Influence of α2-adrenomimetics on incidence of choroidal effusion following laser trabeculoplasty in primary open angle glaucoma

Baranov I.Ia.; Shiryaev I.V.; Molodkina N.A.; Efimov O.A.; Mitrofanova N.V.

doi:https://doi.org/10.17116/oftalma201813405126

Baranov I.Ia.

Sankt-Peterburgskiĭ filial FGBU MNTK "Mikrokhirurgiia glaza" im. akad. S.N. Fedorova

Shiryaev I.V.

Saint-Petersburg branch of the Academician S.N. Fyodorov IRTC «Eye Microsurgery», 21 Yaroslava Gasheka St., Saint-Petersburg, Russian Federation, 192283

Molodkina N.A.

Saint-Petersburg branch of the Academician S.N. Fyodorov IRTC «Eye Microsurgery», 21 Yaroslava Gasheka St., Saint-Petersburg, Russian Federation, 192283

Efimov O.A.

Saint Petersburg branch of S. Fyodorov Eye Microsurgery Federal State Institution, 21 Yaroslava Gasheka St., Saint Petersburg, Russian Federation, 192283

Mitrofanova N.V.

Sankt-Peterburgskiĭ filial FGBU MNTK "Mikrokhirurgiia glaza" im. akad. S.N. Fedorova

Influence of α2-adrenomimetics on incidence of choroidal effusion following laser trabeculoplasty in primary open angle glaucoma

Authors:

Baranov I.Ia., Shiryaev I.V., Molodkina N.A., Efimov O.A., Mitrofanova N.V.

More about the authors

Journal: Russian Annals of Ophthalmology. 2018;134(5): 26‑31

DOI: 10.17116/oftalma201813405126

Read: 1298 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Baranov IIa, Shiryaev IV, Molodkina NA, Efimov OA, Mitrofanova NV. Influence of α2-adrenomimetics on incidence of choroidal effusion following laser trabeculoplasty in primary open angle glaucoma. Russian Annals of Ophthalmology. 2018;134(5):26‑31. (In Russ.)
https://doi.org/10.17116/oftalma201813405126

Подписка 2026 Вестник офтальмологии (Russian Annals of Ophthalmology)

Использование инфографики авторами научных работ

Close metadata

Recommended articles:

The role of the structure of the lamina cribrosa in the diagnosis and treatment of glaucoma. Structural and circulatory changes in the lamina cribrosa with aging and elevated intraocular pressure. Russian Annals of Ophthalmology. 2025;(1):76-82

Neuroprotective therapy of glaucoma. Russian Annals of Ophthalmology. 2025;(1):83-90

Ciliochoroidal detachment as a complication of glaucoma surgery. Part 1. Theories of pathogenesis, symptoms and diagnosis. Russian Annals of Ophthalmology. 2025;(3):79-84

Ciliochoroidal detachment as a complication of glaucoma surgery. Part 2. Treatment and prevention. Russian Annals of Ophthalmology. 2025;(3):85-91

Modern approaches to combined surgery for cataract and primary open-angle glaucoma. Russian Annals of Ophthalmology. 2025;(3):92-99

The effect of initial conservative hypotensive therapy on the outcomes of selective laser trabeculoplasty in primary open-angle glaucoma. Russian Annals of Ophthalmology. 2025;(5):16-22

Features of daily patterns of blood flow parameters in the internal carotid arteries in primary open-angle glaucoma. Russian Annals of Ophthalmology. 2025;(5):66-71

Assessment of adherence to treatment in patients with resistant arterial hypertension according to Russian-language literature. A systematic review. Russian Cardiology Bulletin. 2025;(4-2):101-111

Abstract:

Purpose — to evaluate the influence of different topical hypotensive drugs on incidence of choroidal effusion (CE) following laser trabeculoplasty as the second stage of combined laser-surgical treatment plan in patients with primary open-angle glaucoma (POAG). Material and methods. The study included 60 patients with previously operated stage I and II POAG who has «b—c» intraocular pressure (IOP) on maximum hypotensive therapy. Fistulizing subscleral removal of the outer wall of Schlemm’s canal (a.k.a. subscleral sinusotomy) was the first stage of treatment plan. The second stage took place 14 days later in the form of laser trabeculoplasty. In order to reduce the risk of IOP spikes, all patients were prescribed specific hypotensive therapy 5 days prior to the procedure. The 1st group included 30 patients (30 eyes) who were asked to use Brimonidine-Purite (0.15%). The 2nd group included 30 patients (30 eyes) who used either nonselective β-blockers, or carbonic anhydrase inhibitors. IOP was measured on days 1, 5, 9, and 12 after stage 1, as well as after laser trabeculoplasty. Ophthalmic examination included ultrasound imaging and optical coherence tomography. Results. After the combined laser-surgical treatment, the IOP reliably decreased in both groups. Choroidal effusion was observed in 7 cases in the 1st group and in 15 cases in the 2nd group. Change in IOP was less prominent in patients who had received instillations of α2-adrenomimetic (p<0.05). Conclusion. Patients who received Brimonidine-Purite 0.15% before laser trabeculoplasty had lower IOP drop than those on pre-surgical therapy with nonselective β-blockers or carbonic anhydrase inhibitors. Topical application of 0.15% Brimonidine-Purite 5 days prior to laser trabeculoplasty as the second stage of combined laser-surgical treatment resulted in statistically significant reduction of the incidence of postoperative choroidal effusion, likely due to α2-adrenomimetics inhibiting the secretory function of the ciliary Body to the lesser extent than drugs of other groups that were tested.

Keywords:

primary open-angle glaucoma

hypotensive topical therapy

α2-adrenomimetics

subscleral sinusotomy

laser trabeculoplasty

choroidal effusion

Authors:

Baranov I.Ia.

Sankt-Peterburgskiĭ filial FGBU MNTK "Mikrokhirurgiia glaza" im. akad. S.N. Fedorova

Shiryaev I.V.

Saint-Petersburg branch of the Academician S.N. Fyodorov IRTC «Eye Microsurgery», 21 Yaroslava Gasheka St., Saint-Petersburg, Russian Federation, 192283

Molodkina N.A.

Saint-Petersburg branch of the Academician S.N. Fyodorov IRTC «Eye Microsurgery», 21 Yaroslava Gasheka St., Saint-Petersburg, Russian Federation, 192283

Efimov O.A.

Saint Petersburg branch of S. Fyodorov Eye Microsurgery Federal State Institution, 21 Yaroslava Gasheka St., Saint Petersburg, Russian Federation, 192283

Mitrofanova N.V.

Sankt-Peterburgskiĭ filial FGBU MNTK "Mikrokhirurgiia glaza" im. akad. S.N. Fedorova

Close metadata

References:

Nikolashin SI, Machehin VA. Non-penetrating deep sclerectomy with Shlemmov’s drainage the channel in treatment of primary open-angle glaucoma. Oftal’mokhirurgiya. 2012;1:17-20. (In Russ.)
Carassa RG, Bettin P, Fiori M, Brancato R. Viscocanalostomy versus trabeculectomy in white adults affected by open-angle glaucoma: a 2-year randomized, controlled trial. Ophthalmology. 2003;5(110):882-887. https://doi.org/10.1016/s01616420(03)00081-2
Chihara E, Hayashi K. Relation beetwen the volume of the lake and intraocular pressure reduction after nonfiltering glaucoma surgery: a spectral-domain anterior segment optical coherence tomography study. J Gllaucoma. 2011;8(20):497-501. https://doi.org/10.1097/ijg.0b013e3181f4649
Goldsmith JA, Ahmed IK, Crandall AS. Nonpenetrating glaucoma surgery. Ophthalmology Clinics of North America. 2005;18:443-460. https://doi.org/10.1016/j.ohc.2005.05.008
Mendrinos E, Mermoud A, Shaarawy T. Nonpenetrating glaucoma surgery. Survey of ophthalmology. 2008;6(53):592-630. https://doi.org/10.1016/j.survophthal.2008.08.023
Petrov SYu, Podgornaya NN, Aslamazova AE. Choroidal effusion. Natsional’nyi zhurnal glaukoma. 2015;1:92-102 (In Russ.)
Zharov VV, Rykov VP. Choroidal effusion (tj the question etiology and pathogenesis., prevention and treatment). RMZh. Klinicheskaya oftal’mologiya. 2009;10(1):40-41. (In Russ.)
Volkov VV. On the pathogenesis and therapy of post-operative choroidal detachment. Vestnik oftal’mologii. 1973;5:31-36. (In Russ.)
Ivanova ES, Egorova EV, Shpak AA, Gorbunova NYu, Farazheva EE. Pre-clinical diagnosis of early postoperative course features after surgeries of non-fistulizing types in case of primary open-angle glaucoma. Oftal’mokhirurgiya. 2011;1:28-33. (In Russ.)
Takhchidi KhP, Egorova EV, Ivanova ES, Farazheva EE, Lyubimova TS. Analysis of risk factors of ciliochoroidal detachment after non-penetrating deep sclerectomy. Oftal’mokhirurgiya. 2010;1:10-12. (In Russ.)
Baranov IYa, Chizh LV, Mitrofanova NV. Comparative evaluation of the results microfiltering technique subscleral removing outer wall of the Schlemm’s canal and microinvasive non-penetrating deep sclerectomy. Prakticheskaya meditsina. 2012;59(1):171-174. (In Russ.) https://doi.org/10.17691/stm2015.7.2.18
Baranov IYa, Shiryaev IV, Mitrofanova NV, Molodkina NV, Balashevich LI. Long-term results of combined surgery for open-angle glaucoma. Vestnik oftal’mologii. 2017;1:32-36. (In Russ.) https://doi.org/10.17116/oftalma2017133132-36
Egorova EV, Uzunyan DG. Laser correction of drain system formed with transconjunctival deep sclerectomy at origin of postoperative hypertension. Vestnik Orenburgskogo gosudarstvennogo universiteta. 2007;12(12):73-78. (In Russ.)
Krylova IA. Laser decsemetogoniopuncture as a preventive measure for ophthalmohypertension in the early terms followed microinvasivenonpenetrating deep sclerectomy. Vestnik Tambovskogo universiteta. 2015;6(20):1662-1664. (In Russ.)
Oftal’mofarmakologiya. Pod red.: Egorov E.A. Astakhov Yu.S., Stavitskaya T.V. M.: Izdatel’stvo GEOTAR-Media; 2005. (In Russ.)
Khouri AS, Lama PJ, Fechtner RD. Beta blockers. In: Netland PA (Ed.). Glaucoma medical therapy. Principles and management. 2nd ed. Oxford: Oxford University press; 2008.
Zolotarev AV, Karlova EV, Lebedev OI, Stolyarov GM. Medication assisted activation of unveoscleral outflow of intraocular fluid in glaucoma: pathogenic aspects. Vestnik oftal’mologii. 2013;4:1-5. (In Russ.)
Toris CB, Camras CB, Yablonski ME. Acute versus chronic effects of brimonidine on aqueous humor dynamics in ocular hypertensive patients. Am J Ophthalmol. 1999;128(1):8-14.
Lebedev OI, Chetvergova AE, Surov AV, Pechkurova TA, Kalizhnikova EA. Pathogenic mechanisms of a₂-adrenergic agonists’ hypotensive action. Natsional’nyi zhurnal glaukoma. 2017;16(2):19-26 (In Russ.)
Baranov IYa, Chizh LV, Mitrofanova NV. Sposob lecheniya otkrytougol’noi glaukomy. Patent na izobretenie №2520820 ot 27.06.14. (In Russ.) www.mntk.spb.ru