First Author: N.Pomytkina RUSSIA
Co Author(s): I. Kravchenko E. Sorokin
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To analyze cases of development of rhegmatogenous retinal detachment in patients after secondary cataract YAG-capsulotomy.
The research was performed in the State Institution Eye Microsurgery Complex named after academician S.N. Fyodorov, Khabarovsk, Russia
A retrospective analysis of patients' medical records for 2013-2016 was conducted. 19 cases of development of retinal detachment were revealed in patients who had previously undergone secondary cataract YAG-capsulotomy. There were 5 women (26%), men – 14 (74%). The average age was 63±0.5 years. The group of 'early' detachments - up to 6 months after the YAG-capsulotomy - included 5 people (26.3%). A group of 'late' detachments - on average 2 years after capsulotomy - included 14 people (73.7%).
In early terms, the cause of retinal detachment was valvular rupture in patients with emmetropia, hyperopia, or myopia of low degree: the mean value of anterior-posterior axis was 24.1 mm. In late terms, the development of retinal detachment occurred in the majority of patients (11 persons - 78.6%) against the background of the progression of the rhegmatogenous dangerous forms of peripheral vitreochorioretinal dystrophies. In 9 of these 11 patients there was myopia of high degree, in 2 patients - emmetropia, the mean value of anterior-posterior axis was 26.57 mm. In the group with progression of PVCRD in 6 out of 9 patients with high myopia (66.7%) and in one emmetropia (50%) in the period preceding the development of retinal detachment, limiting laser coagulation of the retina in the paired eye was carried out. In patients with secondary cataract there are problems of preoperative examination of the periphery of the retina due to the rigidity of the pupil and the nonoptimal mydriasis, screening of the periphery of the retina by the edge of the optic part of the IOL, and the changes in the capsular bag itself.
1. YAG-capsulotomy of secondary cataract is a risk factor for retinal detachment. 2. In the early period after YAG-capsulotomy the development of retinal detachment is caused by the formation of valvular ruptures, in late terms - the progression of prognostically dangerous forms of peripheral vitreochorioretinal dystrophies in patients with high myopia. 3. Thorough examination of the periphery of the retina and implementation of limiting laser coagulation of the retina play crucial role in the prevention of retinal detachment after the secondary cataract YAG-capsulotomy.