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

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.

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