PROGNOSIS, PREVENTION, AND TREATMENT OF DIABETIC CATARACT SURGERY POSTOPERATIVE COMPLICATIONS

Aim. To study immune and antioxidant status of diabetic cataract patients and to assess the efficacy of preoperative preparation for diabetic cataract surgery to prevent intra- and postoperative complications and the efficacy of cataract treatment in metabolic syndrome patients. Patients and methods. 136 cataract patients (272 eyes) were examined (mean age 62±3.2 years). Among these patients, women predominated (n = 74). Control group included 25 healthy volunteers (10 men and 15 women) aged 32‑56 (mean age 44.3±2.4 years) without ocular diseases (50 eyes). Two patient groups were examined. Group 1 included 78 patients (mean age 54±1.5) younger than 60 (52.5 %) with similar lens morphological changes and metabolic disorders who were diagnosed with complicated (diabetic) cataract. Group 2 included 58 patients with age-related cataract. Tear, anterior chamber (AC) humor, and blood tests were performed. Immune status, lipid peroxidation parameters in tear fluid and blood, active peroxiredoxin 6 (PRDX6) and / or its breakdown fragments in tear fluid and AC humor were studied. In group 1 (age-related cataracts), somatic disorders were diagnosed in 4.5 % of cases, in group 2 (complicated cataracts), somatic disorders were diagnosed in 100 % of cases. Expression of protective enzymes against oxidative stress in tear fluid was studied. Activity of tear antioxidant enzymes under oxidative stress conditions in therapy and after cataract surgery was evaluated. Results. Postoperatively, increase in PRDX6 level was revealed in age-related cataract patients. The absence of phaco complications confirms these findings. In complicated (diabetic) cataracts, PRDX6 level was 6‑times less than in age-related cataracts. Conclusions. Prophylaxis of inflammatory complications in age-related cataract patients can be performed using the following schedule: 0.5 % levofloxacin 4 times daily, bromfenac once daily. 

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