[Late observations on the effectiveness of a new antiglaucoma operation--"concealed" sinusotrabeculotomy--in initial...

The paper describes results after surgical treatment of patients with initial exfoliative glaucoma in 150 eyes. Of them, sinusotrabeculectomy (STET) was made in 49 eyes, sinusotrabeculotomy (STT)--in 50, a new, proposed by the authors, operation--a "cap peak" sinusotrabeculotomy (CPSTT)--in 66 eyes; the latter excludes direct fistulization of the anterior chamber under the superficial scleral flap. It is noted that CPSTT at initial exfoliative stage of glaucoma leads to a remarkably lower incidence of complications at the time of operation and early postoperative period. Hyphema and anterior chamber emptying were recorded at the time of STET in 22.4% and 16.3%, of STT--in 8.0% and 10.0%, while at the time of CPSTT--only in 3.0% and 1.5%, respectively. Iridocyclitis, flat anterior chamber and detachment of the choroid were observed after STET in 32.6%, 24.5% and 26.5%, after STT--in 22.0%, 14.0% and 16.0%, and after CPSTT--in 6.0%, 4.5% and 1.5%, respectively. In remote terms (3 years after the operations), stabilization of visual acuity and visual field was recorded after STET in 69.3% and 85.7%, after STT--in 82.0% and 90.0%, and after CPSTT--in 87.9% and 92.4%, respectively. Stable normalization of intraocular pressure took place after STET in 93.8%, after STT--in 98.0%, and after CPSTT--in 96.9%. After STET and STT, hypotony was recorded in 28.5% and 18.0%, respectively, and after CPSTT--in none of the cases. The operation of a "cap peak" sinusotrabeculotomy is proposed as an operation of choice for treatment of exfoliative and common open-angle glaucomas in persons above 65 years of age.