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Yusef Yu.N.

Krasnov Research Institute of Eye Diseases;
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Vvedenskiy A.S.

Krasnov Research Institute of Eye Disease

Alkhumidi K.

Research Institute of Eye Diseases

Fokina N.D.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Demidov A.L.

Research Institute of Eye Disease

Surgical treatment of hypermature cataract in patients with lens subluxation and small pupil

Authors:

Yusef Yu.N., Vvedenskiy A.S., Alkhumidi K., Fokina N.D., Demidov A.L.

More about the authors

Journal: Russian Annals of Ophthalmology. 2021;137(5‑2): 175‑180

DOI: 10.17116/oftalma2021137052175

Views: 1520

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Table of contents

To cite this article:

Yusef YuN, Vvedenskiy AS, Alkhumidi K, Fokina ND, Demidov AL. Surgical treatment of hypermature cataract in patients with lens subluxation and small pupil. Russian Annals of Ophthalmology. 2021;137(5‑2):175‑180. (In Russ.)
https://doi.org/10.17116/oftalma2021137052175

Подписка 2025 (Russian Annals of Ophthalmology)
 
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Studying the possibilities of hybrid (femtosecond laser-assisted) phacoemulsification in complicated situations is a relevant problem in cataract surgery.

PURPOSE

To develop a technique for hybrid (femtosecond laser-assisted) phacoemulsification in patients with a combination of hypermature cataract, small pupil and lens subluxation.

MATERIAL AND METHODS

Hybrid (femtosecond laser-assisted) phacoemulsification of hypermature cataracts was performed in 36 patients (36 eyes) aged 63 to 78 years with grade I—II lens subluxation in combination with small pupil. The initial circular femtolaser capsulotomy was performed within the small pupil using the VICTUS system (Technolas Perfect Vision, Germany). After dilating the pupil with retractor hooks, the capsulorhexis was manually expanded to the required diameter.

RESULTS

In all cases, the resulting capsulorhexis had a regular round shape with a smooth edge, without radial ruptures. This made it possible to apply modern methods of fixation and centration of the capsular bag in case of lens subluxation and to perform intracapsular implantation of an intraocular lens (IOL). Complete intracapsular fixation of the IOL with optics edge fully covered by the edge of the capsulorhexis in the postoperative period was achieved in 34 (94.4%) cases. In 2 (5.6%) cases in the postoperative period, the edge of the capsulorhexis exceeded the edge of the IOL optics. The loss of corneal endothelial cells 3 months after surgery was 8.8±1.9%.

CONCLUSION

The use of the proposed combined technique of capsulorhexis made it possible to perform the most physiologically appropriate intracapsular IOL implantation in all patients with hypermature cataract, small pupil and lens subluxation.

Keywords:

cataract
lens subluxation
femtosecond laser
phacoemulsification
IOL

Authors:

Yusef Yu.N.

Krasnov Research Institute of Eye Diseases;
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Vvedenskiy A.S.

Krasnov Research Institute of Eye Disease

Alkhumidi K.

Research Institute of Eye Diseases

Fokina N.D.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Demidov A.L.

Research Institute of Eye Disease

Received:

03.06.2021

Accepted:

02.07.2021

List of references:

  1. Krasnov MM, Kasparov AA, Mamikonyan VR, Yusef YuN, Vvedenskiy AS, Yusef SN. A new modified phacoemulsification operation in lenticular subluxation. Vestnik oftal’mologii. 2000;116(1):10-12. (In Russ.).
  2. Malyugin BE, Semikova MV, Verzin AA. Comparative results of experimental and clinical study of papillary rings and polymer retractors in phacoemulsification in eyes with insufficient diaphragmatic fuction of the iris. Oftal’mokhirurgiya. 2003;3:18-25. (In Russ).
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  7. Kankariya VP, Diakonis VF, Yoo SH, Kymionis GD, Culbertson WW. Management of small pupils in femtosecond-assisted cataract surgery pretreatment. Ophthalmology. 2013;120(11):2359-2360. https://doi.org/10.1016/j.ophtha.2013.07.057
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  11. Teshigavara T, Meguro A, Sanjo S, Hata S, Mizuki N. The advantages of femtosecond-laser-assisted cataract surgery for zonulopathy. International Medical Case Reports Journal. 2019;12:109-116.  https://doi.org/10.2147/IMCRJ.S189367
  12. Yusef YuN, Yusef SN, Vvedenskiy AS, Avetisov KS, Alkharki L. Femtolaser phacoemulsification of overripe cataracts. Oftal’mologiya. 2020;17(3s):592-596. (In Russ.). https://doi.org/10.18008/1816-5095-2020-3S-592-596
  13. Avetisov SE, Mamikonyan VR, Yusef YuN, Yusef SN, Ivanov MN, Avetisov KS. Hybrid phacoemulsification: a new stage in the improvement of cataract surgery. Vestnik oftal’mologii. 2014;130(2):4-7. (In Russ.).
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