Применение интраоперационной ОКТ в хирургическом лечении перезрелых катаракт с фемтолазерным сопровождением

Abstract

Purpose. To evaluate the capabilities of intraoperative OCT in optimizing the femtocapsulotomy technique during the surgical treatment of overripe cataracts with femtolaser support. Material and methods. The study included 20 patients (20 eyes) with overripe cataracts who underwent femtolaser-assisted cataract surgery (FACS). The patients were divided into 2 groups (10 eyes in each group). For the 1st group, femtocapsulorexis was performed taking into account the morphological changes in the anterior lens capsule and the state of the lens according to intraoperative OCT. Dosing of the laser energy depended on the condition of the anterior capsule and the underlying altered cortical masses. For prophylactic purposes, to reduce the tension of the anterior capsule and equalize the intralenticular pressure (ICP) gradient, cohesive-dispersed viscoelastics were preliminarily introduced. The anterior capsule was stained with trypan blue to improve visualization. For the 2nd group, the femtocapsulorexis technique was standard. Results. There were no cases of radialization of the anterior lens capsule in the 1st group. In all cases, a perfectly round, centrally located capsulorhexis with a diameter of 5-5.2 mm was achieved. The IOL was implanted into the capsule bag, without intra- and postoperative complications. An incomplete capsulotomy was performed with a femtolaser in 3 cases in the 2nd group. Out of these 3 cases, in two cases, radialization of the anterior capsulorhexis occurred without transition to the posterior capsule. The IOL was implanted in the capsule bag in all cases. Conclusion. The use of intraoperative OCT makes it possible to evaluate morphological changes in the lens capsule and to plan the individual parameters and femtocapsulorexis algorithm, which reduces the risk of complications of overripe cataract surgery with femtolaser support. Key words: intraoperative OCT, overripe cataract, femtolaser support.