A DIFFERENTIATED APPROACH TO ENERGY PHACOFRAGMENTATION IN AGE-RELATED CATARACTS SURGERY

Aim. Analysis of complications arising in the process of fragmentation of the lens nucleus, by various methods the energy of the impact in the surgical treatment of age-related cataracts.

Material and methods. The study included 550 patients (677 eyes) operated for cataract in the period from 2015 to 2017 in the Krasnodar branch of the S. Fedorov Eye Microsurgery Federal State Institution. According to the method of energy crushing of the lens nucleus, all patients were divided into 3 groups. For group 1 – ultrasound technology (bimanual phacoemulsification of cataract (FCE) was used; for group 2 – Nd: YAG-laser with a wavelength of 1,44 μm technology of laser cataract extraction (LCE) was used; group 3 – infrared femtosecond laser technology (femtosecond laser support phacoemulsification (FFCE) was used.

Results. When using FFCE minimum percentage of complications in comparison with the FCE and LCE in cases of uncomplicated age-related cataracts was observed. In has been proved that in the presence of complicated cataracts, combined with a defect or weakness of the ligamentous apparatus of the lens, a pronounced syndrome, irido-ciliary dystrophy (IFIS-syndrome), bad expanding pupil; as well as in cataract with high degrees of density of nuclei, and in agitated patients, both FCE and LCЕ can be used. In our opinion LCE is preferable.

Conclusion. Differentiated approach to the choice of the optimal method of phacofragmentation results in minimum intra – and postoperative complications, as well as better outcome for the patients.