Saratov JOURNAL of Medical and Scientific Research

To the question of diferential diagnostics of secondary phacogenic glaucomas with a small anterior chamber

Year: 2019, volume 15 Issue: №2 Pages: 474-477
Heading: Ophtalmology Article type: Original article
Authors: Zamyrov A.A., Gavrilova I.A., Demakova L.V.
Organization: Kirov State Medical University, Kirov State Ophthalmology Hospital, «Sozvezdie» Ophtalmology Clinic
Summary:

Purpose: to determine diferential diagnostic criteria and surgical tactics in the treatment of swelling cataract and cataract in combination with subclinical lens subluxation associated with phacogenic glaucoma with a small anterior chamber. Material and Methods. Clinical traits and surgical treatment of 54 patients (54 eyes) were analyzed. Patients were divided in two groups. In patients of the frst group (32 eyes) the lens thickness did not difer from the paired eye. In patients of the second group (22 eyes) the diference was 1.1±0.3 mm. Results. In the frst group the mobility of the lens associated with a defect in the ligamentous apparatus was detected. In this case the methods of capsular bag stabilization were used. In the second group decrease in intraocular pressure and a deepening of the anterior chamber were noted after the opening of anterior lens chamber and evacuation of a part of cortical masses. Conclusion. In the diferential diagnosis of swelling cataract and cataract with subclinical lens subluxation the main criterion is signifcant between-eyes diference in the anteroposterior size of the lense according to the results of ultrasound biomicroscopy. Preoperative diferential diagnosis of swelling cataract and subclinical subluxation of the lens allows selecting the optimal surgical technique of cataract extraction and minimizing the possible complications. The method of simultaneous vitrectomy with transciliary access and cataract phacoemulsifcation is efective in treating of swelling cataract and cataract with subclinical subluxation of the lens associated with phacogenic glaucoma with small anterior chamber.

Bibliography:
1 Goryacheva OYu, Gavrilova TV, Goryachev YuN. The experience of ultrasound phacoemulsifcation with the implantation of an intraocular lens in patients with age-related cataracts and complicated cataracts in combination with glaucoma. In: Proceedings of the V Eurasian Conference on Ophthalmosurgery. Ekaterinburg, 2009; p. 35
2 Kolesnikova MA, Svirin TA, Strelkova NF, et al. Results of swelling cataract extraction. In: Glaucoma: Problems and Solutions. M, 2004; p. 362–3
3 Malov IV. Surgical treatment of phacogenic glaucoma in patients with senile cataract: DSc abstract. Samara, 2005; 267 p.
4 Tahchidi KhP, Machekhin VA, Nikolashin SI. Surgical treatment of phacogenic glaucoma with shallow anterior chamber. Ophthalmosurgery 2008; (2): 5–9
5 Pradhan D, Hennig A, Kumar J, Foster A. A prospective study of 413 cases of Lens-induced Glaucoma in Nepal. Ind J Ophthalmol 2001; (49): 103–7
6 Qamar AR. Phacomorphic glaucoma: an easy approach. Pak J Ophthalmol 2007; 23 (2) 77–9
7 Ramakrishnan R, Maheshwari D, Kader MA, et al. Visual prognosis, intraocular pressure control and complication in phacomorphic glaucoma following manual small incision cataract surgery. Indian J Ophthalmol 2010; 58 (4): 303–6
8 Singh RH, Al-Arrayyed, Krishnan R. Intraocular lens implantation in phacomorphic glaucoma. Bahrain Medical Bulletin 2002; 24 (3): 110–4
9 Svetlova OV, Kugleev AA. Diagnostics and dynamic classifcation of lens contusional displacements. In: Actual problems of pediatric ophthalmology. St. Petersburg: PMI, 1995; p. 57–8
10 Fedorov SN, Egorova EV. Errors and complications in the implantation of the artifcial lens. Moscow: MNTK Eye Microsurgery Publ., 1992; 244 p.

AttachmentSize
2019_02-1_474-477.pdf256.1 KB

No votes yet