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Session Title: Subluxed IOLs and Scleral Fixation
Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30
Paper Time: 10:19
Venue: E102 (First Floor)
First Author: : K.Novak RUSSIA
Co Author(s): : A. Zagorulko M. Nemsitcveridze
To value safety and efficiency of the laser cataract extraction in patients with Fuch"s endothelial dystrophy using laser radiation ? = 1,44 mcm.
St.-Petersburg Branch IR&TC "Eye microsurgery" named after academician S. Fyodorov, Saint-Petersburg, Russia.
Investigation involved 54 patients (68 eyes) with primary Fuch"s Dystrophy, who were performed laser cataract extraction (LCE). All patients were gone through standard ophthalmological examination before operation. Endothelial cells density (ECD) was measured additionally in the central part "cornea guttata" and in 6 points on the middle periphery. All patients were also performed pachymetry. Morphometric parameters of posterior corneal epithelium were evaluated for all patients. The ECD and central corneal thickness (CCT) were compared preoperatively, and 1 day, 1 week, 1 month, 6 months, and then 1 year and 2 years postoperatively. LCE operations were performed by laser system "Rakot VI". Standard technique of LCE operation with forming of "crater" and "cup" in destructible nucleus. During operation viscoelastic Celophthal was used to protect the posterior corneal epithelium. In all cases we used a balanced physiological solution ("BSS+"). In all cases the posterior chamber intraocular lens was implanted. Period of investigation was 2 years.
Average loss of ECD in the central part "cornea guttata" was 4,7%. In the area of intact cornea the average loss of ECD made 3,5%. In 1 week the variability index (VI) increased by 14,0%, and 1 month after LCE, the numbers of VI partly restored and remained stable further on. Percent of hexagonal cells made 59,4% in 1 month after operation. It was stable afterward. Coefficient of form was stable during all investigation period, and was equal to its preoperative index 0,77. By results of keratopa?hymetry 11 patients after LCE with nucleus density of 3-4 degree, had corneal thickening in all its parts. Thickening was more evident in the central part of cornea. In 1 week after operation pahymetry indexes stabilized and remained at the level equal to the initial one.
1. As the result of LCE among the patients with Fuch"s endothelial dystrophy we noticed that there was no considerable loss of endothelial cells in early and late post-operative period. 2. The lack of corneal EED development in the long-term period shows, that laser radiation with the wave length 1,44 mcm doesn"t injure endothelial cells and is fairly safe for corneal endothelium. 3. LCE may be the chosen method for patients with Fuch"s endothelial dystrophy.
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