For the first time, the intraoperative intralenticular pressure was measured in patients with intumescent cataract. A dependency was defined between the thickness of the lens and the anterior layer of liquefied lenticular masses, anterior chamber depth, and intralenticular pressure magnitude; based on this, a mathematical model for intralenticular pressure measurement was constructed.

1. It has been found that on ultrasound biomicroscopy, mature intumescent cataract is notable for a 10--15° wider equatorial angle as compared to the fellow eye, which can be regarded as spherophakia. 2. Five different structural variants of the swollen opaque lens have been described. 3. The mechanism of uncontrolled tearing of the anterior capsule during creation of the anterior capsulorhexis has been studied and the expediency of two-stage capsulorhexis with lenticular mass removal from capsular bag compartments proved.

No abstract

Primary open-angle glaucoma combined with dry eye syndrome is the leading cause of irreversible blindness. Complement system remains nearly unexplored in this disorder. The aim of our study was to evaluate the parameters of complement system in primary open-angle glaucoma and dry eye syndrome among elderly persons. The study was conducted at the S. Fedorov Center of Eye Microsurgery (Tambov Branch), and enrolled 62 patients aged 60 to 74 years with primary open-angle glaucoma combined with dry eye syndrome, and 33 patients free of this pathology. The blood complement system was studied by hemolytic method and enzyme immunoassay, and the C1 inhibitor was studied by chromogenic method. To assess possible contribution of the complement system components to the mentioned eye disorder, appropriate odds ratios were calculated, according to the generally accepted method. The study of blood complement system in elderly patients with combined primary open-angle glaucoma and dry eye syndrome have shown, first of all, high C3a level (up to 106.2±3.9 ng/ml), increased contents of C5a (4.5±0.2 ng/ml), and factor H (215.9±5.2 mcg/ml), along with decreased C1 inhibitor (to 168.4±6.1 mcg/ml). In the age-matched control group, the contents of appropriate plasma complement factors were, respectively, 45.2±4.0 ng/ml; 3.1±0.2 ng/ml; 141.5±4.3 mcg/ml; 237.9±5.8 mcg/ml, showing significant difference for all these parameters. An important pathogenetic role of C3a component, C5a component, factor H, and the C1 inhibitor in development of combined primary openangle glaucoma with dry eye syndrome was confirmed by the values of odds ratio (OR) with maximum value for the C3a component (OR 4.035, CI 3.640-4.283, p < 0.0001), which indicates increased risk of developing the mentioned ophthalmopathology in old age. High odd ratios were also characteristic of C5a blood components (2.946; CI 2.618-3.547), C3 (2.821; CI 2.453-3.264), factor H (2.765; CI 2.431-3.148). Less significant changes were revealed for other complement components thus suggesting only marginal association with development of primary open-angle glaucoma with dry eye syndrome in old age This indicates that the development of primary open-angle glaucoma with dry eye syndrome is associated with activation of these factors of the complement system. The revealed features of the complement system will enable us for more effective diagnostics of these combined eye disorders.

Purpose: tо evaluate the diagnostic capabilities of optical coherence tomography (OCT), Scheimpflug camera and ultrasound biomicroscopy (UBM) in examining topography of the ocular anterior segment and lens in mature intumescent cataract. Patients and methods. 23 eyes with mature intumescent cataract were examined using OCT (RTVue-100, Optovue, USA), Scheimpflug camera (Pentacam HR, Oculus, Germany) and UBM (UD 8000, Tomey, Japan). We examined the anterior chamber depth, profile and magnitude of the anterior chamber angle, distance “trabecula-iris at 500 microns”, thickness of the liquid lenticular mass layer, lens thickness, Zinn ligament length within four segments, equatorial angle. Results. We managed to measure the anterior chamber depth using UBM and Scheimpflug camera. UBM measurement was 1.96 ± 0.14 mm, Scheimpflug camera — 1.91 ± 0.11 mm. We revealed narrowing of the anterior chamber angle up to 11.54 ± 2.19° in UMB examination, to 11.49 ± 2.17° in OCT measuring and to 11.63 ± 2.21° in examining by Scheimpflug camera. Distance “trabecula-iris 500” was 0.212 ± 0.037 mm in UMB examination, 0.218 ± 0.042 mm — by means of OCT, Scheimpflug camera measurement was unsuccessful. The rest parameters were examined only by UBM. The lens thickness was 5.26 ± 0.13 mm. The anterior layer of liquid lenticular mass was 0.85 ± 0.06 mm. Zinn ligament length in the outer segment was 0.708 ± 0.072 mm, in the internal segment — 0.731 ± 0.089 mm, in the superior segment — 0.704 ± 0.084 mm, in the inferior segment — 0.876 ± 0.089 mm. The equatorial angle in two opposite segments was 32.52 ± 0.92°. Conclusion. Ultrasound biomicroscopy has the biggest value in examining topography of the ocular anterior segment and lens in mature intumescent cataract, since only this method allows achieving the whole complex of data necessary to evaluate the swelling lens parameters. This can serve as a basis for developing the appropriate tactics of surgical intervention.

No abstract

Intumescent cataract surgery is one of the topical problems of ophthalmology. The article reviews methods of intumescent cataract diagnostics and structural features of swelling lens. Manual or femtolaser-assisted anterior continuous circular capsulorhexis and intumescent cataract phacoemulsification techniques require further research.

Цель. Оптимизировать технологию факоэмульсификации перезрелой Морганиевой катаракты. Материал и методы. Исследование выполнено на 21 глазах 21 пациента с перезрелой Морганиевой катарактой. В I группу вошли 10 пациентов, у которых хирургическое вмешательство проводилось по усовершенствованной технологии с использованием иридокапсулярных ретракторов. Во II группу были включены ретроспективные результаты ФЭК с имплантацией ИОЛ у 11 пациентов, выполненной по стандартной технологии. Оптимизированная техника операции у пациентов I, основной группы, заключалась:y в последовательном использовании четырех иридокапсулярных ретракторов при выполнении капсулорексиса - для стабилизации капсульного мешка во время кругового разрыва передней капсулы, во время факоэмульсификации - для стабилизации капсульного мешка в сагиттальной плоскости при эмульсификации ядра.y капсульного кольца – для дополнительной стабилизации сводов и создания каркаса капсульного мешкаy использования scaffold – технологии – выведение последнего фрагмента ядра в переднюю камеру, имплантация ИОЛ и факоэмульсификация его над ИОЛ для сохранения целостности задней капсулы при ее патологической подвижности. Результаты. У пациентов I группы, осложнений во время операции не наблюдалось. У пациентов II группы наблюдалось 2 случая разрыва задней капсулы, один случай разрыва края переднего капсулорексиса без перехода его на заднюю капсулу. Всего 14,3%.В I группе в послеоперационном периоде осложнений не наблюдалось. Во II группе в 2 случаях наблюдался отек роговицы, складки десцеметовой мембраны, которые были купированы консервативным лечением на 4 –5 сутки после операции. Выводы. Оптимизированная технология факоэмульсификации перезрелой Морганиевой катаракты с использованием 4 иридокапсулярных ретракторов, капсульного кольца и примененияscaffold – технологии позволила уменьшить количество операционных осложнений по сравнению с стандартной технологией и сделать хирургическое вмешательство при данной патологии более эффективным и безопасным.