Современные тенденции в лечении глаукомы

Практически во всех регионах России глаукома занимает 1-е место среди причин инвалидности вследствие офтальмопатологии, что соответствует общемировым тенденциям роста заболеваемости глаукомой и ее лидирующего положения среди причин, приводящих к необратимой слепоте. Лечение глаукомы направлено на снижение внутриглазного давления (ВГД). В данном обзоре представлены основные современные тенденции развития медикаментозной терапии глаукомы, лазерной хирургии, фистулизирующей, дренажной и непроникающей хирургии, а также новейшей микроинвазивной хирургии глаукомы (МИХГ). В настоящее время на фармацевтическом рынке существует множество гипотензивных капель. Для повышения приверженности лечению предложены фиксированные комбинации лекарственных средств, разрабатываются также эффективные способы доставки лекарств, снижающих ВГД при минимальных побочных эффектах. Дальнейшее развитие лазерной хирургии делает ее методом выбора при стартовом лечении (селективная лазерная трабекулопластика), а также расширяет возможности ее применения при различных стадиях глаукомы (микроимпульсная циклофотокоагуляция). Все это существенно снижает частоту классических макроинвазивных антиглаукомных операций. Существовавший ранее разрыв между консервативной медикаментозной терапией и антиглаукомной хирургией призваны заполнить новейшие процедуры МИХГ. В последние годы на всех этапах терапии первичной открытоугольной глаукомы отмечают появление новых фармацевтических препаратов, методов и имплантов, описание которых и стало целью данного обзора.

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