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Compensating the Descemet's membrane defect (a clinical case study)
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01.01.2018 |
Voronin G.
Mamikonyan V.
Trufanov S.
Narbut M.
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Vestnik oftalmologii |
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0 |
Ссылка
The article describes a clinical case of Descemet's membrane detachment that occurred during cataract phacoemulsification with implantation of intraocular lens. Significant corneal edema developed in the early post-op period. Considering the ability of endothelium to close its own defects even with large injury area, the patient was followed-up for 2 years. Corneal edema was treated during 4 months and concluded with instillations of osmotic and anti-inflammatory drugs. At 1.5-2 months of therapy, the edema was gradually decreasing, and by the 4th month of the follow-up the cornea was practically transparent. Density of endothelial cells in central cornea, where the Descemet's membrane was absent, comprised 1000 cells/mm2. Further observation revealed cornea staying transparent for 2 years after the surgery. Complete optical recovery of patients with Descemet's membrane defect in this case study is supported by similar clinical cases briefly described in the article, and evidence that structural functional recovery of the corneal endothelial layer is possible even when it has large defects (more than 2.5 mm in diameter).
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Influence of cataract phacoemulsification on eye hydrodynamics in patients with prior trabeculectomy
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01.01.2018 |
Avetisov S.
Erichev V.
Petrov S.
Volzhanin A.
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Vestnik Oftalmologii |
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0 |
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© 2018, Media Sfera. All rights reserved. At present, phacoemulsification and trabeculectomy are the most widespread surgery methods in cataract and glaucoma treatment, generally recognized as the gold standard. Among elderly patients, comorbid glaucoma and cataract are extremely prevalent, so the order of the two surgeries and the time interval between them are pivotal choices when planning treatment strategy. The reason for it is that almost any eye surgery is considered a risk factor for long-term trabeculectomy effectiveness. In attempts to solve this problem, numerous studies have been conducted on the impact of cataract surgery on filtration bleb scarring. The problem of determining the time interval between surgeries, as well as other treatment nuances, remains relevant despite the long history of research and publications. Some results are cited as general recommendations on treatment tactics (increasing the time interval between operations, using antimetabolite and anti-inflammatory therapy, minimizing intraoperative traumatism). However, currently there are no specific recommendations for one of the most important factors - the time interval between cataract extraction and trabeculectomy.
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