The dissertation is devoted to increase of efficiency of treatment of patients with primary open-angle glaucoma and cataract by application in glaucoma surgery implantes glaucoma drainage device (Ex-Press) combined with the traditional phacoemulsification, mathematical analysis of progression of the glaucomatous process and education anti-scarring in the area of operation. The study of the results of surgical treatment and dynamic observation in 115 patients (121 eyes) with primary open-angle glaucoma, combined with cataract for 24 months was conducted. Observation over a period of 6 months was carried out in 204 patients (271 eyes). With a 24-month observation period, the composition of the groups was as follows: Тhe first group consisted of 30 patients (33 eyes) who had undergone a Ex-Press (P-50 model) in combination with phacoemulsification. The second group consisted of 30 patients (31 eyes) who performed a Ex-Press (model P-200) in combination with phacoemulsification. The third group consisted of 55 patients (57 eyes) who had undergone deep sclerectomy in combination with phacoemulsification. With a monitoring period of 6 months, the composition of the groups was as follows: the first group consisted of 65 patients (90 eyes), the second group consisted of 64 patients (88 eyes), the third group consisted of 75 patients (93 eyes). The average IOP (pneumotonometric) level before surgery in group I was 22.9 ± 2.9 mm. Hg. In the second group, the mean IOP level was 22.8 ± 3.5 mm. Hg (p I / ІІ> 0,05), in the third group the average IOP level for the operation was 22,6 ± 3,4 mm. Hg, (p I / III> 0,05), (p II / III> 0,05). The IOP level was corrected for the thickness of the cornea. All surgical interventions were performed by one surgeon, according to a single algorithm. Phacoemulsification was performed using the Infinity® Vision System (Alcon) ophthalmic system. In patients with implanted Ex-Press P-200, 24 months after surgery, the level of pneumotonometric IOP decrease was 1.1%, and the true IOP was 4.8% below, than in patients with implanted Ex-Press P-50. Comparative analysis of the best corrected visual acuity after 12 months after surgical treatment showed the advantages of implantation of Ex-Press P-200, which ensured its statistically significant increase to a level of 0.79 ± 0.02, which is 25.31% higher than in patients with deep sclerectomy performed and 5.06% higher than in the group where Ex-Press P-50 is implanted. After 24 months. after surgery, changes in the thickness of Avg GCC and NFL in groups with implanted Ex-Press were statistically insignificant (p> 0.05), which indicates the stabilization of glaucoma. For the first time, according to the mathematical analysis of the effectiveness of surgical treatment of POAG in combination with cataract for 6 months, the best indicators of glaucoma process stabilization during implantation of Ex-Press P-200 in combination with phacoemulsification (n = 2.68) were found, which is 5.9% higher than with the implantation of Ex-Press P-50, and 90% higher than when performing deep sclerectomy. The results of the impact of prognostic factors on the level of intraocular pressure at 12 months after implant surgery glaucoma filtration device in combination with cataract phacoemulsification. The influence of possible prognostic factors on the level of intraocular pressure at 12 months after implant surgery glaucoma filtration device P-50 and P-200 in combination with cataract phacoemulsification in 60 patients (64 eyes). To determine the effect on IOP chosen for the study (using linear univariate regressio-correlating analysis) the following factors: age, gender, stage of glaucoma, the level of preoperative intraocular pressure (pneumotonometry), the level of the true intraocular pressure before operation (P), the degree of pigmentation of the trabeculae, the coefficient ease the outflow of internal fluid (S). As criterion of efficiency of operative intervention was used the level of true IOP (Ro) in 12 months. after surgery. Statistical processing of results was performed using SOFTWARE "Statistica V. 10" (Stat Soft) and Excel 2010 (Microsoft Corporation). In the result of the study established that the linear correlation of the signs is missing. None of the factors in our study were not statistically significantly associated with the level of IOP at 12 months after implant surgery mcrodriguez the device as model R-50 and model R-200. Revision of bleb - method of dealing with scarring ways outflow of intraocular fluid. The main problem glaucoma surgery is excessive scarring ways outflow of intraocular fluid, which is created during antiglaucomatozhnykh operations. A pronounced proliferative process in the area of surgical intervention leads to repeated elevation of IOP and further decompensation of glaucomatous process. Increased intraocular pressure to the level of more than 21 mm of mercury. article when using three antihypertensive drugs include carbonic anhydrase inhibitor, beta - blocker and prostaglandin analogue, was an indication for revision bleb at the proposed methodology. The basis for our proposed audit methodology, bleb entrusted with the task of restoring the patency of the device for filtration of the ocular fluid Ex-PRESS through the use of accessible and user-friendly tools. Monitoring the results of the revision of bleb was carried out for 21 months after surgery. During the observation in group i, 6 of RFP, in group II - 1 RFP. Normalization of the IOP after the revision of bleb in the first group were observed for 21 months. in 60 % of cases (3 eyes) within 6 months. in 20 % of cases (1 eye). In 20 % of cases (1 eye), And the group held a second revision of bleb in 6 months after the first intervention. Normalization of IOP after revision of bleb in the II group were observed for 21 months in 100 % of cases. The number of revisions carried out within 30 months. after the main operation in connection with the decompensation of IOP in the group Ex-Press P-50 was 18.18% of cases, in the group Ex-Press P-200 - 3.22% of cases.
