Management of Residual Refractive Error After  Cataract Phacoemulsification. Part  2. Intraocular Approaches

Pershin, K.B.; Pashinova, N.F.; Цыганков, А. Ю.; Гурмизов, Е. П.; Баталина, Л. В.

doi:10.18008/1816-5095-2017-2-106-112

Cited by 5 publications

(7 citation statements)

References 27 publications

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“…Замена ИОЛ -один из способов интраокулярной коррекции аметропий после факоэмульсификации катаракты [76]. Эксплантация и замена мультифокальной ИОЛ относятся к наиболее радикальным методам коррекции неудовлетворённости пациента от проведённого хирургического вмешательства.…”

Section: эксплантация и замена мультифокальных иолunclassified

Multifocal Intraocular Lenses Implantation in Presbyopia Correction. Literature Review

Pershin¹,

Pashinova²,

Konovalova³

et al. 2019

Acta biomedica scientifica

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Reduced dependence on glasses is an increasingly common expectation among those who want to take advantage of new surgical opportunities, especially for patients who lead an active lifestyle. Currently, due to the increase in the duration of active life in people over 40, there is a need for effective correction of presbyopia. Multifocal intraocular lenses are increasingly used in the treatment of presbyopia. After implantation of multifocal intraocular lenses most patients have no need for spectacle or contact vision. However, complications can affect the patient’s quality of life and level of satisfaction. The most common complications of multifocal correction are blurred vision and the presence of optical phenomena (“halo” and “glare”), associated with residual ametropia, clouding of the posterior capsule, large pupil size, anomalies of the wave front, dry eye and lens decentration. The main reasons for this are the failure to attempt to neuroadapt a patient, the dislocation of the lens, the residual refractive error and the clouding of the lens. The review presents the main features of various models of multifocal intraocular lenses, their implantation techniques, associated complications and methods for their correction. The development of multifocal correction of presbyopia and ametropia seems to be a promising direction in ophthalmic surgery.

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Section: эксплантация и замена мультифокальных иолunclassified

Multifocal Intraocular Lenses Implantation in Presbyopia Correction. Literature Review

Pershin¹,

Pashinova²,

Konovalova³

et al. 2019

Acta biomedica scientifica

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“…В настоящее время хирурги все чаще выполняют сочетанные оперативные вмешательства, при которых одномоментно в ходе хирургического лечения катаракты осуществляется коррекция сопутствующего роговичного астигматизма. Для этого выполняют послабляющие лимбальные кератотомические надрезы (мануальная кератотомия) или фемтоаркуатную кератотомию (с помощью фемтосекундных лазерных технологий), а также имплантируют торические интраокулярные линзы (ИОЛ) [4][5][6]. На рынке доступны ИОЛ Acry.LISA Toric (Carl Zeiss, Германия) с возможностью коррекции астигматизма до -12 дптр и изготовлением по индивидуальному заказу [7], однако в ряде случаев заранее определить ИОЛ, необходимую для имплантации, затруднительно, в связи с этим актуален поиск новых методов коррекции.…”

Section: Correction Of High Corneal Astigmatismunclassified

“…При необходимости устранения высоких степеней сопутствующего катаракте роговичного астигматизма при недостаточной эффективности перечисленных выше методов, а также для улучшения качества послеоперационной некорригируемой остроты зрения требуется дополнительная коррекция остаточного астигматизма [6].…”

Section: Correction Of High Corneal Astigmatismunclassified

Correction of High Corneal Astigmatism during Cataract Surgery

Pershin¹,

Pashinova²,

Konovalov³

et al. 2019

Oftalʹmologiâ

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Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

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“…В настоящее время для докоррекции остаточной аметропии при псевдофакии применяют несколько подходов, включая лазерные рефракционные вмешательства: лазерный кератомилез in situ (LASIK) и фоторефракционную кератэктомию (ФРК), а также интраокулярные вмешательства, такие как имплантация добавочных (piggyback) ИОЛ и замена ИОЛ [6,7]. В ряде работ показано, что лазерные рефракционные вмешательства -LASIK и ФРК -более точны и предсказуемы при коррекции небольших сферических и цилиндрических аметропий, в то время как добавочные ИОЛ и замена ИОЛ -при коррекции больших сферических аметропий [6][7][8][9]. В настоящее время накоплен значительный опыт отдельных исследований безопасности и предсказуемости применения лазерных рефракционных вмешательств для коррекции остаточных аметропий после хирургии катаракты [3,[8][9][10][11][12][13][14][15], рефракционной замены ИОЛ [16][17][18][19] и имплантации факичных [20] и добавочных [21] ИОЛ.…”

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Keratorefractive Surgery for Residual Refractive Error Correction in Pseudophakic Patients

et al. 2020

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Purpose. Evaluation of the visual and refractive results of additional correction using LASIK and PRK methods in patients with residual refractive error after previous cataract surgery. Patients and methods. The prospective open study included 57 patients (79 eyes) who previously underwent cataract phacoemulsification (n = 37) or refractive lensectomy (n = 42) with various IOL models implantation (2012–2017). The average age of patients was 50.8 ± 13.9 (19–79) years. Operations LASIK (91.1 %) and PRK (8.9 %) were carried out according to standard methods. In 6 cases, femtosecond laser supported by laser correction. The target refraction ranged from –0.25 to 0.25 D in most (97.5 %) cases. The follow-up period ranged from 6 to 9 months. Results. The patients were divided into groups according to the type of residual refractive error (Group 1 — myopia, group II — emmetropia and group III — hyperopia). Statistically significant differences were determined for the species of previously implanted IOLs — in group II, the frequency of monofocal IOLs was significantly higher (p < 0.05). In group II, the values of the cylindrical component of refraction were significantly higher compared with groups I and III (p < 0.05). In group I, a significant (p < 0.05) decrease in the spherical component of refraction from –1.36 ± 0.92 to –0.2 ± 0.8 D was observed. In patients of group II, there was a slight increase in the spherical component of refraction from 0 ± 0.20 to 0.25 ± 0.29 D (p > 0.05). In group III, a significant (p < 0.05) decrease was observed in the spherical component of refraction from 1.27 ± 0.69 to 0.43 ± 0.49 D. When analyzing the cylindrical component of refraction in group I, its decline was noted from –0.69 ± 0.5 to –0.38 ± 0.46 D (p > 0.05). In group II, the largest decrease in the cylindrical component was observed from –1.6 ± 1.0 to 0.03 ± 1.10 Dptr (p < 0.01). In all the studied groups, a statistically significant (p < 0.05) increase in UCFVA was revealed in the postoperative period. Indicators K1 and K2 did not significantly change. Conclusion. The high efficiency of the correction using the LASIK, PRK and femtoLASIK methods on pseudophakic eyes with the achievement of the target refraction in most of the studied cases was shown. This method can be used as an alternative to spectacle and contact correction in patients with residual refractive error after cataract phacoemulsification and refractive lensectomy with IOL implantation.

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Management of Residual Refractive Error After Cataract Phacoemulsification. Part 2. Intraocular Approaches

Cited by 5 publications

References 27 publications

Multifocal Intraocular Lenses Implantation in Presbyopia Correction. Literature Review

Multifocal Intraocular Lenses Implantation in Presbyopia Correction. Literature Review

Correction of High Corneal Astigmatism during Cataract Surgery

Keratorefractive Surgery for Residual Refractive Error Correction in Pseudophakic Patients

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