Surgical Treatment of Complicated Cataract in Patients with High-Grade Ametropia (Literature Review)

Carrying out phacoemulsification in eyes with concomitant pathology — extreme ametropia requires an individual approach due to the characteristics of the anteroposterior size of the eyeball and the presence of concomitant pathology. Difficulties arise at the stages of calculating the anterior-posterior axis of the eye, preoperative diagnosis, calculating the optical power of the intraocular lens, phacoemulsification and postoperative management. In the preoperative management of patients with hypermetropia, attention should be paid to the anterior eye segment, the angle of the anterior chamber of the eye, intraocular pressure; patients with high myopia require a detailed examination of the fundus. Difficulties in the intraoperative period in patients with short eye length are associated with the shallow depth of the anterior chamber, lack of space for manipulation; patients with long eyes require additional anesthesia to relieve pain when filling the eyeball with irrigation fluid. In the postoperative period, hyperopic patients need monitoring of intraocular pressure, myopic patients need fundus ophthalmoscopy with optical coherence tomography. To identify treatment tactics for cataract surgery in patients with high degrees of ametropia according to modern literature data. To perform the review, a search of literature sources was analyzed in the PubMed database using the keywords “cataract”, “high hyperopia”, “high myopia” and data from publications on the topic of the article for the period up to 2023 inclusive. The literature analysis has shown that recently more and more attention has been paid to the problem of high-grade ametropia. This is due to the widespread, progressive disease course, early cataracts development and other complications that significantly reduce vision.

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