Статья профессора Кожухова А. А. с 36-го "Конгресса Европейского общества хирургов катаракты и рефракционных хирургов (ESCRS)", Вена, Австрия, 2018 год.

Sclerocorneal fixation of posterior chamber intraocular lenses (PCIOL) in complicated cases of cataract surgery (CCCS)

Session Title: Cataract Surgery Complications/Management

First Author: : A.Kozhukhov RUSSIA                      

Abstract Details

Purpose: 

Development of safe and effective method of treatment of aphakia with the help of transcleral fixation of PCIOL. In CCCS with fragile zonules/poor capsular-bag stability PCIOL implantation is associated with high risk of IOL instability,subluxation/dislocation of lens into vitreous-body. There are methods for correction of complicated aphakia,when it's impossible for intracapsular IOL fixation, depending on localization of lens:anterior chamber fixation/pupillary fixation/posterior chamber with fixation to ciliary sulcus. Each of these methods have +/Therefore, now it's important issue to search for new effective method of correction with transscleral suture technique for fixation PCIOL for non-standard cases, which doesn't contain above shortcomings. 

Setting: 

Clinic" Medline-service", Moscow, Russia 

Methods: 

The study was conducted on 40 patients.VA before operation: 0.01 - 0.2 sc, 0.05 - 0.4 cc, depending on degree of cataract maturity and on concomitant pathology. SLE revealed brown cataract in 17 patients, mature cataract - in 15 patients. At the same time, 27 patients were diagnosed with subluxation of the lens of different degrees ,in 5 patients-luxation of the lens into the vitreous body. Aphakia occurred in 8 patients: 5 cases - posttraumatic, 3 cases - the consequences of complicated cataract surgery. Patients were operated according to the method of sclerocorneal fixation of IOL proposed by us. 

Results: 

The period of patients' observation was up to 3 years. VA 1 week after surgery was 0.1-1.0 sc, 0.2 -1.0 cc. 36 patients showed myopic refraction from -0.5 to -2.5 D, astigmatism to -1.5 D and hypermetropic refraction in 4 cases within +0.75 D. IOP was registered normal: varied from 13 - 20 mm. Ultrasound biomicroscopy 1 week after surgery confirmed correct IOL centration for 37 patients, and revealed vertical decentration of 1 mm for 3 patients, which did not affect the VA. 

Conclusions: 

1.The proposed method of transscleral fixation of the IOL into the iridociliary sulcus is low-traumatic and highly effective, which is confirmed by postoperative results. 2.The developed surgical technique leads to rapid visual and social rehabilitation of patients, thanks to the use of modern technologies of small incisions and the absence of post-operative sutures requiring subsequent removal. In addition, it allows to preserve the pupillary function and avoid significant post-operative complications. 

С оригиналом статьи также можно ознакомиться на официальном сайте ESCRS - http://www.escrs.org/vienna2018/programme/poster-village-details.asp?id=30740