Clinical features after cataract phacoemulsification in patients with age cataract combined with primary open angle glaucoma

Poster Details

First Author: A.Petrunya UKRAINE

Co Author(s):    V. Yavtushenko   O. Evsyukova           

Abstract Details

Purpose:

To study the clinical features in postoperative period in patients with cataract in combination with primary open-angle glaucoma.

Setting:

The research was carried out at the clinical base of Luhansk State Medical University, 122 patients aged 47 to 79 year were examined. All the patients were diagnosed with age cataract. In 64 patients the cataract was combined with primary open-angle glaucoma on both eyes (the main group). 58 patients with cataract were the control group.

Methods:

Initial cataract was diagnosed in 68 patients, immature - in 43 patients, mature - in 11 patients. In the main group there were 21 patients with stage I glaucoma, 36 patients with stage II, 7 patients with stage III. Normal intraocular pressure (a) with the use of local hypotensive drops was diagnosed in 36 patients, moderately elevated (b) - in 28 patients. All patients were performed phacoemulsification on one eye (Alcon Legacy Everest device or Infiniti) by one surgeon and by corneal tunnel incision of 2,6mm with implantation of posterior chamber IOL flexible model Alcon Acrysof or Alcon IQ through the injector Monarch II. The localization of the cut was on 9 or 10 hours. 68 patients of the main group additionally had trabeculectomy in the inner-lower or outer-lower quadrant. The operations had no complications. Ophthalmologic examination included acuity of vision determination, refractometry, forward and reverse ophthalmoscopy, perimetry, tonometry, tonografy, biomicroscopy. The study of electrical sensitivity threshold by phosphene(ESTF), the liability of the visual analyzer by the index of critical frequency of flicker disappearance by phosphine(CFFDF) and critical flicker fusion frequency(CFFFF).

Results:

In the postoperative period in the study group inflammatory reaction the 1st degree according to Sergienko N.M. classification in the form of folds descemet's membrane and corneal edema, a small mist in the anterior chamber moisture, iris hyperemia and edema was detected in 3patients (4.7%). The 2nd stage inflammatory response in the form of phenomena with iritis and corneal edema and destsemetit along the postoperative wound, opalescence anterior chamber moisture and the appearance of flakes of fibrin and precipitates on the IOL, the formation of posterior synechiae was found in 2 (3,1%) patients. Consequently, the postoperative inflammatory response in the main group was observed in 5 (7,8%) patients in the control group it was not found. In the main group after surgery visual acuity increased moderately to 0,56 ± 0,002 (P <0,001). The level of ESTF decreased slightly average to 96 ± 0,03 mA (P> 0,05). Revealed a weak increase in the rate CFFDF to 42,8 ± 0,03 Hz (P <0,01) and CFFFF to 38,4 ± 0,05 Hz (P <0,01). In the control group after surgery visual acuity improved an average of 0,93 ± 0,003 (P <0,001). Dynamics of the remaining functional and electrophysiological parameters were mild and uncertain.

Conclusions:

1. In 7.8% of patients with cataracts in combination with primary open-angle glaucoma after surgery there is the postoperative inflammatory response compared with patients without glaucoma, which subsequently leads to the development of complications. 2. The data allow to consider appropriate prophylactic treatment for the correction of metabolic abnormalities in patients with cataract in combination with primary open-angle both before and after surgery. FINANCIAL DISCLOSURE?: No