Yusef Yu N, Vvedenskiy A S, Yusef S N, Voronin G V, Alkharki L, Shkolyarenko N Yu, Fokina N D
Research Institute of Eye Diseases, Moscow, Russia.
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Vestn Oftalmol. 2020;136(5. Vyp. 2):204-208. doi: 10.17116/oftalma2020136052204.
Prevention of the anterior capsular contraction syndrome (ACCS) in the late postoperative period in patients with lens subluxation is a current problem of phacoemulsification (PE).
To develop and clinically evaluate a differentiated method of surgical prophylaxis against ACCS during PE in patients with lens subluxation.
Phacoemulsification surgery with in-the-bag IOL implantation and postoperative follow-up were carried out in 192 patients (192 eyes) with cataract and lens subluxation. In all patients, complete anterior capsulorhexis at the beginning of the surgery was not possible. A differentiated approach was used for capsulorhexis extension at the final stage of the operation after in-the-bag IOL implantation. Three groups of patients were formed according to the three most common clinical situations.
There were no signs of ACCS development in as many as 189 (98.4%) cases. In 3 (1.6%) cases, slight narrowing of the anterior capsulorhexis opening was noted, however, with no effect to the IOL position and functional results of the operation.
The differentiated approach to anterior capsulorhexis in patients with lens subluxation allowed to perform phacoemulsification with in-the-bag IOL implantation and to avoid ACCS development in the late postoperative period.
预防晶状体半脱位患者术后晚期的前囊收缩综合征(ACCS)是白内障超声乳化术(PE)当前面临的一个问题。
制定并临床评估一种针对晶状体半脱位患者在超声乳化术中预防ACCS的差异化手术方法。
对192例(192眼)患有白内障和晶状体半脱位的患者进行了囊袋内人工晶状体植入的超声乳化手术及术后随访。所有患者在手术开始时均无法完成完整的前囊撕囊。在囊袋内人工晶状体植入后的手术末期,采用差异化方法进行前囊撕囊扩展。根据三种最常见的临床情况将患者分为三组。
多达189例(98.4%)病例未出现ACCS发展的迹象。3例(1.6%)病例中,前囊撕囊口有轻微狭窄,但对人工晶状体位置及手术功能结果无影响。
对晶状体半脱位患者采用差异化的前囊撕囊方法,能够进行囊袋内人工晶状体植入的超声乳化术,并避免术后晚期ACCS的发生。