Abstract
Purpose: To assess the capsular tension ring implantation effect on the IOL position according to different devices in the long term period after uncomplicated phacoemulsification.Patients and methods. The study enrolled 234 patients (273 eyes) with cataract without zonular weakness. A standard examination, optical biometry and Sheimpflug imaging were performed preoperatively. In all cases phacoemulsification with IOL implantation, supported by CTR in 11 % of cases (30 eyes) was performed in 1, 3, and 6 months after surgery autorefractometry, visual acuity, biometry, OCT of anterior segment and ultrasound biomicroscopy were provided.Results. By the 3rd month a small shift of IOL towards the retina was revealed without any refraction changes. In cases with CTR implantation the anterior chamber depth was stable. According to OCT data the angle of IOL tilt in the horizontal meridian gradually decreased, the dynamics was significant from 3 months (p = 0.032). There were no changes in the vertical direction. After CTR implantation IOL position did not significantly change. There was no difference between the groups (p > 0.05) by 6 month. The phenomenon of IOL “deflection” according to OCT data was observed in 20.87 % of cases was in 1 month after operation. In the presence of CTR its frequency decreased to 15.00 %, and in the absence, it increased to 21.63 %. In every fifth case of deformation the measurements did not give us a definite reason to further consider it a “deflection” by 6 months after the operation. In 4.24 % of cases fact of IOL “deflection” was absent at the first month but appeared by the 6 month. There was not any case of CTR implantation among described cases of IOL position change.Conclusion. Fluctuation of anterior chamber depth is observed up to 3 months after uncomplicated phacoemulsification. Changes in IOL tilt angle occur throughout the observation period with a significant decrease in the horizontal plane by 6 month. Implantation of the CTR should stabilize anterior chamber depth, block the IOL tilt and also reduce the percentage of IOL deflection cases in the defined group.
Highlights
Изменение положения оптической части ИОЛ в зад‐ ней камере [1,2,3,4,5], ее децентрация и наклон [6] могут приводить к ошибкам послеоперационной рефракции и снижению качества зрения за счет наличия индуци‐ рованных аберраций высшего порядка [7,8,9,10]
Anatomical characteristics of the eyes according to several biometry devices
Measurement of the distances in the anterior eye segment with OCT: pupil diameter, distances from the iris edges to the anterior IOL surface
Summary
В исследование вошли 234 пациента (273 глаза), про‐ ходивших лечение в клинике офтальмологии ВМедА им. Кирова в период с сентября 2016 по октябрь 2019 года с диагнозом «начальная катаракта без признаков слабости связочного аппарата хрусталика». Выборка со‐ стоит из 106 мужчин и 128 женщин, средний возраст ко‐ торых составил 71,99 ± 9,40 года (от 21 до 90 лет). Всем пациентам на дооперационном этапе прове‐ дено стандартное офтальмологическое обследование, биометрия с помощью приборов IOLMaster 500 (Carl Zeiss Meditec, Германия), Lenstar LS 900 (Haag-Streit, Швейцария), кератотопография Pentacam (Oculus, Германия). Во всех случаях выполнена факоэмульсификация с внутрикапсульной имплантацией ИОЛ платформы. Параметр / Parameter Сила имплантированной ИОЛ, дптр / IOL power, D Аксиальная длина, мм / Axial length, mm Сила роговицы в пологом меридиане, дптр / Corneal power at the flat meridian, D Сила роговицы в крутом меридиане, дптр / Corneal power at the stip meridian, D Глубина передней камеры, мм / Anterior chamber depth, mm Толщина нативного хрусталика, мм / Lens thickness, mm Диаметр роговичного сегмента, мм / White-to-white distance, mm IOL Master. Lenstar LS 900 20,87 ± 4,34 (8,0–35,0) 23,95 ± 1,72 (19,91–29,72) 43,37 ± -1,68 (38,99–48,80) 44,37 ± 1,77 (39,68–49,56) 3,18 ± 0,40 (2,10–4,36) 4,42 ± 0,40 (2,98–5,61) 11,99 ± 0,49 (9,38–13,40)
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