К вопросу профилактики капсульного блока после факоэмульсификации катаракты с имплантацией заднекамерной интраокулярной линзы

Abstract

Purpose. Method for the formation of anterior capsulorhexis for the prevention of capsular block in cataract phacoemulsification with implantation of a posterior chamber IOL was suggested. Material and methods. 67 patients (67 eyes) were operated on, for whom capsulorhexis was performed according to the method proposed by the authors in the form of an ellipse with a large axis of 7.0–7.5 mm along the tunnel incision and a small axis of 4.0–5.0 mm. Results. We did not observe any complications during the operation, as well as in the early and late postoperative period (damage to the anterior capsulorhexis, capsule block, bullous keratopathy, etc.). Only 2 patients (3%) were diagnosed intraoperatively with posterior capsule fibrosis, which required posterior capsulorhexis, which was performed after IOL implantation. At the same time, it should be noted that capsulorhexis was technically easier to carry out, since access to the posterior capsule was increased due to the previously performed oval anterior capsulorhexis. It was noted that the proposed method of forming the anterior capsulorhexis facilitates the insertion of the working part of the chopper over the edge of the lens when using the core fracture technique, reduces the risk of damage to the lens capsules, ensures reliable fixation of the IOL in the capsule bag and increases access for carrying out the posterior capsulorhexis, if necessary. After the operation UCVA and BCVA showed statistically significant increase, as much as possible after a month, but the difference with the data at the hospital discharge is statistically unreliable. After 1 year, visual functions remained stable, IOP was normalized. Conclusion. The proposed method for the formation of anterior capsulorhexis in cataract phacoemulsification with implantation of a posterior chamber IOL reliably eliminates the possibility of a capsule block due to the formation of an oval shape of the capsule hole. In addition, during the operation, it facilitates the insertion of the working part of the chopper over the edge of the lens when using the core fracture technique, reduces the risk of damage to the lens capsules, ensures reliable fixation of the IOL in the capsule bag by preserving sufficient peripheral flaps of the anterior capsule, and also increases access for posterior capsulorhexis under the IOL, if necessary. Keywords: cataract phacoemulsification, posterior chamber IOL, capsule block, oval capsulorhexis.