva O.А., Egorov E.А., Kazantseva А.Yu. Clinical results of surgical resection of the sclera in patients with primary glaucoma. // RMJ. 2017. № 28. P. 2057–2058.