ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2021-4-769-777ophthalmology-1678Research ArticleОБЗОРЫREVIEWSБиометрия и силиконовая тампонада витреальной полости глаза. ОбзорBiometry in Silicone Oil Filled Eyes. A ReviewКуликовА. Н.KulikovA. N.

Куликов Алексей Николаевич, доктор медицинских наук, доцент, полковник медицинской службы, начальник кафедры и клиники офтальмологии им. В.В. Волкова

ул. Академика Лебедева, 6, Санкт-Петербург, 194044

Kulikov Alexey N., MD, Associate Professor, colonel of medical services, head of Ophthalmology chair and V. Volkov clinic

Academician Lebedev str., 6, St. Petersburg, 194044

ДаниленкоЕ. В.DanilenkoE. V.

Даниленко Екатерина Владимировна, кандидат медицинских наук, начальник офтальмологического отделения (неотложной помощи)

ул. Академика Лебедева, 6, Санкт-Петербург, 194044

Danilenko Ekaterina V., PhD, head of the ophthalmological department (emergency care)

Academician Lebedev str., 6, St. Petersburg, 194044

https://orcid.org/0000-0002-6384-0117КузнецовА. Р.KuznetsovA. R.

Кузнецов Александр Романович, врач-офтальмолог офтальмологического отделения (неотложной помощи)

ул. Академика Лебедева, 6, Санкт-Петербург, 194044

Kuznetsov Alexandr R., ophthalmologist

Academician Lebedev str., 6, St. Petersburg, 194044

pit-ark@mail.ruГВОУВО «Военно-медицинская академия им. С.М. Кирова» Министерства обороны Российской ФедерацииРоссияMedical Military Academy named after S.M. KirovRussian Federation202128122021184769777Copyright © Куликов А.Н., Даниленко Е.В., Кузнецов А.Р., 20212021Куликов А.Н., Даниленко Е.В., Кузнецов А.Р.Kulikov A.N., Danilenko E.V., Kuznetsov A.R.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/1678

Представление о «золотом стандарте» современной витреоретинальной хирургии неразрывно связано с использованием силиконовой тампонады витреальной полости глаза. Одним из осложнений длительного (по данным разных авторов, от 2 недель до 2 лет) пребывания силиконового масла в витреальной полости глаза является помутнение хрусталика. В этом случае среди причин, ведущих к развитию катаракты, выделяют гидрофобность полидиметилсилоксанов, непосредственный контакт с передним фронтом силиконового пузыря, макрофагальная и токсическая реакция, трофические нарушения. Это делает актуальной проблему катарактальной хирургии и предварительного расчета интраокулярной линзы на фоне пребывания силиконового масла перед его выведением из витреальной полости наряду с затруднениями при визуализации глазного дна и минимизацией количества операций путем проведения комбинированных вмешательств. Известно, что основная ошибка в расчете силы искусственного хрусталика связана с погрешностями в измерении переднезадней оси как наиболее значимой составляющей расчета интраокулярной линзы. В условиях силиконовой тампонады погрешность измерений, а следовательно, и планирование послеоперационной рефракции остается до конца не решенной проблемой. Ряд авторов публикуют сведения, сообщающие о 58 % случаев достижения запланированной рефракции после комбинированного лечения. Некоторые исследователи указывают на то, что после выполнения факоэмульсификации на авитреальных глазах и планирования имплантации искусственного хрусталика средняя ошибка в расчете его силы составляет 0,8 дптр, несмотря на широкое применение оптической биометрии. Она представлена несколькими методиками: частичной когерентной интерферометрией, оптической низкокогерентной рефлектометрией и оптической когерентной томографией, которые реализованы в таких приборах, как IOLMaster 500, Lenstar LS 900 и IOLMaster 700, имеющих свои особенности и точность измерения. Исследование их преимуществ, а также разработка точного метода расчета интраокулярной линзы на фоне силиконовой тампонады для снижения ошибок в достижении целевой рефракции демонстрирует медико-социальное значение этой проблемы.

The “gold standard” of modern vitreoretinal surgery is silicone oil tamponade of the vitreous cavity. The lens opacity development is in the list of complications of prolonged silicone oil eye filling (from 2 weeks to 2 years). Polydimethylsiloxanes hydrophobicity, direct contact with the front of the silicone bladder, macrophage and toxic reaction, trophic disturbances are the causes leading to the cataract initiation. This makes the problem of cataract surgery and preliminary intraocular lens calculation in silicone oil filled eyes before its removing very relevant as well as cloudy retina visualization and the necessity of minimization of number of operations through their combination. Certainly, the main error in IOL power calculation is associated with axial length measurement inaccuracy, as the most significant term of an equation. Silicone oil filled eyes biometry errors, and, consequently, postoperative refraction biases remain unresolved problem until now. To date authors report only 58 % of cases in which target refraction was achieved after combined surgery. Some researchers figure out that average calculation error after phacoemulsification with IOL implantation in avitreal eyes was 0.8 D despite of the optical biometry usage. Today it is represented by several methods: partial coherent interferometry, optical low-coherence reflectometry and optical coherence tomography, which are implemented in devices such as IOLMaster 500, Lenstar LS 900 and IOLMaster 700, which have their own characteristics and measurement accuracy. Their advantages as well as creation an accurate IOL calculation method for silicone oil filled eyes could reduce postoperative refraction error that outline significant medical and social problem.

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