december 22, 2024

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2015, № 12 (187)

Shilovskikh O.V., Safonova O.V. PHACOEMULSIFICATION OF UVEAL CATARACT WITH SYNECHIOTOMY, POSTERIOR CAPSULORHEXIS, PARTIAL VITRECTOMY AND ORIGINAL METHOD OF IOL IMPLANTATION: REMOTE RESULTS Cataract is a frequent complication of chronic uveitis. There are literary data concerning the results of surgery in this pathology. Lensectomy, extracapsular extraction, phacoemulsification with or without intraocular lens implantation as well as partial or subtotal vitrectomy have been described. Postoperatively, complications influencing visual outcome such as pupil occlusion, iris bombee, secondary cataract often develop. Working out new methods of surgery minimizing complications frequency is actual. The paper presents the experience of surgery in 111 eyes of 83 patients with uveal cataract. The operations were performed using authors' method including ultrasound cataract phacoemulsification with preliminary synechiotomy, posterior capsulorhexis, partial vitrectomy and intraocular lens implantation. Haptics of the intraocular lens were placed into the capsular bag and optic part was placed behind the posterior capsulorhexis. No intraoperative complications were observed. Visual acuity in 1–2 days after surgery was: above 0.5 — in 43.2 % of cases, 0.2–0.5 — in 34.2 %, below 0.2 — in 22.6 %. Most significant increase of visual acuity after the operation was observed in patients with preoperative visual acuity above 0.5 and below 0.2. Complications included local posterior synechiae without iris bombee in 2 eyes (1.8 %), increase of intraocular pressure — 7.2 %, uveitis recurrencies — 17 %, deposits on IOL — 11.4 %, pre-existing macular edema — 40 %, macular edema in 1 — 6 months after surgery — 5.4 %. Subtotal vitrectomy with epiretinal membrane removal was performed in 9 eyes (8.1 %). The developed method of uveal cataract surgery is safe, provides good anatomic results and a significant increase of visual acuity. Cases with low postoperative visual acuity are associated with pre-existing macular edema. Epiretinal membrane is a risk factor for cystoids macular edema progression after phacoemulsification of uveal cataract and is an indication for vitrectomy. Key words: uveal cataract, posterior capsulorhexis, chronic uveitis.

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References:

1. Prieto-del-Cura M., Gonzalez-Guijarro J. Complications of uveitis: prevalence and risk factors in a series of 398 cases. Arch. Soc. Esp. Oftalmol., 2009. Vol. 84.№ 10. P. 523-528.

2. Velilla, S., Dios E., Herreras J. Fuchs' heterochromiciridocyclitis: a review of 26 cases. Ocul.Immunol.Inflam. 2001.Vol. 9. № 3. P. 169-175.

3. Agrawal R., Murthy S., Ganesh S. Cataract surgery in uveitis. Int. J. Inflam. 2012. Vol. 10. P. 1155-1171.

4. Drozdova E.A., Tarasova L.N., Teplova S.N. Uveitis in rheumatic diseases. M., 2010. — 160 p.

5. Egorova E.V., Tolchinskaya A.I., Ioshin I.E. at al. An intraocular correction of aphakia in patients with postuvealcataracts.Ophthalmosurgery. 2001. № 1. P. 20-28.

6. Egorova E.V., Tolchinskaya A.I., Ioshin I.E. et al. Surgical technology "small cut" in early removal of postuveal cataract with intraocular correction of aphakia. Euro-Asian Conf. ofophthalmosurgery, 1st: Materials.-Ekaterinburg, 2001, P.58-59.

7. Terrada C., Julian K., Cassoux N., Prieur AM., Debre M., Quartier P., LeHoang P., Bodaghi B. Cataract surgery with primary intraocular lens implantation in children with uveitis: long-term outcomes. J. Cataract Refract. Surg. 2011.Vol. 37, № 11. P. 1977-1983.

8. Mehta S., Linton M., Kempen J. Outcomes of cataract surgery in patients with uveitis: a systematic review and meta-analysis. Am J Ophthalmol. 2014 Oct; 158 (4): 676-692.

9. Lin CP., Yeh PT, Chen PF, Yang CM, Hu FR. Cataract extraction surgery in patients with uveitis in Taiwan: risk factors and outcomes. J Formos Med Assoc. 2014 Jun; 113 (6): 377-84.

10. S.Stephen Foster, MD, Frances Barrett, RN, MS. Cataract Developmtnt and Cataract Surgery in Patients with Juvenile Rheumatoid Arthritis — associated Iridocyclitis. Ophthalmology, 1993, vol.100, N6, p.809-817.

11. Kemp PS, Longmuir SQ, Gertsch KR, Larson SA, Olson RJ, Langguth AM, Syed N, Oetting TA. Cataract surgery in children with uveitis: retrospective analysis of intraocular lens implantation with anterior optic capture. J PediatrOphthalmol Strabismus. 2015 Mar-Apr; 52 (2): 119-25.

12. Casteels I, Taylor D. Cataracts in children with uveitis. Br J Ophthalmol. 1992 Feb; 76 (2): 66-7.

13. Kanski JJ. Lensectomy for complicated cataract in juvenile chronic iridocyclitis.Br J Ophthalmol. 1992 Feb; 76 (2): 72-5.

14. Nobe JR, Kokoris N, Diddie KR, Cherney EF, Smith RE. Lensectomy-vitrectomy in chronic uveitis.Retina. 1983; 3 (2): 71-6.

15. Yoeruek, E. Long-term visual acuity and its predictors after cataract surgery in patients with uveitis. Eur. J. Ophthalmol. 2010. Vol. 20. № 4. P. 694-701.

16. Ram J., Gupta A., Kumar S., Kaushik S., Gupta N., Severia S. Phacoemulsification with intraocular lens implantation in patients with uveitis. J. Cataract Refract. Surg. 2010.Vol. 36, № 8. P. 1283-1288.

17. Kawaguchi, T. Phacoemulsification cataract extraction and intraocular lens implantation in patients with uveitis. T. Kawaguchi, M. Mochizuki, K. Miyata. J. Cataract. Refract. Surg. 2007.Vol. 33.№ 2. P. 305-309.

18. Yamane C., Vianna R., Cardoso G., et al. Cataract extraction using the phacoemulsification technique in patients with uveitis. Yamane C., Vianna R., Cardoso G. et al. Arq. Bras.Oftalmol. 2007. Vol. 70. № 4. P. 683-688.

19. Egorova E.V., Tolchinskaya A.I., Ioshin I.E. at al.An intraocular correction of aphakia in patients with postuvealcataract.Ophthalmosurgery. 2001. № 1. P. 20-28.

20. Egorova E.V., Tolchinskaya A.I., Ioshin I.E. et al. Surgical technology "small cut" in early removal of postuveal cataract with intraocular correction of aphakia. Euro-Asian Conf. of ophthalmosurgery, 1st: Materials. Ekaterinburg, 2001, P.58-59.

21. Holland GN, Van Horn SD, Margolis TP. Cataract surgery with ciliary sulcus fixation of intraocular lenses in patients with uveitis. Am J Ophthalmol. 1999 Jul; 128 (1): 21-30.

22. Suelves AM., Siddique SS., Schurko B., Foster CS. Anterior chamber intraocular lens implantation in patients with a history of chronic uveitis: five-year follow-up. J Cataract Refract Surg. 2014 Jan; 40 (1): 77-81.

23. Secchi AG. Cataract surgery in exudative uveitis: effectiveness of total lens removal, anterior vitrectomy, and scleral fixation of PC IOLs. Eur J Ophthalmol. 2008 Mar-Apr; 18 (2): 220-5.

24. Androudi S., Ahmed M., Fiore T., Brazitikos P., Foster CS. Combined pars planavitrectomy and phacoemulsification to restore visual acuity in patients with chronic uveitis. J Cataract Refract Surg. 2005. Mar; 31 (3): 472-8.

About this article

Authors: Shilovskih O.V., Safonova O.V.

Year: 2015

Editor-in-chief

Sergey Aleksandrovich
MIROSHNIKOV

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