Клиническая оценка эффективности применения оригинального способа хирургического лечения катаракты у пациентов с заболеваниями макулы, получающих анти-vegf терапию

Abstract

Aim. To evaluate the effectiveness of an original method of cataract surgical treatment in patients with macular diseases receiving anti-VEGF therapy according to registered indications. Methods. A retrospective data analysis of patients who received complex treatment, including ultrasound phacoemulsification in combination with intravitreal injections of angiogenesis inhibitors (IVIAI; ranibizumab, aflibercept) before and after surgery and prolonged anti-inflammatory therapy (betamethasone injections into sub-Tenon's space), was carried out. The study group consisted of 20 patients (including 12 women, average age 77.0 years, predominant (65 %) nosology was is neovascular age-related macular degeneration) who received anti-VEGF therapy for at least 12 months before and after surgery and did not have gross compliance violations in this period. Results. An increase in best corrected visual acuity (decimal chart) was recorded from 0.18 before phacoemulsification to 0.47 1 month after surgery (p < 0.01), followed by maintaining the achieved values after 12 months (0.48, p < 0.01); decrease in central retinal thickness during the year of treatment prior to surgery from 392.4 µm to 262.6 µm (p < 0.01), remaining stable in the next 12 months (229.2 µm, p = 0.61). The average number of IVIAI performed 12 months after phacoemulsification was statistically significantly less than in the year preceding the operation (3.05 and 4.10, respectively, p < 0.01). Conclusion. High efficiency and safety of the proposed treatment method in patients with combination of cataract and macular diseases indicated for anti-VEGF therapy have been confirmed. Key words: cataract, phacoemulsification, method of treatment, macular diseases, anti-VEGF therapy.