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Оptimization of surgical treatment of patients with age-related cataract

Work number - M 44 AWARDED

Presented Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine

Grytsenko I.A.

Today, cataract surgery is considered to be the most safe and effective method of surgical treatment, due to the development and widespread extension of the method of phacoemulsification. (Pershin K. B., Malyugin B. E., Takhidi H.P., Maloney W.F.). In recent years, the intensive introduction of femtosecond laser- assisted cataract surgery (FLACS), which provides better and more predictable surgical technique (Nagy Z., Bali S. J., 2014), is being implemented in practice.

However the use of FLACS has limitations related to the anatomical properties of the eyeball, the size of the pupil, the density of the lens (Conrad-Hengerer I., Nagy Z., 2014). 155 patients (185 eyes) with the age of the cataract with varying degrees of density of the lens were under observation.

         We have improved the needle for the phacoemulsification, which differs from the standard ones by creating the teeth on the end surface of its tubular part along the entire length of the impact elliptic surface, which provide a better mechanical injection into the lens material and a more even distribution of ultrasonic energy.

Thus, the use of an improved needle for ultrasound in patients with age-related cataracts with a high degree of density can reduce the total mechanical and ultrasound energy for emulsification of the lens on average by 41,68 %.

We have developed a mathematical model based on the data of the ultrasound topographic density of the lens in patients with age-related cataracts, which allows us to determine the most optimal mode of total energy required for emulsification of the lens to the operation.

Recommendations for the choice of ultrasonic phacoemulsification as an independent method or ultrasonic phacoemulsification in combination with a femtosecond laser in patients with age-related cataracts, depending on the degree of lens density, have been developed. When performing laser fragmentation in patients with age-related cataracts with a higher degree of lens density, there was a gradual decrease in the efficiency of laser cutting of its layers. So, in cases with a high degree of density at which using the mathematical model is determined the estimated total energy of more than 14,1 cu, it is advisable to conduct phacoemulsification using the advanced needle. In cases with a low degree of density, where the total energy is less than 14,1 cu, it is expedient to conduct ultrasonic phacoemulsification using a femtosecond laser.

Number of publications: 10, в т.ч. 5 статей, 5 тез доповідей. Отримано 2 патенти України на корисну модель.