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Retinal detachment risk after laser cataract extraction in follow-up postoperative period in patients with high degree myopia

Poster Details

First Author: S.Sakhnov RUSSIA

Co Author(s):    E. Leksutkina   V. Krylov           

Abstract Details



Purpose:

To estimate the possibility of retinal detachment (RD) risk decrease after laser cataract extraction (LCE) in follow up postoperative period at patients with high degree myopia (HDM) and visually relevant cataract.

Setting:

FSBI 'The Academician S.N. Fyodorov IRTC 'Eye Microsurgery' of the Ministry of Public Health of the Russian Federation, Krasnodar Branch

Methods:

At 254 eyes of HDM patients with anterior-posterior axis ≥26mm at the age from 25 till 72 years bimanual LCE method on Russian laser equipment 'RAKOT' Nd: Yag 1.44 mkm was used. This technology provides capsulorexis, laser lens fragments destruction and cortical mass aspiration through micro incision for aspiration-irrigatition and laser tips. In 18 cases iris retractors were used. With the aim of maximal keeping of vitreoretinal configuration for prevention of vitreous body displacement anteriad and traction appearance in all cases intracapsular IOL were implanted, even in cases with calculated zero refraction, but in 23 cases having big capsular bag intracapsular tension rings were implanted additionally. The operation was carried out under cover of elastic protector. LCE was performed by standard method at 15 eyes with early made radial keratotomy. In 7 cases LCE was carried out at myopic eyes with early implanted negative intraocular lens, because of this the operation was started from artificial lens defragmentation with scissors in anterior chamber and it's extraction, farther standard LCE was carried out. At 5 eyes LCE was performed after earlier successfully treated RD. LCE results were observed retrospectively to 7 years.

Results:

During the LCE operation 3 tears of lens posterior capsule was got which didn't involve change of operation plan. In early postoperative period complications were not noted. 2 patients in late postoperative period posterior capsule opacity was advanced, which required discission perfoming. One week after laser discission of lens posterior capsule RD was advanced, which involved surgical intravitreous interfering. On the other 252 eyes RD wasn't registered. Inspite of manipulation amount and time increase in cavity of myopic eye at 7 patients with early implanted negative IOL and 15 eyes after radial keratotomy as well as earlier operated concerning RD in 5 eyes LCE didn't influence on retina state and cornea condition in observable postoperative period. Endothelial cells loss was less than 6%. Visual acuity in each specific case was maximal and depended on individual initial condition of retina at patient with HDM.

Conclusions:

Nd: Yag 1,44 mkm laser using for cataract extraction at patients on eyes with high degree myopia with anterior-posterior axis ≥26 mm is preferably and safely. In postoperative period at appearance of possibility in lens posterior capsule discission at its opacity for the reduction of RD development risk, it is desirable to prefer instrumental interference but not laser discission. FINANCIAL INTEREST: NONE

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