MANUAL AND YAG-LASER ANTERIOR CAPSULORHEXIS SURGERY OF CONGENITAL ECTOPIA OF THE LENS IN MARFAN SYNDROME IN CHILDREN

Abstract

Purpose. is to optimize the tactics of performing anterior capsulorhexis in children with congenital lens subluxation in Marfan syndrome with the use of manual and YAG - laser technique. Material and methods. There were observed 25 patients (34 eyes) aged 4 to 11 years old with lens subluxation: 7 children (10 eyes) with congenital cataract and 18 patients (24 eyes) of the clear crystalline lens in Marfan syndrome. The degree of ectopia was different: 14 eyes - 1 degree, 16 eyes-2 degree and 4 eyes-3 degree of crystal ectopia. Manual circular continuous capsulorexis performed 15 eyes in 12 childrens, YAG-laser capsulectomy-19 eyes in 13 children. Results. Use of YAG - laser equipment allowed to excise planned part of of the anterior capsule without mechanical pressure on not fixed lens. Full of YAG-laser anterior capsulorhexis could not be executed in eyes with 3 degree subluxation of the lens (a significant portion of the anterior capsule is covered with an iris). Manual method allowed to execute anterior capsulorhexis at any degree of subluxation of the lens, but required multiple manipulations on the anterior capsule because of clinical and anatomical features anterior capsule in eyes with subluxation of the lens, which significantly prolonged the time of surgery, increasing the risk of developing exudative and proliferative reactions. YAG - laser anterior capsulotomy (dissection of the anterior capsule by YAG laser) with the completion of capsulotomy with the help of instrumental method increases the quality of the surgery. Conclusion.To perform anterior capsulorhexis in children with lens subluxation 1 and 2 degrees can be applied a manual and YAG-laser methods, each of which has its advantages and disadvantages.