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Outcomes of a spontaneous dislocation of the 'IOL-capsular bag' complex of non-traumatic genesis after a phacoemulsification

Poster Details

First Author: Y.Belonozhenko RUSSIA

Co Author(s):    E. Sorokin              

Abstract Details



Purpose:

The analysis of gravity and outcomes of a spontaneous dislocation of the 'IOL-capsular bag' complex after phacoemulsification (PE) of non-traumatic genesis. It is known that weakness of zonular support when planning PE meets quite often, from 7% to 13%. In the remote terms after PE in some cases there is a spontaneous dislocation of the 'IOL-capsular bag' complex. However there is no consensus about surgical tactics at weakness of tissues of Zinn's ligament.

Setting:

The Khabarovsk branch of the State Institution Eye Microsurgery Complex named after S.N. Fyodorov, Khabarovsk, Russia

Methods:

The analysis of 50 eyes (49 patients, from 2005 for 2014, a method of continuous selection) with a dislocation of the 'IOL-capsular bag' complex of non-traumatic genesis was carried out. The age varied from 61 to 89 years, on the average 71.4+3.5 years. Men were 34, women - 15. Initially in 9 eyes there was an age-related cataract, in 41 eyes - complicated cataract. In structure of the complicated cataract were presented: primary open-angle glaucoma - 24 eyes, a pseudoexpholiative syndrome - 26 eyes, a myopia of high degree - 4 eyes, pigmentary retinitis - 2 eyes, a diabetic retinopathy - 6 eyes. In 27 eyes the unripe stage of the cataract was defined, in 18 - mature, in 5 eyes - an overripe stage. The IOL following models were implanted: Hanita - 11 eyes; RSP-2 - 12 eyes; T-26 - 12 eyes; Rayner C-flex - 1 eye; Acrysof Natural - 7 eyes; MIOL-2 - 3 eyes; MIOL Flex - 2 eyes; Hydrowieve - 1 eye; T-19 - 1 eye. Terms of a dislocation of the 'IOL-capsular bag' complex in a vitreous body after PE made from 3 months to 12 years, on the average 5.5±2.0 years.

Results:

In 18 eyes in the early postoperative period after PE there was an intraocular pressure level increase: from 26 to 34 mm Hg (on the average 30.3 mm Hg). In 10 eyes it was sturdily stopped by a hypotensive regimen. In 8 eyes 1-1,5 months later it was necessary to perform antiglaucoma operation. In 8 eyes in 3-3.5 years IAG-laser surgery of the secondary cataract was executed. In all these 8 eyes in 5.5 years the 'IOL-capsular bag' complex dislocation was found. Hemophthalmos developed after operation of replacement of the complex in 2 cases, recurring uveitis - in 1 case. In total 15 eyes (30%) demanded numerous courses of stationary conservative treatment after repeated operations. After all actions stable visual acuity without correction in comparison with the period after PE was found only in 6 eyes (12%). In 40 eyes (80%) there was noted decrease in vision without correction on the average on 0.21 D. It was also fixed the increase in vision in 4 eyes (8%). 17 patients (34%) From 49 are on a hypotensive regimen to the present time, receiving annual stationary conservative treatment.

Conclusions:

1. The dislocation of the 'IOL-capsular bag' complex is frequent complication of cataract surgery. According to our data, in most cases the initial condition of eyes was burdened by accompanying pseudoexpholiative syndrome, glaucoma, diabetic damages of an eye, a myopia of high degree. 2. Ways of prevention of dislocation of the complex intend more careful preoperative assessment of stability of ligaments and if necessary to carry out extra capsular fixing of IOL at PE. FINANCIAL INTEREST: NONE

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