Betamethasone-loaded bioresorbable drainage in primary open-angle glaucoma surgery

PURPOSE . To investigate the use of betamethasoneloaded bioresorbable drainage in patients with primary open-angle glaucoma undergoing fistulizing surgery to increase the stability of its hypotensive effect. METHODS . The study included two groups of 50 patients (50 eyes): the main group underwent surgery using a bioresorbable polylactic acid drainage device loaded with betamethasone solution, while the control group received the same drainage device without betamethasone. Patients were examined at baseline, postoperatively, then at 1 and 2 weeks, as well as at 1, 3, 6, and 12 months. Interleukin-6 (IL-6) and interleukin-10 (IL-10) levels in tear fluid were assessed before and after surgery using enzyme-linked immunosorbent assay (ELISA). RESULTS . At 1 year postoperatively, intraocular pressure (IOP) was significantly lower in the main group compared to the control group (15.48±1.74 vs. 17.52±2.25 mm Hg; p <0.05). In the main group, IL-6 levels in tear fluid decreased postoperatively from 32.7 [0.0; 784.2] to 8.15 [0.0; 1031.2] pg/ml, remaining significantly lower than in the control group (p=0.026), whereas IL-10 levels remained unchanged. IL-6 levels in the control group did not change postoperatively. No significant differences were observed between the groups in IL-10 levels preoperatively (p=0.817) or postoperatively (p=0.029). The superior hypotensive effect of the novel surgical approach was associated with greater filtration bleb height compared to the control group (0.71±0.20 vs. 0.57±0.13 mm; p=0.002), scleral cavity height (0.47±0.16 vs. 0.39±0.14 mm; p=0.015), and intrascleral cavity volume (3.58±1.51 vs. 2.07± 0.82 mm³; p < 0.001). The incidence and severity of postoperative complications did not differ between groups (6.8%). CONCLUSION . The findings confirm the high efficacy and safety of glaucoma surgery using a bioresorbable polylactic acid drainage device loaded with betamethasone for primary open-angle glaucoma. ELISA results indicate that the use of this drainage method is associated with reduced postoperative inflammation.