Опыт применения ИОЛ c отрицательными значениями рефракции при катаракте, осложненной экстремально высокой миопией

Abstract

Purpose. To analyze the postoperative result of visual and refractive functions in patients with extremely high myopia, taking into account the initial changes in the macular zone and rather complex calculations of the optical power of negative aphakic IOLs. Materials and methods. On the basis of S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, 57 negative aphakic IOLs were implanted over the past 3 years, which amounted to an average of 0.14% of the total number of implanted IOLs. All patients who were supposed to have a negative IOL implanted in the list of preoperative diagnostics included OCT of the posterior segment of the eye and ultrasound scanning to assess the existing degenerative changes in the posterior segment of the eye. Results. The average visual acuity before surgery in the group of emmetropes was ±0.32, and in patients with extremely high myopia, visual acuity did not exceed 0.1 in 2018, 0.23 in 2019, and 0.22 in 2020. In the operated extreme myopes, the mean BCVA increased to ±0.43, which is slightly lower than the average BCVA of the operated emmetropes during the same period (±0.58). None of the patients had intraoperative complications. Posterior capsule opacification was noted in 20 cases (35%) within 12-14 months after cataract surgery, which is several times higher in comparison with emmetropes, where posterior capsule opacification is observed in 8-15%, depending on the IOL model. Conclusion. This group of patients requires a particularly careful preoperative diagnosis, as well as surgery with increased caution due to the presence of concomitant pathology of the posterior segment of the eye. The experience of using negative IOLs for cataract in patients with extremely high myopia has shown good results in relation to postoperative visual and refractive functions, despite the fact that BCVA in extreme myopes after surgery is limited by the initial changes in the macular zone. Key words: negative aphakic IOLs, extremely high myopia, complicated cataract.