Study of preoperative symmetry of distance «lens equator – ciliary processes» in patients with combination of senile cataract with clinical manifestations of involutional connective tissue dysplasia

Purpose. Study of state of the Zonule of Zinn in patients with combination senile cataract with systemic involutional connective tissue dysplasia. Material and methods. 97 patients (97 eyes) – combination senile cataract with involutional pathology in connective tissue (the main group). 1st subgroup: 31 patients with kyphoscoliotic deformity of the 3d and 4th degree (classification by V.D. Chaklin (1973)); 2nd subgroup – 66 patients with chronic venous insufficiency 2nd and 3d degree (the CEAP classification) against the background of varicose veins of the lower extremity. Patients of both subgroups were comparable in terms of cataract stages and nuclear cataract lens density in Buratto classification. The control group – 55 patients (55 eyes) similar sex and age with senile cataracts without involutional connective tissue pathology. We estimated the symmetry of distance «lens equator – ciliary processes» in 2 meridians: at 6 and 12 hours. The presence of asymmetry of 0.3 mm or more was sign of weak zonular support (according to ultrasonic biomicroscopy). Results. In the control group, the distance was 0.3 mm in 3 eyes (5%), with intraoperative formation of folds in the anterior capsule. In 10 eyes of the 1st subgroup of the main group (32%), the presence of distance asymmetry was revealed: intraoperative, signs of subluxation of the lens of the 1st degree were detected in 7 eyes. In the 2nd subgroup of the main group, distance asymmetry was detected in 24 eyes (37%). Folded anterior lens capsule was determined intraoperative in 14 eyes (21%) during anterior capsulorhexis and lens mobility during nucleus emulsification. Conclusion. A statistically significant difference in frequency of asymmetries of distances «lens equator – ciliary processes» in 2 opposite meridians was revealed between groups of patients with senile cataract against the background of systemic somatic involutional pathology of connective tissue and without it (35% vs. 5%; p < 0.01). Keywords: senile cataract, Zonule of Zinn, involutional changes in connective tissue, ultrasound biomicroscopy