RESUMEN
The review presents the history of development and improvement of methods for intraocular lens (IOL) exchange. Existing techniques of IOL exchange are comparatively analyzed.
Asunto(s)
Implantación de Lentes Intraoculares , Lentes Intraoculares , Ojo Artificial , Estudios Retrospectivos , Agudeza VisualRESUMEN
Prevention of decentration and dislocation of the "capsular bag + intraocular lens" (IOL) complex in the late postoperative period is an actual problem of surgical treatment of patients with pronounced lens subluxation. PURPOSE: To conduct a comparative clinical study of positional stability of the "capsular bag + IOL" complex in the late postoperative period after application of a combined technique of capsular bag fixation in patients with subluxation of the lens. MATERIAL AND METHODS: Phacoemulsification (PE) with in-the-bag IOL implantation and postoperative observation was performed in 213 patients (234 eyes) with cataract and pronounced lens subluxation. The 1st group consisting of 138 patients (153 eyes) underwent capsular bag fixation of the combined technique with simultaneous use of 4 modified iris-retractors and one or two capsular tension rings (CTRs). The 2nd group included 75 patients (81 eyes) who in the course of PE had their capsular bag fixed beyond the edge of capsulorhexis with only 4 modified iris-retractors. Preoperative state of the lens and the evaluation of the frequency and degree of decentration of the «capsular bag + IOL¼ complex in the postoperative period were performed using data acquired with ultrasound biomicroscopy (UBM). RESULTS: Significant (more than 1 mm according to UBM) IOL's optic decentration was observed in the 1st group after applying the combined capsular bag fixation technique in 12 (7.8%) cases, and in the 2nd group after isolated use of modified iris-retractors in 48 (59.3%) cases. CONCLUSION: The use of the combined capsular bag fixation technique not only improves the conditions for carrying out PE with in-the-bag IOL implantation in patients with pronounced lens subluxation, but also contributes to a substantial (an average of 8 times) reduction in the incidence of significant decentration of the «capsular bag + IOL¼ complex in the late postoperative period.
Asunto(s)
Subluxación del Cristalino , Lentes Intraoculares , Facoemulsificación , Capsulorrexis , Humanos , Implantación de Lentes Intraoculares , Complicaciones Posoperatorias/cirugíaRESUMEN
Morphometric studies using a laser retinal thickness showed great differences in the impact of hydromonitoring phacofragmentation and ultrasound phacoemulsification on the thickness of the central retinal region. Unlike ultrasound phacoemulsification, hydromonitoring phacofragmentation caused no transient increase in the thickness of the central retinal area. The performed studies revealed no correlation between the equivalent time of ultrasound and ultrasound phacoemulsification and the changes in the thickness of the central retinal region and fovea.