DYNAMIC CHANGES OF THE POSTERIOR POLE OF THE EYE AFTER CATARACT PHACOEMULSIFICATION WITH INTRAOCULAR LENS IMPLANTATION

Objective. To study the effect of uncomplicated phacoemulsification through the corneal incision with implantation of the intraocular lens (IOL) for changes in the macular region of the retina. Methods: The study included 35 eyes of 35 patients who underwent uncomplicated phacoemulsification with IOL implantation. The average age of the patients was 67±2,3 years, among them were 19 women and 16 men. Exclusion criteria: retinal pathology (postthrombotic and diabetic retinopathy, wet form of age-related macular degeneration and other diseases of the retina), previous eye injuries, uveitis, intra-operative complications. Retinal thickness in the fovea, the macula, and macular volume were measured by optical coherence tomography on the first day, after 2 weeks, 1 and 3 months after surgery. Results. In the period between the first day and two weeks after surgery there were the statistically significant incensement in retinal thickness in the macula from 306,64±21,15 mkm to 321,46±27,83 mkm (p <0.05), in the fovea from 211,45±20,24 mkm to 218,69±17,84 mkm (p<0.05), macular volume from 8,08±0,35 cubic mm to 8,46±0,54 cubic mm were registered. By the end of the first month after surgery maximum retinal thickness was 327,23±27,16 mkm, thickness in the fovea 220,31±18,63 mkm, macular volume 8,61±0,55 cubic mm. After 3 months, the maximum thickness of the retina reached 325,11±26,13 mkm, in the fovea 220,31±18,63 mkm, macular volume 8,55±0,49 cubic mm. Conclusion. There was an incensement of macular volume and retinal thickness in the period between the first day and two weeks after uncomplicated cataract phacoemulsification with intraocular lens implantation. The growth of these indicators continued within the first month after surgery, three months after phacoemulsification there was a downward trend. This can be important in determining the duration of drug therapy in the postoperative period.

coherence tomography, retinal thickness in the macula and fovea, macular volume, reactive syndrome

1. Gehring J. R: Macular edema following cataract extraction. Arch. Ophthalmol. 1968;80:626–631.

2. Biro Z., Balla Z., Kovach B. Change of foveal and perifoveal thickness measured by OCT after phacoemulsification and IOL implant. Eye. 2008;22:8–12. doi:10.1038/ sj.eye.6702460

3. Lobo C.L., Faria P.m., Soares M. A., Bernardes R.C., Cunda — Vaz J. G. Macular alterations after small– incision cataract surgery. J. Cataract Refract. Surg. 2004;30:752–760.

4. Галоян Н.С. Сравнительная оценка влияния гидромониторной факофрагментации и ультразвуковой факоэмульсификации на морфометрические пара метры центральной области сетчатки. Вестник офтальмологии 2008;1:8–11. [Galoyan N.S. Comparative evaluation of the hydromonitor phakofragmentation effect and ultrasonic phacoemulsification on the central region of the retina morphometric parameters. Annals of Ophthalmology=Vestnik oftal’mologii. 2008;1:8–11. (in Russ.)].

5. Руденко В. А., Сорокин Е. Л. Изучение морфометрических особенностей глаз пациентов с тракционным макулярным отеком после факоэмульсификации по поводу возрастной катаракты. Кубанский научный медицинский вест ник. 2013;2:21–25. [Rudenko V. A., Sorokin E. L. The study of the morphometric features of the patients eyes with traction macular edema after phacoemulsification for age-related cataracts. Kuban scientific medical bulletin=Kubanskij nauchnyj medicinskij vestnik. 2013;2:21–25. (in Russ.)].

6. Grewing R., Becker H. Retinal thickness immediately after cataract surgery measured by optical coherence tomography. Ophthalmic Surg. Lasers. 2000;31:215–217.

7. Лоскутов И.А., Мельникова Л.П., Калугина О.Н. Оценка состояния макулярной области и остроты зрения у пациентов с глаукомой после факоэмульсификации. Глаукома. 2011; 3:46–50. [Loskutov I.A., Mel’nikova L.P., Kalugina O.N. Assessment of the the macular area state and visual acuity in patients with glaucoma after phacoemulsification. Glaucoma=Glaukoma. 2011;3:46–50. (in Russ.)].

8. Астахов С.Ю., Гобеджишвили М.В. Послеоперационный макулярный отек, синдром Ирвина-Гасса. Клиническая офтальмология. 2010;11(1):5–8. [Astakhov S.Yu., Gobedzhishvili M.V. Postoperative macular edema, Irvine-Gass syndrome. Clinical ophthalmology=Klinicheskaya oftal’mologiya. 2010;11(1):5–8. (in Russ.)].

9. Леванова О.Г., Чупров А.Д., Архипова Л.Т. Повторные оперативные вмешательства на глазу — фактор риска послеоперационного увеита. Офтальмохирургия и терапия 2003;1–2:14–16. [Levanova O.G., Chuprov A.D., Arkhipova L.T. Repeated surgical interventions on the eye are a risk factor for postoperative uveitis. Ophthalmosurgery and therapy=Oftal’mokhirurgiya i terapiya. 2003;1–2:14–16. (in Russ.)].

10. Nussenblatt R.B., Kaufman S.C., Palestine A.G. et al. Macular thickening and visual acuity. Measurement in patients with cystoid macular edema. Ophthalmology. 1987;94:1134–1139.

11. HendersonB., KimJ., Ament C. et al. Clinical pseudophakic cystoid macular edema Risk factors for development and duration after treatment. J. Cataract. Refract Surg. 2007;33:1550–1558.