Affiliation:
1. Medical Military Academy named after S.M. Kirov
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.
Publisher
PE Polunina Elizareta Gennadievna
Reference17 articles.
1. Balashevich L.I., Danilenko E.V., Sharov T.V., Efimov O.A. Deformation of flexible models of intraocular lenses with different degree of haptic elements shrinkage. Fyodorov Journal of Ophthalmic Surgery = Oftalmokhirurgiya. 2012;1:4–8 (In Russ.).
2. Kulikov A.N., Kokareva E.V., Dzilikhov A.A. Axial disturbances of intraocular lenses: diagnostics and prediction for change of post-operative refraction. Point of view. East-West = Tochka zrenija. Vostok-Zapad. 2018;1:25–31 (In Russ.).
3. Kulikov A.N., Kokareva E.V., Dzilikhov A.A., Kondratov V.S., Danilenko E.V. Analysis of intraocular lens position dynamic after phacoemulsification according to low coherence reflectometry, ultrasound biomicroscopy and optical coherence tomography methods. Modern technologies in ophthalmology = Sovremennye tekhnologii v oftalmologii. 2018;4:123– 128 (In Russ.).
4. Kulikov A.N., Danilenko E.V., Dzilikhov A.A. Analysis of the axial IOL displacement dynamics and associated refraction shift after phacoemulsification in patients with short eyes depending on pseudoexfoliation. Modern technologies in ophthalmology = Sovremennye tekhnologii v oftalmologii. 2019;5:65–69 (In Russ.). DOI: 10.25276/2312-4911-2019-5-65-69
5. Findl O., Hirnschall N., Draschl P., Wiesinger J. Effect of manual capsulorhexis size and position on intraocular lens tilt, centration, and axial position. J Cataract Refract Surg. 2017;43:902–908. DOI: 10.1016/j.jcrs.2017.04.037