K.B. PERSHIN¹, N.F. PASHINOVA¹, M.M. KONOVALOVA², A.Yu. TSYGANKOV¹, M.E. KONOVALOV²

¹«Eximer» Ophthalmology Center, 3/1 Marksistskaya Str., Moscow, Russian Federation, 109147

²Konovalov Ophthalmology Center, 56/6 3^rd Tverskaya-Yamskaya Str., Moscow, Russian Federation, 125047

Pershin K.B. ― Doc. Med. Sc., Professor, Medical Director, tel. (495) 620-35-55, e-mail: kpershin@mail.ru

Pashinova N.F. ― Doc. Med. Sc., Chief Doctor, tel. (495) 620-35-55, e-mail: pashinovan@mail.ru

Konovalova M.M. ― assistant ophthalmologist, e-mail: mariakonovalova11@gmail.com

Tsygankov A.Yu. ― PhD (medicine), scientific assistant, e-mail: alextsygankov1986@yandex.ru

Konovalov M.E. ― D. Sc. (medicine), Professor, Chief Doctor, tel. (499) 250-55-49, e-mail: konovalov@konovalov-eye-center.ru

 The feasibility of performing a primary posterior capsulorhexis in patients with implantation of bifocal IOLs was assessed. A total of 34 patients (40 eyes) were examined and treated. Men accounted for 44.1%, women ― 55.9%. The average age of the patients was 57.1±7.0 years. In all investigated cases, a complex preoperative examination was performed. The phacoemulsification was performed using Stellaris and Infinity microsurgical systems through a corneal temporal tunnel incision of 1.8-2.0 mm. The authors propose a new technique of primary posterior capsulorhexis, including the use of two types of viscoelastics and the implementation of capsulorhexis after implantation of the IOL. In all cases, the bifocal IOL Acrysof IQ Restor was implanted, the target refraction was ±0.25 D. The observation period was from 6 to 60 (13.4±10.2) months. Significant intra- and postoperative complications were not detected. An increase in the UCVA 6 months after surgery (p<0.05) was achieved: from 0.13±0.11 to 0.85±0.21 in the distance and 0.77±0.21 near, BCVA from 0.25±0.20 to 0.93±0.13 in the distance and 0.83±0.21 near. Reduction of the spherical and cylindrical component of refraction is shown. The data obtained indicate the safety and effectiveness of the proposed method. To determine the indications and contraindications, it is necessary to conduct a comparative study with patients with a preserved posterior capsule of the lens and multifocal correction.

Key words: cataract, bifocal IOLs, multifocal IOLs, primary posterior capsulorhexis.

(For citation: Pershin K.B., Pashinova N.F., Konovalova M.M., Tsygankov A.Yu., Konovalov M.E. Experience of primary posterior capsulorhexis in bifocal IOLs implantation. Practical Medicine. 2018)

REFERENCES

1. Pashtaev N.P., Suslikov S.V. Long-term results of 1000 cataracts removal with implantation of combined IOL. Oftal’mokhirurgiya, 1997, no. 2, pp. 20-24 (in Russ.).
2. Vasavada A.R., Praveen M.R. Posterior Capsule Opacification After Phacoemulsification: Annual Review. Asia Pac. J. Ophthalmol. (Phila), 2014, vol. 3, no. 4, pp. 235-240.
3. Stager D.R. Jr, Weakley D.R. Jr, Hunter J.S. Long-term rates of PCO following small incision foldable acrylic intraocular lens implantation in children. J. Pediatr. Ophthalmol. Strabismus, 2002, vol. 39, no. 2, pp. 73-76.
4. Balashevich L.I., Takhtaev Yu.V., Radchenko A.G. Rear capsulorhexis during phacoemulsification with a transparent posterior capsule of the lens. Oftal’mokhirurgiya, 2008, no. 1, pp. 36-41 (in Russ.).
5. Stebnev V.S., Malov V.M., Stebnev S.D. Immediate and distant results of primary back capsulorhexis during phacoemulsification. Vestnik Orenburgskogo gosudarstvennogo universiteta, 2011, no. 14, pp. 352-355 (in Russ.).
6. Stifter E., Menapace R., Luksch A., et al. Anterior chamber depth and change in axial intraocular lens position after cataract surgery with primary posterior capsulorhexis and posterior optic buttonholing. J. Cataract. Refract. Surg, 2008, vol. 34, no. 5, pp. 749-754.
7. Fabrikantov O.L., Nikolashin S.I., Pirogova E.S. Pat. 2601920 Rossiyskaya Federatsiya, A61F. Sposob vypolneniya pervichnogo zadnego kapsuloreksisa do implantatsii intraokulyarnoy linzy na glazakh s fibrozno izmenennoy zadney kapsuloy; zayavitel’ i patentoobladatel’ FGBU “MNTK “Mikrokhirurgiya glaza” imeni akademika S.N. Fedorova” Ministerstva zdravookhraneniya Rossiyskoy Federatsii ― no. 2601920/15; opubl. 10.11.2016 [Pat. 2601920 Russian Federation, A61F. A method of performing a primary posterior capsulorhexis prior to implantation of the intraocular lens in the eyes with a fibrously modified posterior capsule; Applicant and patent holder of FGBU «MNTK» Eye Microsurgery «named after academician S.N. Fedorov «of the Ministry of Health of the Russian Federation — No. 2601920/15; publ. 11/10/2016].