ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2021-3-442-450ophthalmology-1599Research ArticleОФТАЛЬМОХИРУРГИЯOPHTHALMOSURGERYОстрый транзиторный макулярный отек после неосложненной хирургии катарактыAcute Transient Macular Edema after Uneventful Cataract SurgeryБейсекееваЖ. С.BeisekeevaJ. S.

Бейсекеева Жулдыз Сериковна - кандидат медицинских наук, врач-офтальмолог 

ул. Лосиноостровская, влад. 43, Москва, 107564; Нахимовский просп., 56, Москва, 117292

Beisekeeva Juldyz S., PhD, ophthalmologist

Losinoostrovskaya str., 43, Moscow, 107564; Nahimovskiy ave., 56, Moscow, 117292

julbs2015@gmail.comБезруковА. В.BezrukovA. V.

Безруков Александр Валентинович - кандидат медицинских наук, заведующий офтальмологическим отделением 

ул. Лосиноостровская, влад. 43, Москва, 107564

Bezrukov Alexandr V., PhD, head of the Ophthalmology department

Losinoostrovskaya str., 43, Moscow, 107564

КочергинС. А.KocherginS. A.

Кочергин Сергей Александрович - доктор медицинских наук, профессор кафедры офтальмологии 

ул. Баррикадная, 2/1, стр. 1, Москва, 125993

Kochergin Sergei A., MD, Рrofessor of the Ophthalmology department

Barrikadnaya str., 2/1, Moscow, 125993

СамойленкоА. И.SamoylenkoA. I.

Самойленко Александр Игоревич - кандидат медицинских наук, заведующий отделением витреоретинальной патологии 

2-й Боткинский проезд, 5, Москва, 125284

Samoylenko Alexandr I., PhD, head of the Vitreoretinal pathology department

2nd Botkinskii travel, 5, Moscow, 125284

Центральная клиническая больница № 2 ОАО «РЖД»; Офтальмологическая клиника доктора СамойленкоРоссияCentral Clinical Hospital № 2 of Russian Railways; Samoylenko Eye ClinicRussian FederationЦентральная клиническая больница № 2 ОАО «РЖД»;РоссияCentral Clinical Hospital № 2 of Russian RailwaysRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRussian Medical Academy of continious postdiploma education of Healthcare Ministry of Russian FederationRussian FederationГБУЗ «Городская клиническая больница имени С.П. Боткина» Департамента здравоохранения г. МосквыРоссияState Hospital named by S.P. BotkinRussian Federation202130092021183442450Copyright © Бейсекеева Ж.С., Безруков А.В., Кочергин С.А., Самойленко А.И., 20212021Бейсекеева Ж.С., Безруков А.В., Кочергин С.А., Самойленко А.И.Beisekeeva J.S., Bezrukov A.V., Kochergin S.A., Samoylenko A.I.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/1599Цель

Цель: представить описание 17 случаев острого транзиторного макулярного отека, возникшего в первые сутки после неосложненной хирургии катаракты.

Пациенты и методы

Пациенты и методы. Представлен обзор литературы и ретроспективный анализ клинических данных и результатов оптической когерентной томографии (ОКТ) 17 пациентов (17 глаз) с острым транзиторным макулярным отеком.

Результаты

Результаты. В литературе описаны случаи возникновения макулярных разрывов в первые сутки после факоэмульсификации катаракты. Встречаются также случаи макулярного отека, возникающего через несколько недель после неосложненной хирургии катаракты и ассоциирующегося либо с псевдофакичным кистозным макулярным отеком (КМО), либо с развитием тракционного макулярного синдрома (ТМС). Мы наблюдали серию транзиторных макулярных отеков в первые сутки после неосложненной факоэмульсификации катаракты с имплантацией ИОЛ (ФЭК + ИОЛ). Частота отека составила 3,8 % и не имела признаков витреоретинальной тракции или активного острого воспаления. Соотношение мужчин и женщин в исследовании составило 13:4. Наиболее распространенным сопутствующим заболеванием была гипертоническая болезнь (15 из 17). ОКТ проводили при наличии жалоб у оперированных в отношении неудовлетворенности полученным результатом и обнаружения отека в макулярной зоне при офтальмоскопии. По данным ОКТ в первые сутки после ФЭК + ИОЛ отмечался отек и высокая отслойка нейроэпителия (ОНЭ) макулярной зоны, которая разрешилась на 3–6-е сутки. В большинстве случаев задней отслойки стекловидного тела (ЗОСТ) не наблюдалось. Сходные клинические случаи были описаны как макулопатия «буквы А» из-за паттерна на снимках ОКТ у 3 пациентов после рутинной ФЭК + ИОЛ. Мы сравнили свои результаты с известными наблюдениями, классическим псевдофакичным КМО (синдром Ирвина — Гасса) и тракционным макулярным синдромом, а также обсудили вопросы возможного этиопатогенеза данных случаев транзиторного макулярного отека, учитывая морфологию данной зоны.

Заключение

Заключение. Данные наблюдения, возможно, помогут прояснить процессы тканевой гидродинамики в макулярной зоне.

Purpose

Purpose: to present analysis a case reports of 17 patients who had an acute transient macular edema appeared straight after uncomplicated cataract surgery.

Patients and Methods

Patients and Methods. Working with literature and retrospective observational case series reviewing clinical and imaging data from 17 patients (17 eyes) with acute transient macular edema.

Results

Results. There are several cases of acute macular hole development after cataract surgery (complicated and uncomplicated). Also there are reports of macular odema development after several weeks after uncomplicated phacoemulsification due to pseudophakic cystoid macular oedema (Irvine-Gass syndrome) or due to vitreomacular traction syndrome. We observed a series of transient macular oedema with 3.8 % incidence occurring on the first days after uncomplicated phacoemulsification with IOL implantation that had no signs of vitreomacular traction or aqute inflammation. Men suffer frequently than women (14:3). Systemic hypertension prevailed among these patients (15 from 17). Optical coherence tomography (OCT) was made in patients complaining on blure vision and who had signs of macular edema by ophthalmoscopy. By OCT high neuroepithelium detachment was observed at the first day after uneventful cataract phacoemulsification with intraocular lens implantation in 17 patients with quiet postoperative condition of the eye. The edema resolved on the 3–6-th day by standard phaco accompanying pharmacological treatment. In most cases posterior vitreous cortex was adjacent to the retina except 3 patients with posterior vitreous detachment (PVD) in macular area. We found a paper by Costen M.T.J. et al. (2007) about the same striking appearance of maculopathy called by authors “A-sign” maculopathy because of A-shaped pattern on OCT images in 3 patients after routine cataract surgery. Yaman A (2008) and Panagiotidis D (2010) also reported same findings after uncomplicated cataract surgery. We compared our findings with 3 papers mentioned above, as well as with typical pseudophakic cystoid macular edema (CME or Irvine-Gass syndrome) and vitreomacular traction syndrome. We also discussed possible ethiopathogenesis of thеse cases in terms of morphology of the macula region.

Conclusion

Conclusion. This article could improve our understanding of mechanisms of the interstitial fluid flow in the eye tissues. 

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