Клинический случай интраоперационной профилактики капсульного блока при цилиарно-капсульной фиксации трехчастной иол

Abstract

Purpose. To evaluate the clinical efficacy of intraoperative peripheral capsulotomy of the anterior leaf of the preserved capsular sac for the prevention of capsular block during fixation of the haptic elements of a three-piece IOL in the ciliary sulcus and infringement of the optics in the anterior capsulorhexis. Material and methods. Clinical results of phacoemulsification of complicated cataract with femtosecond laser accompaniment against the background of pseudoexfoliation syndrome, grade I subluxation in a 58-year-old patient in the early postoperative period. In addition to standard examination methods, optical coherence tomography of the anterior segment of the eye was used. During the operation, after filling the haptic elements of the three-part IOL into the ciliary sulcus, and the optics into the anterior capsulorhexis, 0.3 mm to the periphery from the edge of the IOL optics with a spear knife, two peripheral capsulotomies of the anterior capsule were performed opposite to each other. Results. On the 2nd day after the operation, BCVA increased and amounted to 1.0, IOP - 11 mm Hg. Art.; before surgery - 0.6 and 22, respectively. According to optical coherence tomography, a sufficient distance between the edge of the iris and the anterior surface of the IOL for free circulation of intraocular fluid was determined, and there were no signs of a capsular block. Conclusion. In the course of the study, it was found that intraoperative peripheral capsulotomy of the anterior leaf of the capsular bag provided natural leaching of viscoelastic from the capsular bag during implantation of a three-piece IOL into the ciliary sulcus with infringement of the optic part in the anterior capsulorhexis on the second day after the operation. Key words: capsular block, capsulotomy, three-piece intraocular lens, cilio-capsular fixation, pseudoexfoliative syndrome.