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First Author: R.Fayzrakhmanov RUSSIA
Co Author(s): M. Bikbov A. Yarmukhametova
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To develop a method of endothelial protection of the cornea during endovitreal surgery with simultaneous performing phacoemulsification.
Ufa Eye Research Institute, Ufa, Russia.
In carrying out of endovitreal surgery (ES) with simultaneous phacoemulsification (PE) a special polymeric device with a non-ionic material structure is used as a protector of cornea - the tight protection of corneal endothelium (TPCE). The patients with the nucleus density grade IV according to the classification of Buratti were selected to analyze the leveling effects of ultrasound with TCPE with endovitreal pathology. The control group (group 1) 20 patients (20 eyes) - PE was performed with the standard technique, ES. The main group (group 2) - 10 patients (10 eyes) - PE was performed with the standard technique with the use of the TPCE, ES. The average patient age was 69,2 ±6,7. The degree of corneal edema in the patients was assessed clinically by biomicroscopy data and by the ability to visualize the fundus after surgical treatment. The peculiarity of surgical treatment was observed in the main group of patients, after a capsulorhexis they were injected TPCE into the anterior chamber with usage of microforceps, after which viscoprotector was added to the anterior chamber.
At day 1 after surgery in group 1 diffuse edema of the entire area of the cornea with the involvement of the stroma and epithelium was observed in 6 patients (30%), the edema of the upper sector of the cornea with the Descemets membrane folds - in 10 patients (50%) and folded changes in Descemet membrane without any sign of stroma and epithelium involvement in the pathological process - in 4 patients (20%). At day 7 diffuse edema maintained in two case (10%), 4 patients (20%) - edema of the upper sector of the cornea, in 4 cases (20%) Descemets membrane folds. At 30th day the cornea was transparent in all patients. In the 2nd group at day 1 after surgery edema of the upper sector of the cornea was observed in 4 cases (40%), Descemets membrane folds without stroma and epithelium involvement in the pathological process - in 4 cases (40%), in 2 case (20 %) the cornea remained biomicroscopically intact. Diffuse edema involving the stroma and epithelium was not observed. At 7 day and day 30 the cornea was clear in all patients (100%).
The obtained results indicate that the usage of TPCE during phacoemulsification with simultaneous performing of endovitreal intervention helps to improve the condition of the cornea, in particular, to reduce stromal edema, to increase the functionality of the surgical treatment results, to decrease the period of hospital stay, to provide with the adequacy of endovitreal surgery. The topicality of the subject and the positive clinical results in the early postoperative period requires further research.