title: [Ultrasound biomicroscopy findings in the area of previous surgical intervention in refractory glaucoma patients under topical ocular hypotensive therapy].
abstract: OBJECTIVE
  to evaluate the effectiveness of different classes of topical hypotensive medications in refractory primary open-angle glaucoma (POAG), judging from structural changes in artificial pathways for intraocular fluid (IOF) visualized with ultrasound biomicroscopy (UBM).
  
  
  METHODS
  UBM analysis was performed in 104 eyes of 102 patients, mean age 68.4 ± 0.8 years, including 41 POAG patients with well controlled intraocular pressure (IOP) (group 1) and 41 refractory POAG patients with poorly controlled IOP (group 2), all under topical hypotensive therapy (prostaglandin analogues, beta blockers, carbonic anhydrase inhibitors, or combination drugs). The control group consisted of 20 patients, who maintained normal IOP after a single glaucoma surgery and did not require medical management.
  
  
  RESULTS
  The following UBM parameters were evaluated: intrascleral cavity and filtering bleb heights and conjunctival and scleral flap thicknesses. Findings differed depending on the condition of IOF outflow pathways. Unlike the poorly controlled patients, UBM parameters in group 1 were comparable to those in the controls. The optimal control of postoperative IOP was achieved on combination therapy (a beta blocker plus a carbonic anhydrase inhibitor).
  
  
  CONCLUSIONS
  In contrast to well controlled POAG patients, target values of IOP were not achieved in refractory POAG patients with either of the topical therapeutic measures. Moreover, intrascleral cavity and filtering bleb heights in these patients were reliably low (p ≤ 0.01), as confirmed by UBM analysis of the area of surgical intervention.
authors: Novosibirsk State Medical University, Ministry of Health of the Russian Federation, 52 Krasnyy prospect, Novosibirsk, Russian Federation, 630003.
authors: O G
authors: OG
authors: Gusarevich
authors: Novosibirsk State Medical University, Ministry of Health of the Russian Federation, 52 Krasnyy prospect, Novosibirsk, Russian Federation, 630003.
authors: A E
authors: AE
authors: Nurlanbayeva
authors: Railway Clinical Hospital on the Station Novosibirsk-Glavnyy, JSC Russian Railways (JSC RZD), 2a Vladimirovskiy spusk, Novosibirsk, Russian Federation, 630003.
authors: A A
authors: AA
authors: Gusarevich
authors: State Novosibirsk Regional Clinical Hospital, 130 Nemirovicha-Danchenko St., Novosibirsk, Russian Federation, 630087.
authors: A Zh
authors: AZ
authors: Fursova
authors: State Novosibirsk Regional Clinical Hospital, 130 Nemirovicha-Danchenko St., Novosibirsk, Russian Federation, 630087.
authors: O G
authors: OG
authors: Fen'kova
authors: Novosibirsk State Medical University, Ministry of Health of the Russian Federation, 52 Krasnyy prospect, Novosibirsk, Russian Federation, 630003.
authors: S V
authors: SV
authors: Aydagulova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D018463:Filtering Surgery; D005902:Glaucoma, Open-Angle / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D033401:Microscopy, Acoustic / Q000379:methods*; D008875:Middle Aged; D012590:Sclera / Q000000981:diagnostic imaging* / Q000601:surgery
chemical_list: D000959:Antihypertensive Agents