Рефракционная замена хрусталика при рефракционной амблиопии: «лечение» или диагностика?

Abstract

Relevance. Refractive amblyopia is one of conditions that reduce best corrected visual acuity (BCVA) in patients. With the advent of new methods of refractive surgery, we note new features of the course of refractive amblyopia in adult patients after refractive surgery. Purpose. Determination of changes in uncorrected visual acuity and BCVA as well as changes in the degree of amblyopia in patients with high-grade refractive errors after implantation of toricIOLs during refractive lens replacement (RLL). Materials and methods. Retrospective evaluation of functional outcomes in 20 patients over 18 years (28 eyes) who received surgical treatment in the form of refractive lens replacement for myopic and hypermetropic astigmatism in the presence of high-grade ametropia with amblyopia. Results. In 35.3% of patients with myopic refraction, the diagnosis of amblyopia was removed. In 41.2%, we saw reducing the degree of amblyopia, 23.5% added 1 line of BCVA without changing the degree of amblyopia. When comparing the BCVA of patients with myopic refraction before and after surgical treatment, significant differences were obtained. In all eyes with hypermetropic refraction, there was no change in the degree of amblyopia after surgery, 22% of operated ones received an increase in BCVA by 1 line. There were no significant differences of BCVA a week after surgery in patients with hyperopic refraction. Conclusion. The revealed change in the degree of amblyopia in patients in early stages after RLL makes us clarify diagnosis and doubt sufficiency of standard methods for diagnosing amblyopia and determining its degree. In amblyopic patients with high myopia, in comparison with patients with hyperopia, refractive replacement of the transparent lens in most cases leads to an increase in BCVA in a short time after. Refractive lensectomy, is a amblyopia treatment, and is an important tool to exclude the diagnosis of amblyopia or reduce its degree. Key words: amblyopia, lens, refractive surgery, myopia, hypermetropia