ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2021-1-103-109ophthalmology-1442Research ArticleКЛИНИЧЕСКИЕ И ЭКСПЕРИМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯCLINICAL & EXPERIMENTAL RESEARCHОценка факторов риска развития поздней дислокации интраокулярной линзыAssessment of Risk Factors for the Development of Late Intraocular Lens DislocationПотемкинВ. В.PotemkinV. V.

Потемкин Виталий Витальевич – кандидат медицинских наук, доцент кафедры офтальмологии, врач-офтальмолог

ул. Льва Толстого, 6–8, корп. 16, Санкт-Петербург, 197089, 

Учебный пер., 5, Санкт-Петербург, 194354

Potemkin Vitaly V. – MD, Assistant Professor Ophthalmology department, ophthalmologist

Lev Tolstoy str., 6–8, build. 16, Saint Petersburg, 197089,

Uchebniy lane, 5, Saint Petersburg, 194354

АстаховС. Ю.AstakhovS. Yu.

Астахов Сергей Юрьевич – доктор медицинских наук, профессор, заведующий кафедрой офтальмологии с клиникой

ул. Льва Толстого, 6–8, корп. 16, Санкт-Петербург, 197089

Astakhov Sergey Yu. – MD, Professor, head of Ophthalmology department

Lev Tolstoy str., 6–8, build. 16, Saint Petersburg, 197089

ГольцманЕ. В.GoltsmanE. V.

Гольцман Елена Владимировна – врач-офтальмолог

Учебный пер., 5, Санкт-Петербург, 194354

Goltsman Elena V. – ophthalmologist

Uchebniy lane, 5, Saint Petersburg, 194354

ageeva_elena@inbox.ruВанС. Ю.VanSyao Yu.

Ван Сяо Юань – аспирант кафедры офтальмологии

ул. Льва Толстого, 6–8, корп. 16, Санкт-Петербург, 197089

Van Syao Yuan – postgraduate of Ophthalmology department

Lev Tolstoy str., 6–8, build. 16, Saint Petersburg

ГБОУ ВПО «Первый Санкт-Петербургский государственный медицинский университет имени И.П. Павлова» Министерства здравоохранения Российской Федерации; СПб ГБУЗ «Городская многопрофильная больница № 2»РоссияFirst Pavlov State Medical University; City Ophthalmologic Center of City hospital No 2Russian FederationГБОУ ВПО «Первый Санкт-Петербургский государственный медицинский университет имени И.П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияFirst Pavlov State Medical UniversityRussian FederationСПб ГБУЗ «Городская многопрофильная больница № 2»РоссияCity Ophthalmologic Center of City hospital No 2Russian Federation202104042021181103109Copyright © Потемкин В.В., Астахов С.Ю., Гольцман Е.В., Ван С.Ю., 20212021Потемкин В.В., Астахов С.Ю., Гольцман Е.В., Ван С.Ю.Potemkin V.V., Astakhov S.Y., Goltsman E.V., Van S.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/1442

Дислокация интраокулярной линзы является серьезным осложнением факоэмульсификации с имплантацией интраокулярной линзы. Среди причин ранней дислокации интраокулярной линзы превалируют интраоперационные осложнения, а также различные варианты смешанной фиксации линзы. В позднем послеоперационном периоде происходит преимущественно дислокация комплекса «капсульный мешок — интраокулярная линза». Основной причиной этого является слабость связочного аппарата, а также несостоятельность капсульного мешка или его фиброзирование.

Цель

Цель: оценить степень влияния различных факторов на развитие поздней дислокации ИОЛ (как в капсульном мешке, так и без него), требующей хирургической коррекции.

Пациенты и методы

Пациенты и методы. В исследование были включены 78 пациентов (78 глаз), поступивших для хирургического лечения дислокации ИОЛ различной степени. Группу контроля составили 62 пациента, поступившие для планового хирургического лечения катаракты в период с октября 2018 по апрель 2020 года. Основными факторами, влияние которых оценивали, были: возраст (≥80 лет), пол, наличие псевдоэксфолиативного синдрома, осевой миопии (ПЗО ≥26 мм), предшествующее витреоретинальное хирургическое вмешательство, рецидивирующий увеит, первичная глаукома, пигментный ретинит, применение внутрикапсульного кольца во время факоэмульсификации.

Результаты

Результаты. Среди исследуемых факторов влияние оказывали возраст, пол, наличие псевдоэксфолиативного синдрома, осевой миопии, первичной глаукомы, имплантация внутрикапсульного кольца.

Заключение

Заключение. Факоэмульсификация является стандартом при хирургическом лечении катаракты. Однако у пациентов с потенциальными рисками развития дислокации ИОЛ хирургам стоит рассмотреть возможность и необходимость дополнительной фиксации ИОЛ.

Dislocation of intraocular lens is a serious complication of phacoemulsification with implantation of intraocular lens. Among the causes of early dislocation of intraocular lens intraoperative complications predominate, as well as various form of their mixed fixation. In the late postoperative period, dislocation of the capsular bag-intraocular lens complex mainly occurs, the main reasons for which are the zonular weakness and the failure of the capsular bag support or its fibrosis.

Purpose

Purpose: to assess the influence of various factors on the development of late IOL dislocation (both in the capsular bag and without it) requiring surgical correction.

Patientes and methods

Patientes and methods. The study included 78 patients (78 eyes) who were underwent surgical treatment of varying degree of IOL dislocation from October 2018 to April 2020. The control group consisted of 62 patients recruited for surgical treatment of cataract at the same period. The main factors for assessment were the following: axial myopia (≥26 mm), previous vitreoretinal surgery, recurrent uveitis, primary glaucoma, retinitis pigmentosa, and the use of the capsular tension ring during phacoemulsification.

Results

Results. Among the factors studied, the following risk factors of late IOL dislocation were revealed: age, gender, the presence of pseudoexfoliation syndrome, axial myopia, primary glaucoma, implantation of the capsular tension ring. Conclusion. Phacoemulsification is the standard surgical treatment of cataract. However, in patients with potential risk factors of developing IOL dislocation, surgeons should consider the use of additional IOL fixation.

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The authors declare that there are no conflicts of interest present.