Cataract surgery complicated by severe adhesions in non-infectious uveitis. Part 2. Results of anatomical and topographic analysis of the anterior segment of the eye

    Abstract

    Original article

    Cataract surgery complicated by severe adhesions in non-infectious uveitis. Part 2. Results of anatomical and topographic analysis of the anterior segment of the eye

    O.V. Safonova, O.V. Shilovskikh, V.N. Kazaikin

    Eye Microsurger y Yekaterinburg Center, Yekaterinburg, Russian Federation

    Purpose. To evaluate the effectiveness of the developed technology of cataract surgery complicated by severe adhesions in non-infectious uveitis.

    Material and methods. The main group — 26 patients (40 eyes) operated for cataract using the developed technology. The comparison group — 21 patients (30 eyes) operated using traditional technology. The control group — 39 patients (40 eyes) with senile cataract operated using standard phacoemulsification with IOL implantation in the capsular bag technique. In the pre- and postoperative period, all patients underwent optical coherence tomography of the anterior segment of the eye using the CASIA-2 (Tomey, Germany), and the following parameters were assessed: anterior chamber depth, angle opening distance, angle recess area, trabecular-iris space area, trabecular iris angle, lens vault, tilt, IOL decentration, distance from the posterior surface of the iris to the anterior surface of the IOL in the nasal, temporal, inferior and superior sectors.

    Results. Twelve months after surgery, no significant differences were found in the main and control groups for most of the studied anatomical and topographic parameters (p>0.05), in contrast to the parameters of the comparison group. The anterior chamber depth values in the main group significantly differed from those in the comparison and control groups (4.42±0.05, 3.51±0.14, 4.17±0.02; p<0.01). The values of the distances from the iris to the anterior surface of the IOL in the main and control groups differed by an average of 0.27 mm (p<0.01), in the main and comparison groups — by 0.69 mm (p<0.01), in both cases the distance was greater in the main group. The IOL tilt in the comparison group significantly exceeded this indicator in the main group — by 4.07 degrees (p<0.01), in the main and control groups — had no significant differences (p>0.05). There were no significant differences in the IOL decentration values in all three groups (p>0.05).

    Conclusion. Based on the data of the anatomical and topographic study of the anterior segment of the eye, it was established that the basis for the effectiveness of the developed technology is the creation of a sufficiently remote distance between the posterior surface of the iris and the anterior surface of the IOL optics, preventing the development of the adhesion process, which, in turn, contributes to the formation of a normal anatomical and topographic profile of the anterior segment of the eye, comparable in its indicators with the standard technology in surgery for uncomplicated senile cataract.

    Keywords: cataract, adhesions, non-infectious uveitis, phacoemulsification, posterior capsulorhexis, anterior segment optical coherence tomography

    For citation: Safonova O.V., Shilovskikh O.V., Kazaikin V.N. Cataract surgery complicated by severe adhesions in non-infectious uveitis. Part 2.

    Results of anatomical and topographic analysis of the anterior segment of the eye. Fyodorov Journal of Ophthalmic Surgery. 2025;4(147): 20–30.

    DOI: 10.25276/0235-4160-2025-4-20-30

    Corresponding author: Olga V. Safonova, o.safonova@list.ru