Analysis of the effectiveness and safety of implantation of drainage devices in glaucoma surgery

Abstract

Currently, trabeculectomy in combination with antimetabolites remains the operation of choice in the treatment of both primary and secondary forms of glaucoma, despite the proven side effects and contradictory long-term hypotensive results. At the same time, methods and technologies of glaucoma surgeries are constantly developing, and with the advent of drainage devices (DD), the possibilities for achieving the necessary hypotensive effect and preserving visual functions have significantly improved, even in prognostically unfavorable clinical situations. Drainage devices are used to improve the outflow of intraocular fluid, reduce intraocular pressure and stabilize glaucomatous optic neuropathy. With the expansion of indications for DD implantation in clinical practice, it is important for specialists to know all the advantages and disadvantages of different types of drainage systems, possible complications and methods of their prevention. This review systematizes literature data on the types of DD, indications and nuances of implantation, postoperative IOP level and duration of hypotensive effect, comparative effectiveness, characteristic complications of early and late postoperative periods (hyperfiltration, hypotension, tube extrusion and exposure, trophic defects, cicatricial transformations of tissues around the drainage platform, endothelial dysfunction of the cornea), as well as methods of their prevention and treatment.