scholarly journals Phacoemulsification and calculation of intraocular lenses in patients given keratorefractive surgery. Part 1

2021 ◽  
Vol 14 (2) ◽  
pp. 55-58
Author(s):  
I. E. Ioshin
Keyword(s):  
Postoperative Period ◽  
Outer Part ◽  
Optical Power ◽  
Intraocular Lenses ◽  
Subconjunctival Injection ◽  
Initial State ◽  
Surgical Technology ◽  
Keratorefractive Surgery ◽  
Surgical Tactics ◽  
Fast Adaptation

Rationale.Qualitative rehabilitation of patients with cataracts who had keratorefractive surgeries depends on phacoemulsification technology and correctly calculated optical power of the IOL. Purpose: present the author’s own approaches to the development of surgical tactics for treating patients with cataracts who underwent keratorefractive surgeries. Material and methods. The complicated character of cataract surgery performed after LASIK — deterioration of visualization due to the presence of an optical ablation zone and a transition zone (6–7 mm) — is successfully compensated by instillations of a dispersed viscoelastic (methylcellulose) onto the surface of the cornea. Another factor is the deepening of the anterior chamber in high myopia, which is uncomfortable for manipulation and may require a lowerlevel of irrigation (up to 60 mm Hg). The technology of surgery performed after radial keratotomy (RK) requires utmost attention to the prevention of surgical astigmatism that could emerge due to biomechanical instability of the cornea. To ensure such prevention, paracentesis is performed outside the zone of keratotomy scars, the main 2.2 mm incision is made after capsulorhexis in the sclerolimbal zone, and at theend of the operation, a subconjunctival injection is performed in the conjunctival zone of the knife keratom entrance for the tamponade ofthe outer part of the incision without suturing. These techniques made it possible to successfully perform more than 200 operations and achieve a favorable course of the postoperative period from the first day. Fast adaptation of the incision (1–2 days), uncomplicated course of the postoperative period and the absence of induced astigmatism are important advantages of this technology. Conclusion. The choice of surgical technology, taking into account the initial state of the eye after LASIK and RK surgeries, is an important task. Yet the main problem with which the doctor is faced after keratorefractive surgery is the difficulty of calculating the optical power of the IOL which must take into account the special needs of the patient with a particular refractive history, which will be reported in part 2 of the article.

scholarly journals Explantation of domestic models of posterior chamber phakic intraocular lenses in the development of subcapsular cataract in higly myopic patients: clinical features

2021 ◽  
Vol 14 (1) ◽  
pp. 61-64
Author(s):  
G. V. Sorokoletov ◽  
E. R. Tumanyan ◽  
A. N. Bessarabov ◽  
M. A. Soboleva
Keyword(s):  
Young Patients ◽  
Optical Power ◽  
Functional Results ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Corneal Incision ◽  
Irrigation Solution ◽  
Phakic Intraocular Lenses ◽  
Surgical Tactics

To date, the operation of choice in young patients with high myopia, is the implantation of posterior chamber phakic intraocular lenses (PIOL), provided that there are contraindications to keratorefractive interventions, However, in the late postoperative period, cataracts may occur, which requires the development of surgical tactics for lens explantation with simultaneous phacoemulsification of cataract (FEC) implementation.The purpose is to develop and analyze a method for removing a PIOL through a 2 mm corneal incision in subcapsular cataract cases.Material and methods. Posterior chamber domestic models of PIOL type RSK-1(3) and RSK-3 in 22 patients (37 eyes), implanted in the S.N. FEDOROV “EYE MICROSURGERY” clinic in 1994 – 2001 had to be removed due to the development of secondary cataracts. PIOL stayed in the eye 2 to 26 years (averagely 14.30 ± 1.30 yrs). In all cases, the P IOL was removed followed by FEC with implantation of a posterior chamber IOL. The optical power of the IOL was calculated mainly in such a way that the residual myopic refraction was 2.0–3.0 D.Results. The intraoperative condition of the anterior chamber was stable, the volume of irrigation fluid consumed was within 90–120 ml. No complications were detected in the early and late postoperative periods. The results of dynamic ophthalmological follow up of patients showed that visual acuity without correction and with correction after surgery averaged 0.2 ± 0.1 and 0.60 ± 0.15, respectively.Conclusion. The proposed method of explantation of domestic lenses of S.N. FEDOROV NMRC MNTK “EYE MICROSURGERY” shows that it enables a safe, simple removal of PIOL in the event of secondary subcapsular cataract, which allows achieving high clinical and functional results without overspending the irrigation solution.

scholarly journals Phacoemulsification and calculation of intraocular lenses in patients given keratorefractive surgery. Part 2

2022 ◽  
Vol 14 (4) ◽  
pp. 118-125
Author(s):  
I. E. Ioshin
Keyword(s):  
Anterior Segment ◽  
Optical Power ◽  
Intraocular Lenses ◽  
Radius Of Curvature ◽  
Thin Lens ◽  
Main Technique ◽  
Iol Calculation ◽  
Hyperopic Shift ◽  
Keratorefractive Surgery ◽  
Master Device

Effective rehabilitation of patients with cataracts who underwent keratorefractive surgeries requires that the optical power of the IOL be calculated correctly to avoid hyperopic error. The purpose of the 2nd part of the research (for the 1st part, see ROJ, 2021; 14 (2): 55–58) is to present the results of cataract phacoemulsification in patients subjected to keratorefractive surgery based on the author’s algorithm for calculating the optical power of the IOL. Material and methods. The algorithm used optical biometry with an IOL-Master device. The main technique of improving the accuracy of IOL calculation after keratorefractive operations has been to introduce amendments to standard IOL calculation formulas. This work proposes an alternative, which consists in using the Hoffer Q formula, as it is more consistent with changes in the anterior segment of the myopic eye after keratorefractive surgery than other basic. The main distinguishing feature of the Hoffer Q formula is that the corneal refraction is not converted into the radius of curvature but is applied directly as the optical power of a “thin lens”. Results. The empirical customized correction was +1.0 D with regard to the estimated planned postoperative refraction (for patients with initial myopia from -3 to -9 D). The use of the “thin lens” principle made it possible to extrapolate this formula and apply it after LASIK surgery and after radial keratotomy. Conclusion. The proposed technique of IOL calculation was implemented for cataract phacoemulsification in over 200 patients who underwent keratorefractive surgeries. No cases of hyperopic shift of postoperative refraction were noted. The deviation from the planned myopic refraction did not exceed 1.0 D.

Intraocular lenses optic power calculation with seven formulas in short eyes

2021 ◽  
pp. 57-61
Author(s):  
K.B. Pershin ◽  
◽  
N.F. Pashinova ◽  
I.A. Likh ◽  
А.Y. Tsygankov ◽  
...  
Keyword(s):  
Axial Length ◽  
Mean Absolute Error ◽  
Optical Power ◽  
Absolute Error ◽  
Intraocular Lenses ◽  
Power Calculation ◽  
Retrospective Comparison ◽  
Monofocal Iol ◽  
The Mean ◽  
Axial Eye Length

Purpose. The choice of the optimal formula for calculating the IOL optical power in patients with an axial eye length of less than 20 mm. Material and methods. A total of 78 patients (118 eyes) were included in the prospective study. 1st group included 30 patients (52 eyes) with short eyes (average axial eye length of 19.60±0.42 (18.54–20.0) mm), 2nd group consisted of 48 patients (66 eyes) with a axial length 22.75±0.46 (22.0–23.77) mm. Various monofocal IOL models were used. The average follow-up period was 13 months. IOL optical power was calculated using the SRK/T formula, retrospective comparison – according to the formulas Hoffer-Q, Holladay II, Olsen, Haigis, Barrett Universal II and Kane. Results. In 1st group, the mean absolute error was determined for the formulas Haigis, Olsen, Barrett Universal II, Kane, SRK/T, Holladay II and Hoffer-Q (0.85, 0.78, 0.21, 0.17, 0.79, 0.73, 0.19 respectively). When comparing the formulas, significant differences were found for the formulas Hoffer-Q, Barrett Universal II and Kane in comparison with the formulas Haigis, Olsen, SRK/T and Holladay II (p<0.05) in all cases, respectively. In 2nd group, the mean absolute error was determined for the formulas Haigis, Olsen, Barrett Universal II, Kane, SRK/T, Holladay II and Hoffer-Q (0.15, 0.16, 0.23, 0.10, 0.19, 0.23, 0,29 respectively). In 2nd group, there were no significant differences between the studied formulas (p>0.05). Conclusion. This paper presents an analysis of data on the effectiveness of seven formulas for calculating the IOL optical power in short (less than 20 mm) eyes in comparison with the normal axial length. The advantage of the Hoffer-Q, Barrett Universal II and Kane formulas over Haigis, Holladay II, Olsen, and SRK/T is shown. Key words: cataract, hypermetropia, short eyes, calculation of the IOL optical power.

scholarly journals THE DYNAMICS OF THE LENGTH OF THE ANTERIOR-POSTERIOR EYE AXIS FOLLOWING THE EXTRACTION OF UNILATERAL CONGENITAL CATARACTS WITH THE IMPLANTATION OF INTRAOCULAR LENSES IN THE CHILDREN DURING THE FIRST YEAR OF LIFE

2017 ◽  
Vol 12 (1) ◽  
pp. 6-10
Author(s):  
L. A Katargina ◽  
T. B Kruglova ◽  
N. S Egiyan ◽  
O. B Trifonova
Keyword(s):  
Surgical Treatment ◽  
Pediatric Population ◽  
Optical Power ◽  
Intraocular Lenses ◽  
First Year ◽  
Congenital Cataracts ◽  
Before And After ◽  
First Year Of Life ◽  
Anterior Posterior ◽  
Anterior Posterior Axis

Introduction. Unilateral congenital cataracts in the children account for up to 16.0% of the total number of congenital cataracts diagnosed among the pediatric population. Aphakia is considered to be the most physiological method for the surgical treatment and correction of unilateral congenital cataracts in the combination with the implantation of intraocular lenses. The optical power of the lenses is calculated based on the results of evaluation of the dynamics of the length of the anterior-posterior eye axis in individual patients. Aim. The objective of the present study was to analyze the dynamics of the length of the anterior-posterior axis of the eyes in the children presenting with pseudophakia following the extraction of unilateral congenital cataract. Materials and methods. The study included a total of 77 children with unilateral congenital cataracts examined before and after the surgical treatment. Phacoaspiration in the combination with the implantation of intraocular lenses was performed in the patients at the age varying from 3 to 11 months. The infants underwent the ultrasound biometric study and the evaluation of the dynamics of the length of the anterior-posterior axis in the affected eye in comparison with that in the contralateral eye before they reached the age of 7 years. Results. The results of this study give evidence of marked variability of the dynamics of the length of the anterior-posterior axis of the eyes following the early surgical treatment of the children presenting with unilateral congenital cataracts. Conclusion. The differences in the tendency toward the change in the length of the anterior-posterior axis of the eyes following the surgical treatment of unilateral congenital cataracts in the children during the first year of life suggest the necessity of further in-depth investigations and the need for the regular follow-up of such patients for the purpose of choosing the proper approach to the correction of the refraction error and ametropia.

Clinical cases of hydrophilic intraocular lenses opacification at late postoperative period

2019 ◽  
Vol 30 (5) ◽  
pp. 161-164
Author(s):  
A.D. Chuprov ◽  
◽  
A.A. Gorbunov ◽  
Y.S. Kuvaitseva ◽  
◽  
...  
Keyword(s):  
Postoperative Period ◽  
Intraocular Lenses ◽  
Late Postoperative Period ◽  
Clinical Cases

Preventive hygiene measures after reparative osteogenesis in patients with chronic generalized periodontitis

2019 ◽  
Vol 24 (2) ◽  
pp. 179-183
Author(s):  
A. I. Musienko ◽  
К. I. Nesterova ◽  
A. A. Musienko
Keyword(s):  
Sodium Bicarbonate ◽  
Postoperative Period ◽  
Modern Problem ◽  
Surgical Technology ◽  
Dental Implantation ◽  
Group I ◽  
Hygiene Measures ◽  
Orthopedic Care ◽  
Therapeutic Measures ◽  
Postoperative Complaints

Abstract Relevance. Improving the efciency of dental orthopedic care for patients with generalized periodontal disease is an actual modern problem.Materials and methods. A comparative evaluation of the effectiveness of various types of toothpaste in the postoperative period of dental implantation due to partial absence of teeth, periodontitis of moderate severity during gum recession was carried out. In group I (group I, n = 32), patients used a paste containing sodium bicarbonate, in group II (n = 25) – without sodium bicarbonate. Postoperative complaints and symptoms of reactive inflammation were monitored for 10 days; before the operation, after 1, 3, 6 and 12 months after it – hygiene indices Silness J., Loe H., Muhllemen; PMA index.Results. In general, the duration of postoperative reactive inflammation in the groups did not have signifcant differences, but in terms of the relief of edema, bleeding and the severity of breath from the mouth, the best results were in the patients of the group. The hygiene indices before the operation and immediately after it were comparable, but a month after the surgical intervention in patients of group I, all the hygiene indices were better, over time these differences increased and had a reliable character. The Muhlemann index was more dependent on the use of single-stage implantation technology using growth factor, while the PMA index, on the contrary, reflected the effectiveness of not only surgical technology, but also the quality of postoperative hygienic and therapeutic measures.Conclusions. Studies have shown that the systematic use in the postoperative period of toothpaste containing sodium bicarbonate allows you to stop edema, bleeding and the severity of breath from the mouth, improves the performance of basic hygiene indices than other types of toothpastes.

Impact of environmental temperature on optical power properties of intraocular lenses

2014 ◽  
Vol 53 (3) ◽  
pp. 453 ◽  
Author(s):  
Bennett N. Walker ◽  
Robert H. James ◽  
Don Calogero ◽  
Ilko K. Ilev
Keyword(s):  
Environmental Temperature ◽  
Optical Power ◽  
Intraocular Lenses ◽  
Power Properties

scholarly journals Exceptional case of surgical treatment of huge inguinal hernia at the woman

2019 ◽  
Vol 21 (2) ◽  
pp. 52-57
Author(s):  
I A Solovyov ◽  
D V Cherkashin ◽  
M V Vasilchenko ◽  
B B Bromberg ◽  
O V Balyura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inguinal Hernia ◽  
Postoperative Period ◽  
Clinical Case ◽  
Exceptional Case ◽  
Self Service ◽  
Surgical Tactics ◽  
The Right ◽  
First Time

Despite significant progress in a health care system the started cases of huge inguinal hernias still meet. For successful treatment of such patients objective diagnostics, preoperative preparation, the choice of suitable tactics of surgery and treatment in the postoperative period is important. The clinical case of treatment by not reducible huge inguinal hernia at the patient of 73 years is presented in article. The patient showed complaints to presence of the big sizes of the hernia in the bottom of a stomach limiting movement of the patient and self-service reducing quality of life. For the first time hernial protrusion in inguinal area has appeared in 2008 which gradually increased in sizes. Since 2015 I have noted the intensive growth of hernia. I didn’t ask for medical care. To clinic it is brought by an ambulance crew with the diagnosis of The Restrained Inguinal Hernia direction. At the time of survey data for infringement weren’t. After comprehensive examination to the patient surgery in volume has been executed: a gryzhesecheniye on the right, plasticity across Liechtenstein. The postoperative period proceeded without complications. The patient is written out for the 13th days after operation. Extremely exceptional clinical case, the choice of adequate stage-by-stage preoperative inspection and treatment, optimum surgical tactics and postoperative kuration is shown. The chosen approach led to prevention of development of a cascade of the complications including a compartment syndrome, to elimination of cosmetic defect and restoration of quality of life.

scholarly journals APPENDICULAR PERITONITIS IN CHILDREN: AN EFFICIENT SURGICAL APPROACH AND INTENSIVE CARE

2020 ◽  
Vol 24 (2) ◽  
pp. 62-70
Author(s):  
O. V. Karaseva ◽  
Kseniia E. Utkina ◽  
A. L. Gorelik ◽  
A. V. Timofeeva ◽  
D. E. Golikov ◽  
...  
Keyword(s):  
Intensive Care ◽  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Postoperative Period ◽  
Diffuse Peritonitis ◽  
Surgical Tactics ◽  
Adhesive Intestinal Obstruction ◽  
Local Protocol

Introduction. Currently, there is no any unified approach to the treatment of complicated forms of acute appendicitis in children. The purpose of our study is to evaluate the effectiveness of the local Protocol for diagnostics and treatment of appendicular peritonitis (AP) in children. Material and methods. 149 children with AP, aged 2 - 17 (11 ± 3.5 ), were included into the study. All of them were treated at the Clinical and Research Institute Emergency Pediatric Surgery and Trauma (CRIEPST) in 2015-2018. In the gender structure, boys (104; 69.8%) prevailed over girls (45; 30.2%). The following parameters were evaluated: AP structure, surgical tactics, postoperative course (incidence of postoperative intestinal failure syndrome (IFS), postoperative complications, length of hospital stay). A tactics for surgical treatment and volume of intensive care in the postoperative period were defined depending on AP severity and according to the local Protocol. Laparoscopic appendectomy was performed in 145 (97.3%) patients. There were no intraoperative complications and conversions in the studied group. In case of periappendiular abscess (PA) 3 (2.7%), patients had puncture and abscess drainage under ultrasound control. Results. While analyzing the AP structure by forms , the following picture was shown: free and abscessed forms were approximately equal - 72 (48.3%) and 77 (51.7%), respectively (p > 0.05). Diffuse peritonitis - 31.5%; generalized - 16.8%; combined - 17.4%; periappendicular abscess (PA) stage 1-14.8%; PA 2-16.8%; PA 3-2.7%. Postoperative complications - 4 (2.7%): postoperative abdominal abscesses - 3 (2.0%); early adhesive intestinal obstruction - 1 (0.7%). In postoperative abscesses, puncture and drainage were performed under ultrasound control; in early adhesive intestinal obstruction - laparoscopic adhesiolysis. All the children recovered. Length of intensive care was 2.9 ± 1.8 days; hospitalization - 12.0 ± 5.2 days. Conclusion. The local Protocol developed by the researchers helps to define a surgical tactics and volume of intensive care in the postoperative period. Laparoscopic surgery, in the vast majority of cases, is an optimal and effective technique for AP surgical treatment in children. Contraindications to laparoscopic surgery are PA 3 and total abscessing peritonitis.

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