Femtolaser-assisted ultrasound phacoemulsification of cataract complicated with a narrow rigid pupil and lens subluxation

Session Details

Session Title: Cataract Surgery Special Cases II

Session Date/Time: Monday 15/09/2014 | 16:30-18:30

Paper Time: 16:54

Venue: Auditorium

First Author: : E.Usubov RUSSIA

Co Author(s): :    M. Bikbov    A. Bikbulatova    M. Absalamov    Y. Burkhanov     

Abstract Details

Purpose:

to evaluate the possibility of femtosecond -assisted cataract extraction in patients with a narrow rigid pupil and lens subluxation

Setting:

Ufa eye research institute. The study is perfomed on 6 patient and and presented as progressive approach in complicated cases in cataract surgery

Methods:

The study included 6 patients (6 eyes) with cataracts of different density and narrow, not amenable to pharmacological mydriasis rigid pupil and lens subluxation with phakodonesis . The age of patients ranged from 70 to 82 years (mean age 76,5 ± 3,5 years). All patients received standard preoperative ophthalmologic examination . Visual acuity before surgery was from the correct light projection to 0.09± 0.02. Femtolaser stage of cataract surgery was performed with a femtosecond laser platform VICTUS ™ (Technolas Perfect Vision / Baush & Lomb). The proposed method is performed as follows. Corneal tunnel incision of 2.2-2.5 mm has been performed, injected into the anterior chamber viscoelastic (adhesive and cohesive), performed mechanical dilatation of the pupil with 'Malyugin pupillring', followed by sealing of the tunnel section. Circular capsulorhexis and fragmentation of the lens into 4-6 pieces (radial fragmentation ) conducted by femtolaser. Removal of the lens standard procedure performed phacoemulsification, implanted capsule ring and intraocular lens.

Results:

All 6 patients with a femtosecond laser obtained centrally located anterior capsulorhexis, rounded shape with a diameter of 5-5.5 mm, achieved lens fragmentation. All operations were performed without complications. Pre-filling of anterior chamber with viscoelastic gave stability of the position of the lens, and the capsulorhexis and nucleus fragmentation minimize the burden on the lens capsular bag. In any case it was not necessary to resort to the intraoperative use of additional devices to stabilize the capsular bag (hooks) . In the early and late periods no any complications. IOL position was stable expressed edema and inflammatory processes have not been identified. Average postoperative visual acuity increased from 0,04 ± 0,02 to 0,7 ± 0,1, intraocular pressure - 17 ± 0,07 mmHg, loss of endothelial cells at 1 month after the operation was 15% of the original amount (decreased from 2480 ± 115 to 2110 ± 150 с/mm2 )

Conclusions:

The clinical results showed that femtolaser-assisted phacoemulsification for complicated cataract in eyes with narrow rigid pupil and lens subluxation is a promising and safe surgical procedure. Application of additional steps: viscotamponade of anterior chamber and 'Malyugin ring' using allows to expand the indications of this technique in complicated cataracts surgery and avoid the need for additional intraoperative stabilize the capsular bag

Financial Interest:

NONE