An effective and gentle method of phacoemulsification does not eliminate the risk of complications after replacing the eye lens for cataracts. Old age of patients concomitant diseases, violation of sterility requirements on the part of medical staff provoke undesirable consequences of the operation.
Eye cataracts are incurable conservative methods: There are no means that can make a clouded lens transparent again. Phacoemulsification, an operation involving the replacement of a worn-out “biological lens” with an artificial one, can restore lost vision with a minimal percentage of complications. To crush the lens that has lost its quality, an ultra-thin needle is used - a phaco tip, which works under the influence of ultrasound. Microscopic punctures (1.8-2 mm) are made for the needle tip; they do not require subsequent sutures, because heal on their own. Through these holes, the crushed lens masses are removed, and an elastic lens is implanted in their place - an artificial lens substitute. The intraocular lens (IOL) expands inside the lens capsule and provides the patient with high-quality vision for the rest of his life. However, even during such high tech operation there are complications:
Intraoperative problems during phacoemulsification are not excluded, but occur rarely - in 0.5% of cases. Postoperative complications occur 2-3 times more often (1-1.5% of cases).
For the first two weeks after surgery, it is necessary to protect the operated eye from bright light, infections and injuries, and use anti-inflammatory drops for tissue regeneration.
Despite preventive measures, in the first and second weeks complications are possible after cataract removal.
Such complications require complex treatment with antibiotics, anti-inflammatory hormonal and non-steroidal drugs.
As a result, symptoms appear: redness, pain, pain in and around the eyes, tearing, retching and fog before the eyes. The pressure returns to normal after the use of special drops, sometimes a puncture is done with washing of the clogged ducts eyeball.
When symptoms of retinal detachment appear: light spots, floaters, dark veil before your eyes, you should immediately consult an ophthalmologist. Treatment is carried out laser coagulation, surgical filling, vitrectomy.
Symptoms: sharp pain, significant deterioration of vision (only light and shade is visible), redness of the eyeball, swelling of the eyelids. Emergency treatment required in an inpatient department eye surgery Otherwise, eye loss and meningitis will develop.
Undesirable consequences may appear 2-3 months after surgery. These include:
An accurate diagnosis of macular edema is possible only with optical tomography and retinal angiography. The disease is treated with antibiotics in combination with anti-inflammatory drugs. With successful therapy, after 2-3 months the swelling resolves and vision is restored.
The correct choice of IOL reduces the likelihood of developing complications: the lowest percentage of post-cataract development is achieved by implantation of acrylic lenses with square edges.
Cornea(or cornea) is one of the elements of the organs of vision, which performs the functions of refraction of light.
When the cornea is functioning correctly this results in a clear display on the retina objects visible to humans.
In certain diseases, the cornea swells, which leads to both disruption of its functions and pathological lesions of its tissues, which subsequently makes it difficult to restore this element.
Such pathological changes are accompanied by the following symptoms:
Sometimes such no symptoms, and it is possible to detect swelling of the eyeball only during examination.
In some cases, this can be done in advance due to patient complaints of hemorrhages and violations of the integrity of the cornea.
Corneal edema occurs quite often, and some do not even suspect that they have suffered such a violation.
This pathological condition is usually cite the following violations and problems:
Sometimes this condition occurs as a result of surgery; swelling is often observed with prolonged use of incorrectly selected contact lenses.
Depending on the reasons, this phenomenon is tolerated more or less asymptomatically, but upon examination by an ophthalmologist it is determined quite quickly.
More often mild to moderate swelling of the eyeball goes away without consequences.
Another complication may be clouding of the cornea, as a result of which vision deteriorates. If measures are not taken in this case, this effect becomes irreversible.
Treatment of edema completely depends on what caused it.
If this is a sign of infection- the patient is prescribed antibiotic drops or antibacterial ointments.
In severe cases, several types of drugs are prescribed at once, including in the form of injections.
If the edema process is not caused by an infection, it is necessary to first eliminate the inflammatory processes. This is done using non-hormonal decongestants.
Swelling is most severe when allergies, and in such cases, swelling extends not only to the cornea, but also to the area around the eyes and eyelids.
In such situations it is necessary to prescribe antihistamines, as well as limiting contact with potential or direct allergens.
Subsequently, if it is difficult to determine the causative agent of the allergy, additionally prescribed hormonal drugs.
And in such cases, it is necessary to take the patient to the hospital as quickly as possible, applying the following to the victim’s eyes as first aid. cold compress.
If the problem occurs due to glaucoma, in most cases surgical intervention is required.
Only an ophthalmologist can accurately determine the necessary treatment methods. after a comprehensive examination.
Based on the diagnostic results, appropriate treatment will be prescribed.
It is not recommended to take measures to eliminate such pathology on your own in order to avoid the development of irreversible complications.
In most cases after surgery to remove cataracts corneal edema occurs.
During this procedure, a large amount of medical solution is passed through the cornea.
As a result, such exposure leads to saturation of the cornea with this liquid, and the longer the lens is washed out, the more pronounced this complication will be.
This is not a critical consequence and does not require special additional treatment..
Such swelling is considered absolutely normal in the first two weeks after surgery.
And if during this time it does not subside, the doctor, who sees the patient for some time after cataract removal, conducts local therapy using injections and instillations of decongestants.
Special attention necessary pay attention to the selection and use of contact lenses. Such optics not only must be selected in accordance with the instructions of specialists.
It must be worn only for the time specified in the instructions, and leaving the lenses overnight is unacceptable (except in cases where these are optics for the treatment of astigmatism).
This video discusses swelling of the cornea after cataract surgery:
Swelling of the cornea In most cases, the patient himself will not notice even if he carefully examines his eyes through a mirror.
Usually such a disease n does not manifest itself with clear symptoms and we have to talk about problems only when the illness manifests itself in other symptoms.
When making such a diagnosis do not start self-medication in an effort to stop the swelling as soon as possible. This must be done only in accordance with an individually developed therapeutic course.
According to statistics from the American Society of Cataract and Refractive Surgeons, approximately 3 million operations to remove various types of cataracts with IOL implantation are performed annually in the United States. At the same time, the number of successful operations is at least 98 percent. Complications that arise during the postoperative process, in most cases, can be effectively treated with conservative or surgical methods.
So, in approximately 1% of cases, after cataract removal using phacoemulsification, cystoid macular edema or Irvine-Gass syndrome occurs. In the case of using the extracapsular technique, this complication can be detected in approximately 20% of patients. At the same time, the risk of complications especially increases in patients suffering from wet AMD, diabetes and uveitis. The incidence of macular edema, in addition, increases in the postoperative period of cataract extraction complicated by rupture posterior capsule or loss of the vitreous. Corticosteroids, angiogenesis inhibitors, and NSAIDs are used to treat macular edema. If there are no results of conservative treatment, vitrectomy may be performed.
Corneal edema is a fairly common complication after cataract removal. Its cause may be a decrease in the pumping function of the endothelium due to mechanical or chemical damage during surgery, an inflammatory reaction, or concomitant ocular pathology. As a rule, corneal edema resolves spontaneously within a few days without treatment. In 0.1% of cases, pseudophakic bullous keratopathy develops, which is accompanied by the formation of bullae (blisters) in the cornea. In this case, hypertonic solutions and ointments are used as treatment for the condition, medicinal contact lenses are recommended, and treatment for the pathology that caused this condition is prescribed. If there is no proper clinical effect, corneal transplantation may be performed.
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"MNTK named after Svyatoslav Fedorov"- a large ophthalmological complex “Eye Mycosurgery” with 10 branches in various cities of the Russian Federation, founded by Svyatoslav Nikolaevich Fedorov. Over the years of its work, more than 5 million people have received assistance. Go to the organization's page in the catalog >>>
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The cornea, the most convex part of the visual apparatus, is responsible for the light-refracting function and is an integral part of the perception of surrounding information.
Corneal edema is a common phenomenon that occurs for various reasons. With edema, the patient experiences a lot of unpleasant sensations. The surrounding objects seem blurry to him, the focus blurs. In this article, you will learn about the causes and symptoms, as well as treatment methods for corneal edema.
The cornea of the eye is the main component of the refractive system. This convex-concave lens, which is no more than one millimeter thick, has 6 transparent layers.
The cornea not only refracts light, but also protects the eyes from negative external influences, for example, from dust particles floating in the air. Having high sensitivity, the cornea saves the eye from clogging by closing the eyelashes, as well as washing away particles with tear fluid. As the lesion develops, its properties change, light transmission decreases, photophobia develops, and vision decreases significantly, especially in the morning and evening hours. 
As a result pathological process swelling in the cornea can contribute to the destruction of the substance of the corneal layer, and then to its necrosis.
The causes of corneal edema may be the following:
Corneal edema manifests itself in the formation of folds and vertical lines in its layers. Violation of its transparency and thickening leads to the appearance of a veil before the eyes and a decrease in visual acuity, and while wearing contact lenses a person begins to experience discomfort.
With constant and prolonged edema, the body begins to compensate for the violation by the appearance of a network of blood vessels in the cornea. At the same time, the structure of the main part of the cornea - the stroma - changes; hemorrhages are formed, lipids penetrate and the transparency of the cornea is impaired.
Corneal edema may be accompanied by symptoms such as:
Often, corneal edema is asymptomatic, and this pathology can only be detected by examination by an ophthalmologist.
If the edema is advanced and chronic, vascularization occurs, i.e., new blood vessels are formed inside the cornea. This sign can only be noticed during a biomicroscopic examination.
Corneal edema leads to clouding and significant vision loss. If corneal edema becomes chronic, surgical intervention is often required.
Therapy depends entirely on the cause that provoked the pathology. Diagnosis is carried out by an ophthalmologist. To exclude infections, they are prescribed laboratory tests. The degree of corneal edema is assessed using a technique called in medicine corneal pachymetry (measuring thickness using ultrasound or optics). If necessary, the ophthalmologist can prescribe a Schirmer test, which will determine the level of tear fluid produced by the eye. 
Treatment tactics medicines is selected depending on the reason that provoked the corneal edema.
If the source of the problem is contact lenses, the first thing to do is stop using them until the symptoms disappear completely.
Bacterial infection often results from improper lens wear. Bacteria that cause corneal edema include: Staphylococcus aureus, Pseudomonas aeruginosa, amoebic infection.
Treatment in this case consists of local use of antibacterial agents., such as Levofloxacin, Ofloxacin. The antibiotics contained in these drugs will quickly and effectively help the patient.
Corneal edema after cataract surgery sometimes occurs the next day after the phacoemulsification procedure. The cause of swelling in this case is the large amount of fluid that passes through the eye during crushing and washing out the replaced lens of the eye. The denser the cataract and the poorer the vision, the more likely it is to develop postoperative corneal edema.
As a rule, corneal edema after surgery does not require additional treatment. Disappears on its own within 1-2 weeks.
In rare cases, swelling is relieved with injections and procedures, which, if necessary, are prescribed by the attending physician. 
Treatment infectious diseases causing corneal edema requires antibacterial, antifungal or antiviral therapy. Typically used local remedies(eye drops), but for more severe conditions, tablets or intravenous injections are prescribed.
At viral diseases use drugs containing interferon (for example, Ophthalmoferon), as well as artificial tears.
For bacterial infections shown antibacterial agents(Moxifloxacin, Levofloxacin).
To relieve allergic corneal edema, the first step is to identify and eliminate contact with the allergen (cosmetics, dust, animal hair, pollen, perfumes). To relieve symptoms, you should take an antihistamine (Diazolin, Suprastin, Diphenhydramine).
Corneal injury is a fairly common occurrence.. Minor injury does not require treatment. If the damage is significant, then a doctor should be called immediately. Before help arrives, you need to blink frequently (if the foreign body does not interfere with this) and rinse your eye with clean water. 
If you are injured, do not rub your eyelids with your fingers, and do not pull out a foreign body stuck into your eye yourself.
If conservative treatment methods do not help, the doctor may recommend surgery. In case of abnormalities in the cornea, a corneal transplant is performed, and in some modern clinics, the cornea is densified with ultraviolet light.
For inflammation and swelling in the eye, you can use prescriptions as additional treatment traditional medicine. Below are the most popular recipes:
Preventive measures against corneal edema:
The correct selection of contact optics plays an important role in the prevention of pathological conditions of the corneal layer. Lenses must be of high quality, allowing oxygen to pass through to the eyes. You need to use lenses correctly.
Select cosmetics for eyelids and eyelashes from a health safety point of view; they should not contain allergens that cause swelling.
After removal of cataracts, glaucoma and other surgical interventions in different parts of the eye, do not burden your visual organs with computer work or reading, so as not to cause a relapse.
You need to choose a job that does not require strong physical activity or bending. When sleeping, you need to lie down so that your head is higher than your feet, which will ensure the necessary outflow of blood.
After treating edema, it is prohibited to swim or go to the sauna.
If you follow these rules, you can avoid repeated swelling of the cornea.
Most often, corneal edema is a reflection of an inflammatory process that has various origins. It is very important to establish the cause of the swelling condition with the help of medical diagnosis, after which it is possible to carry out treatment aimed at effectively eliminating the cause of the disease.
The external organs of human vision include a number of elements, each of which performs its own functions. The cornea is the transparent outer shell of the eyeball, responsible for the refraction of light rays and at the same time protecting the internal tissues from dust, small debris and other foreign bodies. In case of mechanical damage to the eye, it is the stratum corneum that takes the first blow. As a result, corneal edema often develops. When the cornea of the eye is swollen, a person sees surrounding objects as blurry and indistinct, and additional concerns may arise. unpleasant symptoms– feeling foreign body in the eye, lacrimation. Without timely intervention, vision will deteriorate more and more. As a result, the eye may completely lose visual functions.
For information: Swelling of the cornea can be temporary and go away on its own, for example, if a speck gets into the eye or an allergy to smoke or chemical evaporation. But if a number of unfavorable factors coincide, a minor injury can lead to serious complications, up to irreversible degenerative changes in tissues and complete loss visual functions affected eye.
Corneal edema can be caused by both external and internal causes. The most common are:
Symptoms of corneal edema vary depending on the cause. If it is a viral, bacterial or fungal infection, the symptoms will be similar:
Swelling due to allergies manifests itself in almost the same way, with the difference that there is usually no pain, and if there is any discharge, it is insignificant and transparent.
If the cause of corneal edema is any neoplasms in the organs of vision or brain, or increased intraocular pressure, then the patient will complain of the following symptoms:
Swelling of the cornea and eyes in general sometimes signals kidney dysfunction and stagnation in the body. In this case, in addition to swollen eyes, the following symptoms are noted:
With edema, the cornea thickens and becomes denser, becoming less transparent. When the eyeball is illuminated with a slit lamp, folds and vertical lines are visible.
In order to accurately establish the cause of swelling of the cornea and differentiate possible pathologies, the following methods are used:
Based on all the data obtained, the doctor draws up an anamnesis and determines treatment tactics.
Treatment of corneal edema is carried out in two main directions:
The methods of therapy and the drugs used are determined by the diagnosis and degree of damage to the cornea.
Swelling after injury is usually not treated unless mechanical damage there is no eyeball. To eliminate external hematoma, ointments and gels are used that stimulate blood circulation - Troxevasin, Heparin, Bruise-off. Effective in this case folk remedies– various lotions and compresses. If the injuries are serious, treatment is determined by a traumatologist together with an ophthalmologist. In difficult cases, surgery will be required.
Transplantation of an irreversibly damaged cornea is called keratoplasty in ophthalmology. The operation is performed if endothelial dystrophy develops after surgical removal of cataracts. With the help of keratoplasty, it is possible to restore the transparency of the cornea and clarity of vision, and completely eliminate the causes of the pathology.
Based on the area of the cornea that needs to be replaced, the following types of surgery are distinguished:
Depending on the depth of penetration, keratoplasty can be:
The operation consists of removing the affected area layer by layer using special instruments and implanting an artificial flap. The procedure itself is usually performed under local anesthesia and does not take more than a quarter of an hour. But the sutures heal after surgery for at least six months. For the first time after surgery, the patient must wear a bandage and protective lenses. Then up to full recovery Remember to take precautions: do not strain your eyes, do not lift heavy objects, avoid both overheating and hypothermia.
Swelling of the cornea can be treated with improvised means if there are no contraindications to their use. You should not resort to traditional medicine recipes if the swelling is caused by allergies or open wounds of the eye. Bacterial infection, which is accompanied by swelling of the stratum corneum, cannot be cured medicinal plants. In other cases, irritation and swelling can be relieved with gentle home remedies. The most popular, accessible and safe of them:
If there is absolutely nothing available, you can wash your eyes with chamomile infusion or tea leaves, but at the first opportunity you should consult a doctor, undergo an examination and select an adequate treatment regimen.
In most cases, corneal edema can be prevented or at least significantly reduced the risk of its development. To do this, it is enough to follow these simple preventive measures:
Thus, corneal edema is not such an innocent phenomenon as many people believe. Sometimes this is a symptom of eye irritation from poor-quality cosmetics or water. But also swelling of the stratum corneum can signal an increase in intraocular pressure and threaten very serious consequences, including loss of vision. Corneal edema should be treated depending on the cause of its development. Medications, physiotherapy, and folk remedies can be used. In difficult cases, with deep and extensive injuries or irreversible changes tissue is surgically removed.
Owners of patent RU 2476194:
The invention relates to medicine, namely to ophthalmology, and can be used for the treatment of postoperative corneal edema in age-related cataract surgery. To do this, from the first day after surgery, a 0.25% derinat solution is instilled 3 times within 1 minute. Immediately after the last installation, the cornea is exposed to a running pulse magnetic field the AMO-ATOS device, the emitter head of which is located at a distance of 3 mm from the outer surface of the cornea. At the same time they influence laser radiation. In this case, the laser beam from the LAST-01 apparatus is directed through the axial hole in the head of the field emitter. Emitter frequency 5-10 Hz, diaphragm position 4, exposure time 5 minutes, 2-3 sessions per course. The method improves surgical outcomes and reduces the duration of treatment for gerontological patients with the stated pathology by reducing the time for restoration of the normal anatomical, morphological and optical state of the cornea, reducing the incidence of chronic bullous keratopathy, restoring the development of mechanisms that determine the energy and metabolic reserves of the cell. 1 tab., 2 pr.
The invention relates to medicine, in particular to ophthalmology, and can be used in the treatment of gerontological patients in the early postoperative period after cataract extraction.
Postoperative corneal edema is one of the significant problems in the rehabilitation of gerontological patients operated on for cataracts.
The risk of developing edema increases significantly in elderly and senile patients due to the high density of the clouded lens (H.P. Takhchidi, E.V. Egorova, A.I. Tolchinskaya. Intraocular correction in surgery of complicated cataracts. G.U. MNTK " Eye microsurgery” named after academician S.N. Fedorov, M., 2004. P.16-21).
The occurrence of corneal edema is based on decompensation of the corneal endothelium, namely the posterior epithelium, caused by pathophysiological reactions of surgical stress (V.V. Egorov et al. New approaches to prevention aggressive consequences preoperative psychoemotional stress in patients with diabetes mellitus in cataract surgery. VI Int. congress Khabarovsk, Proof. medicine is the basis of modern technology. health - Ministry of Health Hub. Regions, 2007, pp. 121-122).
Postoperative decompensation of the corneal endothelium without timely treatment leads to the development of endothelial-epithelial dystrophy of the cornea, which negatively affects the final visual functions of operated patients.
Drug therapy used for postoperative corneal edema, including installations or parabulbar injections of emoxypine, taufon, balarpan, solcoseryl, ozonated with a physiological solution, etc., does not allow creating the necessary therapeutic concentration of the drug in the cornea, since most of them are washed away with tears during installations, and after parabulbar injections enters the systemic circulation. In addition, biological barriers prevent the creation of therapeutic concentrations of medicinal substances in the endothelium and other morphological elements of the cornea (Cherikchi L.E. Physiotherapy in ophthalmology. Kyiv, 1979, Egorov E.A., Astakhov Y.S. Stavitskaya E.V. General principles drug treatment eye diseases, vol.5, 2004, p.4).
In connection with the above, the effectiveness of drug therapy, including antioxidant, keratoprotective agents for postoperative corneal edema is insufficient (V.D. Antonyuk et al. The use of antioxidants in the complex treatment of corneal edema after cataract removal // Abstracts of the Russian Symposium on Refractive Surgery. - M., 2001).
To accumulate drugs in the cornea, pharmacophoresis methods are used that increase the permeability and resorption capacity of the tissue with the help of constant electric current- electrophoresis or ultraphonophoresis. However, gerontological patients operated on for age-related cataracts are usually somatically burdened by the presence of high blood pressure, chronic organic cardiovascular and neurological diseases, which are an absolute contraindication for electrotherapy and ultrasound therapy. (V.V. Egorov et al. “Physiotherapy in ophthalmology” // Monograph for ophthalmologists and physiotherapists. Khabarovsk. 2010, P. 80).
There is a known method of treating corneal edema in patients in the early postoperative period after cataract extraction using magnetic laser radiation (I.N. Sosin, A.G. Buyavykh. “Physical therapy of eye diseases.” Simferopol, Tavria, 1998, pp. 25, 42 ).
A common disadvantage of physiotherapeutic methods, including magnetic laser therapy, is that they all result in the mobilization of metabolic and functional reserves of the cell, deplete their reserves and can lead to degenerative changes intracellular organelles, and in general - to cell death. Moreover, with aging, the adaptive and regenerative potential of all types of cells, including the corneal endothelium, decreases, and the number of aging cells leaving the division cycle increases. To increase functional activity, maintain the intracellular type of regeneration and viability of aging and damaged endothelial cells of the cornea, first of all, it is necessary to enter the cell with nucleic acids - the building material for intracellular regeneration.
The closest analogue-prototype of the invention for the treatment of postoperative corneal edema in gerontological cataract surgery is the method of instillation magnetophoresis with a 0.25% derinat solution (Savelyeva M.V. Magnetotherapy in the complex treatment of patients with corneal edema after cataract extraction. Abstract of dissertation. Saratov, 2006 ).
Long duration of treatment;
High incidence of chronic bullous keratopathy;
Does not replenish spent intracellular plastic and energy reserves necessary to preserve and restore the viability of the corneal endothelium.
The goal is to increase the efficiency and reduce the duration of treatment of gerontological patients with corneal edema in the early postoperative period after cataract extraction.
The technical result is an improvement in surgical outcomes through a combined effect on the cornea in patients with endothelial decompensation after cataract removal using magnetic laser radiation and the drug Derinat 0.25%.
The technical result is achieved by the fact that from the first day after the operation, in the presence of decompensation of the corneal endothelium, a 0.25% derinat solution is instilled 3 times within 1 minute and immediately after the last installation the cornea is exposed to the running pulsed magnetic field of the AMO-ATOS device, head - the emitter of which is located at a distance of 3 mm from the outer surface of the cornea, and at the same time laser radiation. The laser beam from the LAST-01 device is directed through the axial hole in the field emitter head. Frequency 5-10 Hz, diaphragm position 4, exposure time 5 minutes, 2-3 sessions per course.
The time to restore the normal anatomical, morphological and optical state of the cornea during endothelial decompensation and age-related cataract surgery is reduced;
The incidence of chronic bullous keratopathy is reduced;
The development of mechanisms that are completely blocked as a result of the operation and determine the energy and metabolic reserves of the cell is restored.
The drug derinat is a highly purified sodium salt of native deoxyribonucleic acid (DNA). This drug has regenerative: antioxidant, neurotrophic, immunomodulatory, anti-inflammatory effects (Reference Vidal. Medicines in Russia, 2006).
Intracellular growth of nucleic acids in the cornea activates the processes of intracellular physiological regeneration of the corneal endothelium.
Magnetotherapy, along with anti-inflammatory, anti-edematous and antioxidant effects, increases the depth of penetration of derinat into the corneal tissue and its entry in therapeutic concentrations into the cell (A.V. Skripnik, N.N. Moiseeva. “On the use of magnetic fields in ophthalmology.” Ophthalm. Journal , No. 8, 1990, pp. 492-494).
Low-intensity laser radiation enhances the activity of biosynthetic intracellular reactions, providing this activity energetically.
The table shows comparative analysis treatment of postoperative corneal edema using the installation method of magneto-laser phoresis of a 0.25% derinat solution and installation magnetophoresis of a 0.25% derinat solution.
As can be seen from the table, with the installation method of magneto-laser phoresis of 0.25% derinat solution, the treatment time for postoperative corneal edema is reduced by 2-3 times relative to the comparison group of installation magnetophoresis 0.25% derinat solution and patients discharged from the hospital (3-5 days after surgery), have visual acuity 0.1-0.3 higher than in the comparison group.
B.S., 76 years old, underwent phacoemulsification cataract surgery (FEC) with intracapsular IOL implantation for age-related cataracts. Before surgery, visual acuity was equal to light perception with correct projection. On the 1st day after surgery, endothelial decompensation was diagnosed, the clinical expression of which was: decreased corneal transparency, corneal edema with an increase in corneal thickness to 678 μm versus 540 μm in the initial state and low visual acuity equal to 0.09. After 2 sessions of installation magneto-laser phoresis of a solution of 0.25% derinat, the phenomena of endothelial decompensation of the cornea completely disappeared: the transparency of the cornea and its normal thickness (540 µm) were restored, visual acuity increased to 0.7. 3 months after the FEC operation with IOL implantation, the anatomical, morphological and optical properties of the cornea, and high visual acuity (0.8) are stably maintained as normal.
B.K., 69 years old, on the first day after FEC with IOL implantation in the right eye, corneal opacity and an increase in its thickness to 700 µm were diagnosed due to endothelial decompensation, which indicated the presence of severe corneal edema, Descemet’s membrane folds and low visual acuity, equal to 0.05. After 3 sessions of installation magneto-laser phoresis of a solution of 0.25% derinat, the clinical signs of endothelial decompensation were stopped: corneal edema and folds of Descemet's membrane disappeared, normal thickness (520 µm) and transparency of the cornea were restored. Visual acuity increased to 0.6. Achieved after 3 months positive result treatment remained stable.
Owners of patent RU 2476194:
The invention relates to medicine, namely to ophthalmology, and can be used for the treatment of postoperative corneal edema in age-related cataract surgery. To do this, from the first day after surgery, a 0.25% derinat solution is instilled 3 times within 1 minute. Immediately after the last installation, the cornea is exposed to a running pulsed magnetic field of the AMO-ATOS device, the emitter head of which is located at a distance of 3 mm from the outer surface of the cornea. At the same time, laser radiation is applied. In this case, the laser beam from the LAST-01 apparatus is directed through the axial hole in the head of the field emitter. Emitter frequency 5-10 Hz, diaphragm position 4, exposure time 5 minutes, 2-3 sessions per course. The method improves surgical outcomes and reduces the duration of treatment for gerontological patients with the stated pathology by reducing the time for restoration of the normal anatomical, morphological and optical state of the cornea, reducing the incidence of chronic bullous keratopathy, restoring the development of mechanisms that determine the energy and metabolic reserves of the cell. 1 tab., 2 pr.
The invention relates to medicine, in particular to ophthalmology, and can be used in the treatment of gerontological patients in the early postoperative period after cataract extraction.
Postoperative corneal edema is one of the significant problems in the rehabilitation of gerontological patients operated on for cataracts.
The risk of developing edema increases significantly in elderly and senile patients due to the high density of the clouded lens (H.P. Takhchidi, E.V. Egorova, A.I. Tolchinskaya. Intraocular correction in surgery of complicated cataracts. G.U. MNTK " Eye microsurgery” named after academician S.N. Fedorov, M., 2004. P.16-21).
The occurrence of corneal edema is based on decompensation of the corneal endothelium, namely the posterior epithelium, caused by pathophysiological reactions of surgical stress (V.V. Egorov et al. New approaches to the prevention of aggressive consequences of preoperative psycho-emotional stress in patients with diabetes mellitus in cataract surgery. VI Int. Congress. Khabarovsk, Prov. medicine - the basis of modern health.
Postoperative decompensation of the corneal endothelium without timely treatment leads to the development of endothelial-epithelial dystrophy of the cornea, which negatively affects the final visual functions of operated patients.
Drug therapy used for postoperative corneal edema, including installations or parabulbar injections of emoxypine, taufon, balarpan, solcoseryl, ozonated with a physiological solution, etc., does not allow creating the necessary therapeutic concentration of the drug in the cornea, since most of them are washed away with tears during installations, and after parabulbar injections enters the systemic circulation. In addition, biological barriers prevent the creation of therapeutic concentrations of medicinal substances in the endothelium and other morphological elements of the cornea (Cherikchi L.E. Physiotherapy in ophthalmology. Kyiv, 1979, Egorov E.A., Astakhov Y.S. Stavitskaya E.V. General principles drug treatment of eye diseases, vol.5, 2004, p.4).
In connection with the above, the effectiveness of drug therapy, including antioxidant, keratoprotective agents for postoperative corneal edema is insufficient (V.D. Antonyuk et al. The use of antioxidants in the complex treatment of corneal edema after cataract removal // Abstracts of the Russian Symposium on Refractive Surgery. - M., 2001).
To accumulate drugs in the cornea, pharmacophoresis methods are used that increase the permeability and resorption capacity of the tissue using direct electric current - electrophoresis or ultraphonophoresis. However, gerontological patients operated on for age-related cataracts are usually somatically burdened by the presence of high blood pressure, chronic organic cardiovascular and neurological diseases, which are an absolute contraindication for electrotherapy and ultrasound therapy. (V.V. Egorov et al. “Physiotherapy in ophthalmology” // Monograph for ophthalmologists and physiotherapists. Khabarovsk. 2010, P. 80).
There is a known method of treating corneal edema in patients in the early postoperative period after cataract extraction using magnetic laser radiation (I.N. Sosin, A.G. Buyavykh. “Physical therapy of eye diseases.” Simferopol, Tavria, 1998, pp. 25, 42 ).
A common disadvantage of physiotherapeutic methods, including magnetic laser therapy, is that they all result in the mobilization of metabolic and functional reserves of the cell, deplete their reserves and can lead to degenerative changes in intracellular organelles, and in general, to cell death. Moreover, with aging, the adaptive and regenerative potential of all types of cells, including the corneal endothelium, decreases, and the number of aging cells leaving the division cycle increases. To increase functional activity, maintain the intracellular type of regeneration and viability of aging and damaged endothelial cells of the cornea, first of all, it is necessary to enter the cell with nucleic acids - the building material for intracellular regeneration.
The closest analogue-prototype of the invention for the treatment of postoperative corneal edema in gerontological cataract surgery is the method of instillation magnetophoresis with a 0.25% derinat solution (Savelyeva M.V. Magnetotherapy in the complex treatment of patients with corneal edema after cataract extraction. Abstract of dissertation. Saratov, 2006 ).
Disadvantages of this method:
Long duration of treatment;
High incidence of chronic bullous keratopathy;
Does not replenish spent intracellular plastic and energy reserves necessary to preserve and restore the viability of the corneal endothelium.
The goal is to increase the efficiency and reduce the duration of treatment of gerontological patients with corneal edema in the early postoperative period after cataract extraction.
The technical result is an improvement in surgical outcomes through a combined effect on the cornea in patients with endothelial decompensation after cataract removal using magnetic laser radiation and the drug Derinat 0.25%.
The technical result is achieved by the fact that from the first day after the operation, in the presence of decompensation of the corneal endothelium, a 0.25% derinat solution is instilled 3 times within 1 minute and immediately after the last installation the cornea is exposed to the running pulsed magnetic field of the AMO-ATOS device, head - the emitter of which is located at a distance of 3 mm from the outer surface of the cornea, and at the same time laser radiation. The laser beam from the LAST-01 device is directed through the axial hole in the field emitter head. Frequency 5-10 Hz, diaphragm position 4, exposure time 5 minutes, 2-3 sessions per course.
Advantages of the method:
The time to restore the normal anatomical, morphological and optical state of the cornea during endothelial decompensation and age-related cataract surgery is reduced;
The incidence of chronic bullous keratopathy is reduced;
The development of mechanisms that are completely blocked as a result of the operation and determine the energy and metabolic reserves of the cell is restored.
The drug derinat is a highly purified sodium salt of native deoxyribonucleic acid (DNA). This drug has regenerative: antioxidant, neurotrophic, immunomodulatory, anti-inflammatory effects (Reference Vidal. Medicines in Russia, 2006).
Intracellular growth of nucleic acids in the cornea activates the processes of intracellular physiological regeneration of the corneal endothelium.
Magnetotherapy, along with anti-inflammatory, anti-edematous and antioxidant effects, increases the depth of penetration of derinat into the corneal tissue and its entry in therapeutic concentrations into the cell (A.V. Skripnik, N.N. Moiseeva. “On the use of magnetic fields in ophthalmology.” Ophthalm. Journal , No. 8, 1990, pp. 492-494).
Low-intensity laser radiation enhances the activity of biosynthetic intracellular reactions, providing this activity energetically.
The table presents a comparative analysis of the treatment of postoperative corneal edema using the installation method of magneto-laser phoresis of a 0.25% derinat solution and the installation magnetophoresis of a 0.25% derinat solution.
As can be seen from the table, with the installation method of magneto-laser phoresis of 0.25% derinat solution, the treatment time for postoperative corneal edema is reduced by 2-3 times relative to the comparison group of installation magnetophoresis 0.25% derinat solution and patients discharged from the hospital (3-5 days after surgery), have visual acuity 0.1-0.3 higher than in the comparison group.
B.S., 76 years old, underwent phacoemulsification cataract surgery (FEC) with intracapsular IOL implantation for age-related cataracts. Before surgery, visual acuity was equal to light perception with correct projection. On the 1st day after surgery, endothelial decompensation was diagnosed, the clinical expression of which was: decreased corneal transparency, corneal edema with an increase in corneal thickness to 678 μm versus 540 μm in the initial state and low visual acuity equal to 0.09. After 2 sessions of installation magneto-laser phoresis of a solution of 0.25% derinat, the phenomena of endothelial decompensation of the cornea completely disappeared: the transparency of the cornea and its normal thickness (540 µm) were restored, visual acuity increased to 0.7. 3 months after the FEC operation with IOL implantation, the anatomical, morphological and optical properties of the cornea, and high visual acuity (0.8) are stably maintained as normal.
B.K., 69 years old, on the first day after FEC with IOL implantation in the right eye, corneal opacity and an increase in its thickness to 700 µm were diagnosed due to endothelial decompensation, which indicated the presence of severe corneal edema, Descemet’s membrane folds and low visual acuity, equal to 0.05. After 3 sessions of installation magneto-laser phoresis of a solution of 0.25% derinat, the clinical signs of endothelial decompensation were stopped: corneal edema and folds of Descemet's membrane disappeared, normal thickness (520 µm) and transparency of the cornea were restored. Visual acuity increased to 0.6. After 3 months, the achieved positive treatment result remained stable.
A method for the treatment of postoperative corneal edema in age-related cataract surgery, consisting of the installation of 0.25% derinat and subsequent magnetophoresis, characterized in that from the first day after surgery, a 0.25% derinat solution is instilled 3 times within 1 minute and immediately after of the last installation, the cornea is exposed to the traveling pulsed magnetic field of the "AMO-ATOS" device, the emitter head of which is located at a distance of 3 mm from the outer surface of the cornea and at the same time with laser radiation, while the laser beam from the "LAST-01" device is directed through the axial hole into head - field emitter; emitter frequency 5-10 Hz, diaphragm position 4, exposure time 5 minutes, 2-3 sessions per course.
In addition, now there is no need to wait for a particularly suitable case to perform the operation - it can and should be done immediately.
In some cases, surgery can lead to certain complications. It is worth mentioning that previously an operation was performed when the lens “matured”, and this contributed to its strong compaction, increased the time of surgical intervention several times, and could result in complications. Therefore, cataracts must be removed immediately, at the moment when they become an obstacle to normal life.
It occurs frequently and is manifested by clouding of the posterior capsule. It has been proven that the incidence of secondary cataracts depends on the material used to make the artificial lens. For example, polyacrylic IOLs can cause it in 10% of all cases, silicone ones in 40%, and polymethyl methacrylate lenses in almost 56%. Causes of postoperative cataracts, effective ways its prevention has not yet been studied.
It is generally accepted that its development is due to the migration of the lens epithelium into the space between the lens and the posterior capsule. The epithelium of the lens is the cells that remain after its removal. They degrade image quality by forming deposits. Other possible causes include fibrosis of the lens capsule.
In order to eliminate postoperative complications, a YAG laser is used to make a hole in the center of the opacified area of the posterior capsule.
An increase in IOP is typical for the early postoperative period. It develops due to incomplete washout of viscoelastic, a gel-like drug that is specially injected into the anterior chamber to protect intraocular structures from surgical damage. After removal of eye cataracts, one of the complications is the development of pupillary block, which occurs when the IOL is displaced towards the iris. Eliminating this complication is not difficult; in most cases, you can limit yourself to instilling anti-glaucoma drops for several days.
In 1% of cases, postoperative complications develop after phacoemulsification of eye cataracts, and with the extracapsular technique - in 20%. At the same time, people with diabetes, uveitis or wet AMD are at greatest risk. Also, the occurrence of macular edema is possible after cataract extraction, complicated by rupture of the posterior capsule or loss of the vitreous. Complications are treated with corticosteroids, NSAIDs, and angiogenesis inhibitors. If conservative treatment is ineffective, vitrectomy is sometimes prescribed.
A fairly common complication after surgery. The reasons may be: disruption of the pumping function of the endothelium, due to mechanical or chemical damage during surgery, as well as an inflammatory reaction and concomitant ocular pathology. Usually, the swelling goes away on its own within a few days. Sometimes (0.1%) pseudophakic bullous keratopathy occurs. with the formation of corneal bullae (small blisters). Hypertonic solutions and ointments may be prescribed for treatment. Special contact lenses are often used. Be sure to treat the pathology that caused this condition. Failure of treatment may be a reason to prescribe corneal transplantation (keratoplasty).
It occurs frequently and leads to a deterioration in the operating effect. The degree of induced astigmatism. at the same time, it is directly related to the technology of cataract extraction, the length of the incision, its location, the presence of sutures, and the occurrence of complications in the surgical process. Small degrees of astigmatism can be corrected spectacle correction or contact lenses; in case of severe astigmatism, refractive surgery is recommended.
Rarely seen. Retrospective studies indicate that the risks of IOL migration in patients 5, 10, 15, 20, and 25 years after surgery are approximately 0.1, 0.2, 0.7, and 1.7%. At the same time, it has been established that pseudoexfoliation syndrome, as well as weakness of the zonules of Zinn, can increase the risk of lens dislocation.
Phacoemulsification is the most modern, effective and practical in a safe way radical treatment of cataracts. True, like any operation, there is some risk of developing certain complications.
Surgery may increase the risk of rhegmatogenous retinal detachment. Typically, it is applied to patients who have experienced complications during the surgical process or those who have injured their eyes in the postoperative period, as well as those with myopic refraction and diabetics. In half of all cases, such a detachment occurs in the first year after surgery. It occurs especially often as a complication of intracapsular cataract extraction (5.7%), but practically does not occur after extracapsular cataract extraction (0.41-1.7%) and phacoemulsification (0.25-0.57%). To detect this complication early, the physician should monitor patients with implanted IOLs. The principle of treatment for such a complication is no different from treatment for detachments of a different nature.
Very rarely, choroidal (expulsive) bleeding may occur during cataract surgery. This condition is quite acute and completely unpredictable. It is characterized by the development of bleeding from injured choroidal vessels. which lie along the subretina. providing her with nutrition. Risk factors for developing this condition are arterial hypertension and atherosclerosis, sudden increase in IOP, glaucoma. aphakia. axial myopia. or a small anteroposterior size of the eyeball, as well as old age, taking anticoagulants, inflammatory processes of the eye.
Often it stops on its own without changing visual functions, but occasionally the consequences of bleeding lead to loss of the eye. Basic therapy - complex treatment, including the use of local or systemic corticosteroids, medications with cycloplegic and mydriatic properties, antiglaucoma drugs. In some cases, repeat eye surgery is recommended.
Endophthalmitis is a complication of cataract surgery in which the patient sees poorly and sometimes completely loses vision. Endophthalmitis can significantly reduce visual acuity. A similar complication occurs in 0.13 - 0.7% of cases.
The risk of developing endophthalmitis increases significantly if the patient has blepharitis. canaliculitis, conjunctivitis. entropion, obstruction of the nasolacrimal ducts, after immunosuppressive therapy, when wearing contact lenses or a prosthesis of the fellow eye. Signs of eye infection are: severe tissue hyperemia, pain, increased sensitivity to light, the patient begins to see worse. In order to prevent endophthalmitis, before surgery, instillations of 5% povidone-iodine are prescribed, as well as the introduction of antibiotics into the eye chamber or subconjunctivally, and the sanitation of potential foci of infection. Also, it is very important to use disposable surgical instruments, or thoroughly treat reusable ones with disinfectants. Your doctor will tell you how to behave after cataract surgery, he will give recommendations and prescribe eye drops, medications for post-operative care behind the eyes.
Results of the operation different people may be different. The information provided here is in no way a substitute for medical advice.
How to take Katachrom eye drops correctly
Laser treatment of cataracts is the most progressive and high-tech method of performing cataract operations today. This latest achievement in the field of ophthalmic surgery, well established in the world. Cataract treatment using a femtosecond laser is now available in modern clinics.
Advantages laser treatment cataracts:
The equipment and technologies used during the operation make it possible to carry out a truly personalized operation, taking into account the individual characteristics of the visual system of each patient, and therefore predict the result.
Equipment used for laser treatment of cataracts
How does a surgical femtosecond laser work?
The peculiarity of the femtosecond laser is that its beam can be focused to any depth with an accuracy of several microns. This creates a layer of microbubbles that separates tissue at the molecular level without generating heat or affecting surrounding tissue. The femtosecond laser places many bubbles in close proximity, creating a precise profile of the desired configuration. Thus, there is no cutting, but delamination of the tissues.
According to the American Society of Cataract and Refractive Surgeons, about 3 million cataract surgeries (IOL implantations) are performed annually in the United States (there are no data for Russia). Moreover, the number of successful operations is more than 98 percent. The complications that arise are now, in most cases, successfully treated conservatively or surgically.
It is believed that this complication may be due to the migration of lens epithelial cells remaining after removal into the space between the lens and the posterior capsule, and, as a result, the formation of deposits that impair image quality. Second possible reason fibrosis of the lens capsule is considered. Treatment is carried out using a YAG laser, which is used to create a hole in the central zone of the clouded posterior capsule of the lens.
In the early postoperative period, an increase in IOP is possible. The reason for this may be incomplete washout of viscoelastic (a special gel-like preparation injected into the anterior chamber of the eye to protect its structures from damage) and its entry into drainage system eyes, as well as the development of pupillary block when the IOL is displaced towards the iris. In most cases, using anti-glaucoma drops for several days is sufficient.
Cystoid macular edema (Irvine-Gass syndrome) occurs after phacoemulsification of cataracts in approximately 1% of cases. With the extracapsular lens removal technique, this complication is detected in approximately 20 percent of patients. Those suffering from diabetes, uveitis, and “wet” AMD are at greater risk. The incidence of macular edema also increases after cataract extraction complicated by posterior capsule rupture or vitreous loss. Corticosteroids, NSAIDs, and angiogenesis inhibitors are used for treatment. If conservative treatment fails, vitrectomy may be performed.
Displacement (dislocation) of the IOL is much less common than the complications described above. Retrospective studies showed that the risk of IOL dislocation in patients 5, 10, 15, 20 and 25 years after implantation was 0.1, 0.1, 0.2, 0.7 and 1.7 percent, respectively. It has also been established that in the presence of pseudoexfoliation syndrome and weakness of the zonules of Zinn, the likelihood of lens displacement increases.
After IOL implantation, the risk of developing rhegmatogenous retinal detachment increases. Patients who had complications during surgery, suffered an eye injury in the postoperative period, had myopic refraction, or had diabetes are more susceptible to this risk. In 50 percent of cases, detachment occurs in the first year after surgery. Most often it develops after intracapsular cataract extraction (5.7%), less often - after extracapsular (0.41-1.7%) and phacoemulsification (0.25-0.57%). All patients after IOL implantation should be regularly monitored by an ophthalmologist for early detection of this complication. The principles of treatment are the same as for detachments of other etiologies.
It is extremely rare that choroidal (expulsive) bleeding develops during cataract removal. This is an acute, completely unpredictable condition in which bleeding occurs from the choroidal vessels that lie under the retina and feed it. Risk factors are arterial hypertension, atherosclerosis, glaucoma, aphakia, a sudden increase in IOP, axial myopia or, conversely, a very small anterior-posterior size of the eye, inflammation, taking anticoagulants, and old age.
The risk of development increases if the patient has blepharitis, conjunctivitis, canaliculitis, obstruction of the nasolacrimal ducts, entropion, when wearing contact lenses and a prosthesis of the fellow eye, after recent immunosuppressive therapy. Symptoms of intraocular infection include severe redness of the eye, pain, increased sensitivity to light, and decreased vision. In order to prevent endophthalmitis, instillations of a 5% povidone-iodine solution are used before surgery, antibacterial agents are introduced into the chamber or subconjunctivally, and possible foci of infection are sanitized. It is important to preferentially use disposable or carefully reprocess reusable surgical instruments.
In order to somehow cope with the disease, it is necessary to perform an operation. But, like any other surgical intervention, there are also contraindications for cataract surgery. The operation itself can be performed using several methods, but the choice of method depends on which clinic the operation is performed in and how advanced the disease process is.
There are no true contraindications for eye cataract removal yet. That is, the operation can be performed at almost any age. However, there are so-called relative contraindications that you should definitely pay attention to.
Such contraindications include the following diseases:
These contraindications to cataract surgery should be taken into account, but this does not mean that the operation will be impossible with them. Just before removing a cataract, you should definitely consult with your doctor and find out exactly how the above diseases will affect the course of the operation itself and the healing process.
After the operation, restoration of a person’s vision can take up to a week. However, everything here is strictly individual. This will depend on the method used to carry out the operation and how successful it was.
After cataract surgery, the patient is simply obliged to follow a number of rules.
Firstly, he should not lift more than three kilograms of weight for a long time.
Fourthly, when leaving home at any time of the year, be sure to wear sunglasses.
After lens replacement, complications are minimal. The most common occurrence is opacification of the posterior capsule of the implant. This condition is called secondary cataract. But this interpretation is incorrect, since cataract itself cannot occur. This pathology is not scary and can be successfully corrected with a laser. After surgery, lens displacement, inflammation and infection are also possible. To avoid infection, ophthalmologists recommend using special anti-inflammatory drops after lens replacement. With a properly organized postoperative period, possible complications are minimized.
It should be remembered that eye drops can only slow down the development of the disease, but not heal it completely. But in some cases, surgery cannot be performed, and then eye drops become the main method of treatment. The earlier you start treatment with drugs, the better result. Since cataracts are chronic disease, treatment with drops must be carried out constantly; breaks lead to progression of the disease.
Developed by pharmaceutical companies huge amount drugs for the treatment of cataracts. Eye drops vary in price, effectiveness and side effects.
The situation in ophthalmology is such that none of the drugs for the treatment of cataracts has been independently tested. pharmaceutical company comprehensive effectiveness research. This means that numerous cataract drops do not have an evidence-based scientific basis for use. Vitamins, of course, won't do any harm. But whether they will cure cataracts is a big question.
Immediately after cataract surgery
Treatment of cataracts with earthworms here
What is the difference between laser cataract treatment and traditional surgery?
The main difference between the new technology and traditional surgery is the method of creating access to the internal structures of the eye, the lens, as well as the mechanism of destruction of the lens. During a traditional operation, these stages of intervention are performed using special microsurgical instruments. When using a surgical laser, manipulations are performed non-contactly using a laser beam. Fragmentation of the lens before it is removed from the eye during traditional surgery occurs using only ultrasound. Laser treatment allows this stage to be carried out using a laser beam, and accordingly, the impact of ultrasound is reduced.
Stages of laser cataract surgery
To perform the operation using a new technique, the LenSx surgical femtosecond laser system from Alcon (USA) is used. This is the first femtolaser system of its kind specifically designed for cataract surgery to receive FDA approval. The system has been registered and certified in Russia. The equipment has all the necessary certificates, warranty coverage and multi-level clinical support.
The LenSx surgical laser system is equipped with a built-in intraoperative optical coherence tomograph (OCT). This allows you to study and automatically calculate the parameters of the intervention, and during the operation - to fully control the state of the internal structures of the eye. As a result, the highest level of accuracy and safety of the intervention is achieved. Laser treatment of cataracts can be called a truly personalized operation: the system calculates all parameters individually for each patient.
Results of laser cataract treatment
To protect the injured eye from any damage and infection, it is necessary to strictly adhere to the rules of rehabilitation. Usually, they are the same for everyone, but in some cases, an ophthalmologist can develop an individual list of rehabilitation rules.
During postoperative rehabilitation, you must adhere to the following recommendations:
The most common complication is opacification of the posterior capsule of the lens, or “secondary cataract.” It has been established that the frequency of its occurrence depends on the material from which the lens is made. So, for IOLs made of polyacrylic it is up to 10%, while for silicone ones it is already about 40%, and for those made from polymethyl methacrylate (PMMA) it is 56%. The real reasons leading to this, and effective methods prevention has not currently been established.
Corneal edema is a fairly common complication after cataract removal. The cause may be a decrease in the pumping function of the endothelium, provoked by mechanical or chemical damage during surgery, an inflammatory reaction, or concomitant ocular pathology. In most cases, swelling goes away without any treatment within a few days. In 0.1% of cases, pseudophakic bullous keratopathy develops, in which bullae (blisters) form in the cornea. In such cases, hypertonic solutions or ointments, medicinal contact lenses are used, and treatment is carried out for the cause. this state pathology. If there is no effect, a corneal transplant may be performed.
To enough frequent complications IOL implantation is associated with postoperative (induced) astigmatism, which can lead to a deterioration in the final functional result of the operation. Its value depends on the method of cataract extraction, the location and length of the incision, whether sutures were applied to seal it, and the occurrence of various complications during the operation. To correct small degrees of astigmatism, glasses or contact lenses can be prescribed; for severe astigmatism, refractive surgery can be performed.
In some cases, it resolves on its own and has little effect on the visual functions of the eye, but sometimes its consequences can lead to loss of the eye. Used for treatment complex therapy, including local and systemic corticosteroids, drugs with cycloplegic and mydriatic effects, antiglaucoma drugs. In some cases, surgical treatment may be indicated.
Endophthalmitis is a rare complication of cataract surgery, leading to a significant decrease in visual functions up to their complete loss. The incidence, according to various sources, ranges from 0.13 to 0.7%.
Secondly, you should not make too sudden movements and do not tilt your head too much down. This may cause poor performance in the postoperative period, and in some cases may lead to a repeat operation.
Thirdly, limit exposure to the open sun, do not visit a bathhouse or sauna, and do not use too hot water when washing.
If, after the operation, the patient has some other diseases that affect vision and the condition of the eyes, then the rehabilitation period can drag on for quite a long time.
The most common drops for cataracts are vitaiodurol, vitafacol, Smirnov drops, quinax, oftan-catachrome. The composition of any drops against the progression of cataracts includes vitamins B and C, potassium iodide, amino acids and antioxidants.
Experts believe that out of all the variety of drops special attention They deserve only Quinax eye drops for cataracts. For a stable result, you will need regular use; you need to instill it into the sore eye - one drop three times a day.
IN recovery period some patients experience symptoms such as swelling after cataract surgery. The more advanced the stage of the disease, the higher the likelihood of its occurrence. It can last from 1 to 15 days and requires supervision by a specialist. Only a doctor will be able to determine whether the condition needs correction or is an option for normal rehabilitation of the body.
During the process of phacoemulsification, the clouded lens is crushed using ultrasound. Decomposition products are washed out with a large amount of liquid. At the stage of “mature” and “overmature” cataracts, the swelling of the eye is more pronounced - the nucleus and cortical layers are denser than at the previous stages, and to destroy them, an ultrasound effect of greater power is required, the tissues are subjected to more intensive processing.
The condition of the cornea also affects. If it is weakened, a violation of the outflow of fluid in the patient can be observed before surgery and is a consequence of destructive changes in the eye.
Other reasons may be inflammatory processes, postoperative infections, and concomitant pathologies of the eye tissues.
The cataract has been removed, eye swelling is manifested by the following symptoms:
While under the supervision of a doctor, the patient is protected from possible negative consequences. If the swelling is caused by mechanical stress, it will go away on its own after the completion of the rehabilitation period.
An experienced ophthalmologist will distinguish between postoperative impairment of the pumping function of the epithelium (in other words, the ability to pump fluid out of tissue) from bullous keratopathy. This is a rare complication (occurs in 0.1% of cases) when small bubbles form in the cornea, which are treated with hypertonic ointments and corrective lenses.
Differentiation from cystoid macular edema is also required. The complication occurs in 1% of cases after phacoemulsification (crushing with ultrasound) and in 20% of cases after an extracapsular technique (when the lens nucleus is removed while preserving the capsule).
People with diabetes mellitus, mature and overmature stages of the disease, who have had a capsule rupture or loss of the vitreous during surgery (these consequences are fraught with treatment of an advanced disease) are predisposed to it.
Both conditions, unlike the previous one, require treatment. Modern medicine can successfully correct them with timely supervision by a doctor.
