Modern Approaches in the Medical Rehabilitation of Patients With the Complicated Course of the Early Postoperative Period After the Phacoemulsification of Cataracts

BACKGROUND: The reasons for the development of postoperative reactive inflammation under optimal conditions for the operation are errors in the surgical technique and the presence of viscoelastic residues. The likelihood of developing ophthalmic hypertension exists with the use of viscoelastic of any type. Its incomplete evacuation can be explained by the difficult visualization due to its transparency. Analysis of the dependence of the postoperative period course on the quality of viscoelastic removal at phacoemulsification can be considered to be relevant and expedient. AIM: The aim was to study the type of the postoperative period course depending on the quality of viscoelastics removal at phacoemulsification. MATERIALS AND METHODS: 104 eyes of randomly chosen patients who underwent femto-laser assisted phacoemulsification, divided into 2 groups according to ophthalmic viscoelastics characteristics (colored or transparent). Both groups were split into 2 subgroups each depending on method of viscoelastics removal. Tonometry and biomicroscopy were performed 3 hours after phacoemulsification and on the post-op Day 1. Patients with Tyndall effect were examined daily until its disappearance. RESULTS: At comparable preoperative IOP indices, its elevation 3 hours after surgery took place in subgroups 2a and 2b, the highest being in subgroup 2a. The greatest number of eyes with Tyndall effect, at all follow-up periods, was found in subgroup 2a, the lowest in subgroup 1b. The total number of eyes with keratopathy (as epitheliopathy) observed 3 hours after surgery was 7, four of them being from subgroup 2a. CONCLUSIONS: The conducted research showed that the type of early postoperative period course of phacoemulsification depends on visualization possibility of the viscoelastic and of the method of its removal. Minimal changes of hydrodynamics and maximal number of eyes with absence of inflammation took place when using colored viscoelastic and impulse irrigation method.

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Influence of the quality of viscoelastic removal on phacoemulsification results. Part 1. Type of the postoperative period course depending on the quality of viscoelastic removal in phacoemulsification

Егорова

Vasiliev

Bai

2021

Ophthalmology Reports

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Efficacy Evaluation of Comprehensive Preformed Physical Factors Application against Retinal Complications in the Early Postoperative Period after Cataract Surgery on Eyes with High Myopia

Akulov¹,

Shurygina

2021

Bulletin of Rehabilitation Medicine

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Currently, modern high-tech methods of cataract surgery do not always guarantee high visual acuity after surgery, and are not always insured against the development of early postoperative complications in the eyes with concomitant ocular pathology. Aim. Development and analysis of the preformed physical factors comprehensive application efficacy against retinal complications in the early postoperative period after cataract surgery in patients with high myopia. Material and methods. The study involved 75 patients (75 eyes) with high myopia, aged 58 to 79 years with developing macular edema on the second day after cataract surgery. Patients from the first group (25 people) received standard medical treatment, the second group (25 people) additionally received low-frequency magnetotherapy course, and the third group received extended standard treatment with combined application of low-frequency magnetotherapy and endonasal electrophoresis with pentoxifylline. Assessment of treatment efficacy was performed according to visual acuity data and morphometric parameters of the central retinal zone using optical coherence tomography. The results of Statistica 12.0 (StatSoft, USA) program was used for statistical analysis. Results and discussion. Immediate results of treatment and long-term results up to one month in all groups were objectively confirmed by the morphometric parameters of the central retinal zone. Macular edema reduction in height and area of distribution was significantly different in the third group compared with the first and second groups immediately after treatment and with the continuation of positive dynamics after a month. In the third group, high clinical results were objectively confirmed by the restoration of normal parameters of the central retinal zone after one month of observation. In the first and second groups, lower treatment results were confirmed by the preservation of morphometric signs of edema in the macular region, that required the continuation in the patients’ rehabilitation. Conclusion. Combination of complex application of preformed physical factors with standard medical therapy of exudative processes in the macula after cataract surgery reliably increases functional (visual) result of treatment and reduces rehabilitation period in the majority of patients with high-grade myopia. Thus, the expediency of physiotherapeutic support in relief of retinal edema in the early postoperative period of cataract surgery on eyes with high degree myopia has been substantiated.

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Effectiveness of preformed physical factors in the correction of dry eye syndrome after phacoemulsification: a randomized trial

Shulikova,

Shurygina

2024

Bulletin of Rehabilitation Medicine

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Introduction. Currently, modern high-tech methods of small incision cataract surgery are not always immune to the development of iatrogenic «dry eye» syndrome. Currently, one of the common complications of the anterior segment of the eye after small incision cataract surgery is the development of iatrogenic dry eye syndrome, which leads to a decrease in the quality of medical and social rehabilitation of operated patients. Aim. Development and evaluation of the effectiveness of the complex use of preformed physical factors in the correction of «dry eye» syndrome in patients after phacoemulsification of cataract. Materials and methods. The open randomized controlled clinical trial involved 90 patients (90 eyes) aged from 58 to 75 years, who were diagnosed with «dry eye» syndrome (DES) on the 1st day after phacoemulsification (PE) of cataract. Patients, depending on the treatment, were divided into three groups of 30 people (30 eyes).In the control group, patients received standard tear replacement therapy (RT) with Stillavit 4 times a day for 7 days,in the comparison group — in addition to ST 7 procedures of low-frequency magnetic therapy in the orbital area and in the main group — TRT was expanded by the complex application of low-frequency magnetic therapy to the orbital area and medicinal electrophoresis (EP) of the Taufon using the orbital-occipital technique for 7 daily procedures performed daily. Evaluation of parameters of ocular xerosis included: tear film rupture time, total tear production, and ocular surface disease index according to the OSDI questionnaire. The duration of the study was 6 months. Results and discussion. Complete regression of the xerotic process was observed immediately after treatment in 76,7 % (23) of patients in the main group, in 40 % (12) patients in the comparison group and 20 % (6) of patients in the control group. After 6 months after surgery — in 96.7 % (29) of patients in the main group, in 83,3 % (25) of patients in the comparison group and 70 % (21) of patients in the control group. Conclusion. The developed comprehensive program for the treatment of postoperative «dry eye» syndrome, which includes low-frequency magnetic therapy and medicinal electrophoresis Taufon against the background of tear replacement therapy, helps to significantly improve the clinical outcome of treatment, reduce the recovery time of the ocular surface and improve the quality of life of patients.

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Modern Approaches in the Medical Rehabilitation of Patients With the Complicated Course of the Early Postoperative Period After the Phacoemulsification of Cataracts

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Influence of the quality of viscoelastic removal on phacoemulsification results. Part 1. Type of the postoperative period course depending on the quality of viscoelastic removal in phacoemulsification

Influence of the quality of viscoelastic removal on phacoemulsification results. Part 1. Type of the postoperative period course depending on the quality of viscoelastic removal in phacoemulsification

Efficacy Evaluation of Comprehensive Preformed Physical Factors Application against Retinal Complications in the Early Postoperative Period after Cataract Surgery on Eyes with High Myopia

Effectiveness of preformed physical factors in the correction of dry eye syndrome after phacoemulsification: a randomized trial

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