[Optimization of phacoemulsification technique for Morgagnian cataract].

Q3 Medicine Vestnik oftalmologii Pub Date : 2024-01-01 DOI:10.17116/oftalma202414002124

E S Pirogova, O L Fabrikantov, S I Nikolashin

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Abstract

Purpose: This study was conducted to develop a new optimized phacoemulsification technique for Morgagnian cataract taking into account the anatomical and topographic parameters of the lens nucleus.

Material and methods: A working classification of Morgagnian cataract was developed based on the size of the nucleus: if the edge of the nucleus is visualized at the upper edge of the pupil or between the upper edge and the middle of the pupil, it was classified as an initial stage of Morgagnian cataract with a large nucleus; if the upper edge of the nucleus is visualized in the middle of the pupil and below, it was classified as an advanced stage of Morgagnian cataract with a small nucleus. The first group included six patients who underwent surgery using the scaffold technique with removal of the whole small nucleus into the anterior chamber. The second group included 11 patients who underwent surgery using the scaffold technique with removal of the last fragment of the nucleus into the anterior chamber.

Results: The use of the scaffold technique with removal of the nucleus into the anterior chamber helped reduce the number of intraoperative complications to 16.7% in the first group, compared to 27.3% in the second group, and the percentage of endothelial cell loss to 10.1% in the first group, compared to 10.7% in the second group.

Conclusions: The anatomical and topographic features of the lens and the anterior segment of the eye in Morgagnian cataract with a small nucleus allow for preliminary implantation of an intraocular lens into the capsular bag to protect the posterior capsule during phacoemulsification of the nucleus with minimal mechanical, hydrodynamic and acoustic damage to the surrounding structures of the eye.

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[摩根白内障超声乳化技术的优化]。

目的：本研究旨在根据晶状体核的解剖学和地形学参数，为莫加尼白内障开发一种新的优化超声乳化技术：根据晶状体核的大小对莫加尼白内障进行分类：如果晶状体核的边缘位于瞳孔的上缘或上缘与瞳孔中部之间，则属于晶状体核大的莫加尼白内障初期；如果晶状体核的上缘位于瞳孔中部及以下，则属于晶状体核小的莫加尼白内障晚期。第一组包括 6 名患者，他们接受了支架技术手术，将整个小核摘除到前房。第二组包括 11 名患者，他们接受了支架技术手术，并将最后一块晶状体核摘除到前房：第一组患者术中并发症发生率为16.7%，第二组为27.3%；第一组患者内皮细胞丢失率为10.1%，第二组为10.7%：结论：小核莫氏白内障患者的晶状体和眼球前段的解剖和地形特征允许在乳化手术中将眼内晶状体初步植入囊袋以保护后囊，同时将对眼球周围结构造成的机械、流体动力和声学损伤降至最低。

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来源期刊

Vestnik oftalmologii Medicine-Ophthalmology

CiteScore

0.80

自引率

0.00%

发文量

129

期刊介绍： The journal publishes materials on the diagnosis and treatment of eye diseases, hygiene of vision, prevention of ophthalmic affections, history of Russian ophthalmology, organization of ophthalmological aid to the population, as well as the problems of special equipment. Original scientific articles and surveys on urgent problems of theory and practice of Russian and foreign ophthalmology are published. The journal contains book reviews on ophthalmology, information on the activities of ophthalmologists" scientific societies, chronicle of congresses and conferences.The journal is intended for ophthalmologists and scientific workers dealing with clinical problems of diseases of the eye and physiology of vision.