Optimization of cataract surgery refractive results in patients with pseudoexfoliative syndrome

Poster Details

First Author: S.Pinchuk UKRAINE

Co Author(s):    M. Karliychuk   V. Zamjatin           

Abstract Details

Purpose:

To analyze the refractive shift after phacoemulsification with intraocular lens (IOL) Acreos MI-60 implantation caused by vaulting of IOL due to capsular contraction with and without intracapsular rings.

Setting:

Eye microsurgery clinic " Vash Zir" , Bukovinian State Medical University, Chernivtsy, Ukraine.

Methods:

This study included 79 patients (79 eyes) with mean age 62±1,4 years with senile cataract and pseudoexfoliative syndrome of the I-II degree. Excluding criteria were lens subluxation, glaucoma, previous eye surgeries. All surgeries were performed by one surgeon using standard technic and intracameral anesthesia. In all cases IOL Acreos MI-60 was implanted. Main group included 28 patients (28 eyes) with implanted intracapsular rings. The patients were examined on the next day, in 1 week and in 3 months after surgery. Refraction, uncorrected and bestcorrected visual acuity, and anterior chamber depth by IOL-Master and immersion biometry were checked.

Results:

There were no complications after surgery. In all cases on the next day and in 1 week after surgery target refraction was registered. In control group in 3 months after surgery in 52,9% (27 eyes) of cases myopic refractive shifts more than -0,5 D (max -1,75 D) were observed. In the main group similar changes were observed in 10,7% (3 eyes) of cases (p<0,001). These shifts were caused by anterior vaulting of IOL due to capsular contraction. Anterior chamber depth was decreased by 0,22±0,06 mm in the control group and by 0,05±0,02 mm in the main group (p<0,05). In 7,8% (4 eyes) of cases of the control group hyperopic refractive shifts more than 0,5 D were observed. These shifts were caused by posterior vaulting of IOL. In 77,4% of cases noted changes were eliminated by YAG-laser capsulotomy.

Conclusions:

IOL Acreos MI-60 has some evident advantages – small thickness and possibility of implantation through 1,8 mm incision, four-point fixation and better stability in capsular bag. But sometimes IOL vaulting and refractive shift can occur as a result of capsular contraction syndrome. Implantation of intracapsular rings in eyes with pseudoexfoliative syndrome can be recommended to reduce the severity of capsular contraction and avoid refractive shifts. FINANCIAL DISCLOSURE?: No