Phacoemulsification of Cataract in Patients Undergone Anterior Radial Keratotomy
Sovremennye tehnologii v medicine
The aim of the investigation was to specify the conditions of performing cataract phacoemulsification in patients with previous anterior radial keratotomy (ARK), enabling optimization of the operation results. Materials and Methods. We examined 27 patients (46 eyes) at the age of 44-62 years suffering age-related cataract of various density, who underwent ARK for myopia and myopic astigmatism 22.8±1.4 years ago. Before the operation the refracting power of the cornea and axial eye length were
... l eye length were determined. Intraocular lens power was calculated with the help of Hoffer Q formula with corrections. All patients underwent cataract phacoemulsification with implantation of foldable intraocular lenses in the capsular bag through the tunnelshaped corneal or scleral access 2.2 mm wide. Results. All operations were uneventful. Visual acuity without correction increased from 0.18±0.07 to 0.54±0.07 (p<0.05) on average, with correction from 0.29±0.04 to 0.89±0.04 (p<0.05). Clinical refraction reached -1.35±0.37 D on average. Endothelial cell loss was 5.3% and did not exceed it in uncomplicated phacoemulsification. Creation of a "safety zone" in the form of intact cornea between the tunnel margins and keratomic scars not less than 0.5 mm wide prevented the risk of scar dehiscence during separate steps of phacoemulsification. Conclusion. Precise determination of refracting corneal power and axial eye length, application of the third-generation Hoffer Q formula with corrections, individual approach to the operation access selection depending on the width of the "safety zone" between the tunnel margins and keratomic scars, measures taken to protect endothelium during the operation allow the achievement of high functional results after cataract phacoemulsification in patients undergone ARK.