Офтальмохирургия. 2018; : 19-25
Результаты факоэмульсификации с имплантацией ИОЛ у пациентов с эндотелиальной дистрофией роговицы Фукса
https://doi.org/10.25276/0235-4160-2018-3-19-25Аннотация
Цель. Изучить клинико-функциональные результаты лечения пациентов с катарактой и начальной стадией первичной эндотелиальной дистрофии роговицы Фукса (ДФ) методом ультразвуковой факоэмульсификации с имплантацией эластичной интраокулярной линзы (ИОЛ).
Материал и методы. Ультразвуковая факоэмульсификация с имплантацией ИОЛ и дальнейшее наблюдение за клинико-функциональными параметрами проводилось у 23-х пациентов с катарактой и ДФ: 6 мужчин (26,1%) и 17 женщин (73,9%), средний возраст которых составил 71,2±17,9 года (от 54 до 88 ле т).
Результаты. Интраоперационных осложнений не наблюдали. Транзиторный отек роговицы определяли в 17,4% (4 пациента). В 8,7% (2 пациента) случаев спустя 3-6 мес. после операции отмечали развитие стойкого отёка роговицы, острота зрения 0,2 и ниже. Этим пациентам провели трансплантацию десцеметовой мембраны. Скорригированная острота зрения на всех сроках наблюдения была высокой (0,8±0,11). Средние значения кератопахиметрии (КПМ) составили 582±32 мкм к 6-му мес. послеоперационного периода. Потеря эндотелиальных клеток через 1 мес. после хирургического лечения составила 19%, к 6-ти мес. после операции – 22,4%, к 12-ти – 22,9%, к 24-м – 24,9%. Плотность эндотелиальных клеток ко 2-му году наблюдения составила 745±162 кл/мм2.
Заключение. Проведение ультразвуковой факоэмульсификации с имплантацией гидрофобной модели ИОЛ является возможным и целесообразным для лечения пациентов с начальной стадией дистрофии роговицы Фукса и катарактой. При этом необходимо применять наиболее щадящие ультразвуковые и гидродинамические параметры, а также осуществлять максимальную протекцию эндотелиального слоя роговицы.
Список литературы
1. Ермаков Н.В. Микроскопия заднего эпителия роговицы в реконструктивной хирургии переднего отдела глаза // Съезд офтальмологов России, 6-й: Тез. докл. – М., 1994. – 297 с.
2. Федоров С.Н., Егорова Э.В. Ошибки и осложнения при имплантации искусственного хрусталика. – М., 1992. – 224 с.
3. Abell R.G., Kerr N.M., Howie A.R. et al. Effect of femtosecond laser–assisted cataract surgery on the corneal endothelium // J. Cataract Refract. Surg. – 2014. – Vol. 40. – P. 1777-1783.
4. Adamis A.P., Filatov V., Tripathi B.J., Tripathi R.C. Fuchs’ endothelial dystrophy of the cornea // Surv. Ophthalmol. – 1993. – Vol. 38, № 2. – P. 147-168.
5. Davies E., Jurkunas U., Pineda R 2nd. Predictive Factors for Corneal Clearance After Descemetorhexis Without Endothelial Keratoplasty // Cornea. – 2018. – Vol. 37 (2). – P. 137-140.
6. Day A.C., Gore D.M., Bunce C., Evans J.R. Laserassisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery // Cochrane Database Syst. Rev. – 2016. – Vol. 7. – CD010735.
7. DeBry P., Olson R.J., Crandall A.S. Comparison of energy required for phaco-chop and divide and conquer phacoemulsification // J. Cataract Refract. Surg. – 1998. – Vol. 24, № 5. – P. 689-692.
8. Gavriş M., Horge I., Avram E. et al. Fuchs endothelial corneal dystrophy: is femtosecond laserassisted cataract surgery the right approach // Rom. J. Ophthalmol. – 2015. – Vol. 59, № 3. – P. 159-163.
9. Gharaee H., Kargozar A., Daneshvar-Kakhki R. et al. Correlation between Corneal Endothelial Cell Loss and Location of Phacoemulsification Incision. //J. Ophthalmic Vis. Res. – 2011. – Vol. 6 (1). – P. 13-17.
10. Hayashi K., Hayashi H., Nakao F., Hayashi F. Risk factors for corneal endo- thelial injury during phacoemulsification // J. Cataract Refract. Surg. – 1996. – Vol. 22. – P. 1079-1084.
11. Hayashi K., Yoshida M., Manabe S., Hirata A. Cataract surgery in eyes with low corneal endothelial cell density // J. Cataract Refract. Surg. – 2011. – Vol. 37 (8). – P. 1419-1425.
12. Kaufman H.E., Capella J.A., Robbins J.E. The human corneal endothelium // Am. J. Ophthalmol. – 1966. – Vol. 61. – P. 835-841.
13. Kim H.Y., Budenz D.L. et al. Comparison of central corneal thickness using anterior segment optical coherence tomography vs ultrasound pachymetry // Am. J. Ophthalmol. – 2008. – Vol. 145, № 2. – P. 228-232.
14. Kobayashi A. Analysis of COL8A2 gene mutation in Japanese patients with Fuchs’ endothelial dystrophy and posterior polymorphous dystrophy // Jpn. J. Ophthalmol. – 2004. – Vol. 48, № 3. – P. 195-198.
15. Liu Y., Zeng M., Liu X. Torsional mode versus conventional ultrasound mode phacoemulsification: randomized comparative clinical study // J. Cataract Refract. Surg. – 2007. – Vol. 33, № 2. – P. 287-292.
16. MacLean K.D., Apel A., Wilson J., Werner L. Calcification of hydrophilic acrylic intraocular lenses associated with intracameral air injection following DMEK // J. Cataract. Refract Surg. – 2015. – Vol. 41, № 6. – P. 1310-1314.
17. Manning S., Barry P., Henry Y. et al. Femtosecond laser–assisted cataract surgery versus standard phacoemul- sification cataract surgery: Study from the European Registry of Quality Out- comes for Cataract and Refractive Surgery // J. Cataract Refract. Surg. – 2016. – Vol. 42. – P. 1779-1790.
18. Moloney G., Petsoglou C., Ball M. et al. // Cornea. – 2017. – Vol. 36, № 6. – P. 642-648.
19. Nayak B.K., Jain E.K. Comparison of corneal endothelial cell loss during phacoemulsification using continuous anterior chamber infusion versus those using ophthalmic viscosurgical device: Randomized controlled trial // Ind. J. Ophthalmol. – 2009. – Vol. 57 (2). – P. 99-103.
20. Norouzpour A., Zarei-Ghanavati S. Hydrophilic Acrylic Intraocular Lens Opacification after Descemet Stripping Automated Endothelial Keratoplasty // J. Ophthalmic Vis. Res. – 2016. – Vol. 11, № 2. – P. 225-227.
21. O’Brien P.D., Fitzpatrick P., Kilmartin D.J., Beatty S. Risk factors for endothelial cell loss after phacoemulsification surgery by a junior resident //J. Cataract Refract. Surg. – 2004. – Vol. 30, № 4. – P. 839-843.
22. Parker J., Dirisamer M., Naveiras M. et al. Outcomes of Descemet membrane endothelial keratoplasty in phakic eyes // J. Cataract Refract. Surg. – 2012. – Vol. 38, № 5. – P. 871-877.
23. Popovic M., Campos-Moller X., Schlenker M.B., Ahmed K II. Efficacy and safety of femtosecond laser-assisted cataract surgery compared with manual cataract surgery; a meta-analysis of 14 567 eyes // Ophthalmology. – 2016. – 123. – 2113-2126.
24. Rekas M., Montés-Micó R., Krix-Jachym K. et al. Comparison of torsional and longitudinal modes using phacoemulsification parameters // J. Cataract Refract. Surg. – 2009. – Vol. 35, № 10. – P. 1719-1724.
25. Schultz T., Joachim S.C., Kuehn M., Dick H.B. Changes in prostaglandin levels in patients undergoing femtosecond laser-assisted cataract surgery // J. Refract. Surg. – 2013. – Vol. 29. – P. 742-747.
26. Seitzman G.D. Cataract surgery in Fuchs’ dystrophy // Curr. Opin. Ophthalmol. – 2005. – Vol. 16, № 4. – P. 241-245.
27. Seitzman G.D., Gottsch J.D., Stark W.J. Cataract surgery in patients with Fuchs’ corneal dystrophy: expanding recommendations for cataract surgery without simultaneous keratoplasty // Ophthalmology. – 2005. – Vol. 112, № 3. – P. 441-446.
28. Van Cleynenbreugel H., Remeijer L., Hillenaar T. Cataract surgery in patients with Fuchs’ endothelial corneal dystrophy: when to consider a triple procedure // Ophthalmology. – 2014. – Vol. 121, № 2. – P. 445-537.
29. Walkow T., Anders N., Klebe S. Endothelial cell loss after phacoemulsifica- tion: relation to preoperative and intraoperative parameters // J. Cataract Refract Surg. – 2000. – Vol. 26. – P. 727-732.
30. Weiss J.S., Møller H.U., Lisch W. et al. The IC3D classification of the corneal dystrophies // Cornea. – 2008. – Vol. 27, Suppl. 2. – S1-83.
31. Weiss J.S., Møller H.U., Aldave A.J. et al. IC3D classification of corneal dystrophies--edition 2 // Cornea. – 2015. – Vol. 34, № 2. – P. 117-159.
32. Xie L.X., Yao Z., Huang Y.S. et al. Surgery for treatment of senile cataract with Fuchs’ endothelial dystrophy // Chinese J. Ophthalmol. – 2003. – Vol. 39 (10). – P. 597-600.
33. Yamazoe K., Yamaguchi T., Hotta K. et al. Outcomes of cataract surgery in eyes with a low corneal endothelial cell density // J. Cataract Refract. Surg. – 2011. – Vol. 37, № 12. – P. 2130-2136.
34. Zhy D.C., Shah P., Feuer W.J. et al. Outcomes of conventional phacoemulsification versus femtosecond laser-assisted cataract surgery in eyes with Fuchs endothelial corneal dystrophy // J. Cataract Refract. Surg. –2018. – Vol. 44, № 5. – P. 534-540.
Fyodorov Journal of Ophthalmic Surgery. 2018; : 19-25
Results of phacoemulsification with IOL implantation in patients with Fuchs endothelial corneal dystrophy
https://doi.org/10.25276/0235-4160-2018-3-19-25Abstract
Purpose. To evaluate the results of treatment in patients with cataract and Fuchs endothelial corneal dystrophy (FECD) after phacoemulsification and IOL implantation.
Material and methods. Ultrasound phacoemulsification with IOL implantation and further clinical-functional parameters follow-up was performed in 23 patients: 6 males (26.1%) and 17 females (73.9%), the mean age was 71.2±17.9 (from 54 to 88 years).
Results. No intraoperative complications were registered. Transient corneal edema was observed in 17.4% (4 patients). In 8.7% of cases (2 patients) 3-6 months after the surgery persistent cornea edema was revealed, the visual acuity (VA) was 0.2 and those patients were treated with the Descemet’s membrane transplantation (DMEK). The best corrected visual acuity (BCVA) was high (0.8±0.11) within all follow-up periods. Mean values of corneal pachymetry was 582±32μm 6 months after the surgery. Endothelial cells loss was 19% – 1 month postoperatively, 22.4% – 6 months, 22.9% – 12 months, 24.9% 24 months later. Final endothelial cell density (ECD) 24 months postoperatively was 745±162 cells/mm2.
Conclusions. The US phacoemulsification with hydrophobic IOL implantation is eventual, expedient and efficient for treatment of patients with cataract and early stage of FECD. Minimal US and hydrodynamic parameters settings are favorable to provide a better corneal endothelial protection.
References
1. Ermakov N.V. Mikroskopiya zadnego epiteliya rogovitsy v rekonstruktivnoi khirurgii perednego otdela glaza // S\"ezd oftal'mologov Rossii, 6-i: Tez. dokl. – M., 1994. – 297 s.
2. Fedorov S.N., Egorova E.V. Oshibki i oslozhneniya pri implantatsii iskusstvennogo khrustalika. – M., 1992. – 224 s.
3. Abell R.G., Kerr N.M., Howie A.R. et al. Effect of femtosecond laser–assisted cataract surgery on the corneal endothelium // J. Cataract Refract. Surg. – 2014. – Vol. 40. – P. 1777-1783.
4. Adamis A.P., Filatov V., Tripathi B.J., Tripathi R.C. Fuchs’ endothelial dystrophy of the cornea // Surv. Ophthalmol. – 1993. – Vol. 38, № 2. – P. 147-168.
5. Davies E., Jurkunas U., Pineda R 2nd. Predictive Factors for Corneal Clearance After Descemetorhexis Without Endothelial Keratoplasty // Cornea. – 2018. – Vol. 37 (2). – P. 137-140.
6. Day A.C., Gore D.M., Bunce C., Evans J.R. Laserassisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery // Cochrane Database Syst. Rev. – 2016. – Vol. 7. – CD010735.
7. DeBry P., Olson R.J., Crandall A.S. Comparison of energy required for phaco-chop and divide and conquer phacoemulsification // J. Cataract Refract. Surg. – 1998. – Vol. 24, № 5. – P. 689-692.
8. Gavriş M., Horge I., Avram E. et al. Fuchs endothelial corneal dystrophy: is femtosecond laserassisted cataract surgery the right approach // Rom. J. Ophthalmol. – 2015. – Vol. 59, № 3. – P. 159-163.
9. Gharaee H., Kargozar A., Daneshvar-Kakhki R. et al. Correlation between Corneal Endothelial Cell Loss and Location of Phacoemulsification Incision. //J. Ophthalmic Vis. Res. – 2011. – Vol. 6 (1). – P. 13-17.
10. Hayashi K., Hayashi H., Nakao F., Hayashi F. Risk factors for corneal endo- thelial injury during phacoemulsification // J. Cataract Refract. Surg. – 1996. – Vol. 22. – P. 1079-1084.
11. Hayashi K., Yoshida M., Manabe S., Hirata A. Cataract surgery in eyes with low corneal endothelial cell density // J. Cataract Refract. Surg. – 2011. – Vol. 37 (8). – P. 1419-1425.
12. Kaufman H.E., Capella J.A., Robbins J.E. The human corneal endothelium // Am. J. Ophthalmol. – 1966. – Vol. 61. – P. 835-841.
13. Kim H.Y., Budenz D.L. et al. Comparison of central corneal thickness using anterior segment optical coherence tomography vs ultrasound pachymetry // Am. J. Ophthalmol. – 2008. – Vol. 145, № 2. – P. 228-232.
14. Kobayashi A. Analysis of COL8A2 gene mutation in Japanese patients with Fuchs’ endothelial dystrophy and posterior polymorphous dystrophy // Jpn. J. Ophthalmol. – 2004. – Vol. 48, № 3. – P. 195-198.
15. Liu Y., Zeng M., Liu X. Torsional mode versus conventional ultrasound mode phacoemulsification: randomized comparative clinical study // J. Cataract Refract. Surg. – 2007. – Vol. 33, № 2. – P. 287-292.
16. MacLean K.D., Apel A., Wilson J., Werner L. Calcification of hydrophilic acrylic intraocular lenses associated with intracameral air injection following DMEK // J. Cataract. Refract Surg. – 2015. – Vol. 41, № 6. – P. 1310-1314.
17. Manning S., Barry P., Henry Y. et al. Femtosecond laser–assisted cataract surgery versus standard phacoemul- sification cataract surgery: Study from the European Registry of Quality Out- comes for Cataract and Refractive Surgery // J. Cataract Refract. Surg. – 2016. – Vol. 42. – P. 1779-1790.
18. Moloney G., Petsoglou C., Ball M. et al. // Cornea. – 2017. – Vol. 36, № 6. – P. 642-648.
19. Nayak B.K., Jain E.K. Comparison of corneal endothelial cell loss during phacoemulsification using continuous anterior chamber infusion versus those using ophthalmic viscosurgical device: Randomized controlled trial // Ind. J. Ophthalmol. – 2009. – Vol. 57 (2). – P. 99-103.
20. Norouzpour A., Zarei-Ghanavati S. Hydrophilic Acrylic Intraocular Lens Opacification after Descemet Stripping Automated Endothelial Keratoplasty // J. Ophthalmic Vis. Res. – 2016. – Vol. 11, № 2. – P. 225-227.
21. O’Brien P.D., Fitzpatrick P., Kilmartin D.J., Beatty S. Risk factors for endothelial cell loss after phacoemulsification surgery by a junior resident //J. Cataract Refract. Surg. – 2004. – Vol. 30, № 4. – P. 839-843.
22. Parker J., Dirisamer M., Naveiras M. et al. Outcomes of Descemet membrane endothelial keratoplasty in phakic eyes // J. Cataract Refract. Surg. – 2012. – Vol. 38, № 5. – P. 871-877.
23. Popovic M., Campos-Moller X., Schlenker M.B., Ahmed K II. Efficacy and safety of femtosecond laser-assisted cataract surgery compared with manual cataract surgery; a meta-analysis of 14 567 eyes // Ophthalmology. – 2016. – 123. – 2113-2126.
24. Rekas M., Montés-Micó R., Krix-Jachym K. et al. Comparison of torsional and longitudinal modes using phacoemulsification parameters // J. Cataract Refract. Surg. – 2009. – Vol. 35, № 10. – P. 1719-1724.
25. Schultz T., Joachim S.C., Kuehn M., Dick H.B. Changes in prostaglandin levels in patients undergoing femtosecond laser-assisted cataract surgery // J. Refract. Surg. – 2013. – Vol. 29. – P. 742-747.
26. Seitzman G.D. Cataract surgery in Fuchs’ dystrophy // Curr. Opin. Ophthalmol. – 2005. – Vol. 16, № 4. – P. 241-245.
27. Seitzman G.D., Gottsch J.D., Stark W.J. Cataract surgery in patients with Fuchs’ corneal dystrophy: expanding recommendations for cataract surgery without simultaneous keratoplasty // Ophthalmology. – 2005. – Vol. 112, № 3. – P. 441-446.
28. Van Cleynenbreugel H., Remeijer L., Hillenaar T. Cataract surgery in patients with Fuchs’ endothelial corneal dystrophy: when to consider a triple procedure // Ophthalmology. – 2014. – Vol. 121, № 2. – P. 445-537.
29. Walkow T., Anders N., Klebe S. Endothelial cell loss after phacoemulsifica- tion: relation to preoperative and intraoperative parameters // J. Cataract Refract Surg. – 2000. – Vol. 26. – P. 727-732.
30. Weiss J.S., Møller H.U., Lisch W. et al. The IC3D classification of the corneal dystrophies // Cornea. – 2008. – Vol. 27, Suppl. 2. – S1-83.
31. Weiss J.S., Møller H.U., Aldave A.J. et al. IC3D classification of corneal dystrophies--edition 2 // Cornea. – 2015. – Vol. 34, № 2. – P. 117-159.
32. Xie L.X., Yao Z., Huang Y.S. et al. Surgery for treatment of senile cataract with Fuchs’ endothelial dystrophy // Chinese J. Ophthalmol. – 2003. – Vol. 39 (10). – P. 597-600.
33. Yamazoe K., Yamaguchi T., Hotta K. et al. Outcomes of cataract surgery in eyes with a low corneal endothelial cell density // J. Cataract Refract. Surg. – 2011. – Vol. 37, № 12. – P. 2130-2136.
34. Zhy D.C., Shah P., Feuer W.J. et al. Outcomes of conventional phacoemulsification versus femtosecond laser-assisted cataract surgery in eyes with Fuchs endothelial corneal dystrophy // J. Cataract Refract. Surg. –2018. – Vol. 44, № 5. – P. 534-540.
