Background. The features of performing phacoemulsification (FEC) at different initial conditions of patients and their eyes were investigated. The combination of a short anterior-posterior axis and a thick lens swollen during cataractogenesis or traumatic impact leads to a violation of the normal morphology of the eyeball. In case of shallow anterior chamber syndrome (SACS), there are certain difficulties in performing FEC, which are associated with limited space, and also with the effect of physical factors. The purpose was to analyze the number and nature of complications and to investigate the possibility of reducing them in order to optimize the FEC procedure in eyes with SACS. Materials and methods. We have examined 130 cataract patients with SACS aged 65.5 ± 10.6 years who were divided into 2 groups: group 1 (62 eyes, 62 people) with proposed combined operation of posterior microvitrectomy and FEC (COPMVEFEC) (Patent No. 80762); group 2 (68 eyes, 68 people) underwent FEC by the generally accepted method. Examinations before and after surgery included visual acuity, visual field, intraocular pressure, biomicroscopy, sonography, endothelial microscopy, optical coherence tomography, statistical methods. The settings of the phaco machine used in both groups were the same. Results. Effectiveness of the COPMVEFEC and standard FEC does not differ significantly. With the COPMVEFEC, the opportunity to perform manipulations in a deeper anterior chamber contributed to a 3.5-fold reduction in intraoperative complications compared to the standard FEC method (P < 0.05). The indicators of the state of endothelial cells (EC) in group 1 differed from the corresponding data of group 2 (Р < 0.05), and the loss of EC, on average 9.65 % (Р < 0.05), was 2 times less (P < 0.05), which indicated less traumatization. In the postoperative period, the number of complications in group 1 is 1.2 times less than in group 2 (P < 0.05). Conclusions. The following intraoperative complications (11.8 %) were observed during FEC in eyes with SACS: capture of the iris with a phaco needle, hyphema, tear of the capsulorhexis edge, which led to complications in the postoperative period in 29.4 % of cases, as well as a decrease in corneal EC density (Р < 0.05), polymegethism and polymorphism, reduction of hexagonality. The use of the COPMVEFEC in SACS contributed to the reduction of intraoperative complications by 3.5 times, to 3.3 % (Р < 0.05), and in the postoperative period, by 1.2 times (Р < 0.05). The morphometric parameters of EC of the cornea did not differ significantly from the preoperative ones (Р > 0.05), except for a decrease in the hexagonality index, an increase in corneal thickness was 2.5 times less than in controls (Р < 0.05).
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