Особенности хирургии катаракты и послеоперационного периода у пациентов с глаукомой. Обзор литературы. (сообщение 2)
Abstract
По результатам многих исследований в первые сутки после факоэмульсификации (ФЭК) у пациентов с глаукомой отмечается офтальмогипертензия до 50% случаев. Это возникает за счет механической ретенции камерной влаги в передней камере. Временное снижение функциональности дренажной системы глаза объясняется обтурацией трабекулы частицами пигмента, вискоэластиком, эритроцитами, белковыми элементами, продуктами послеоперационного воспаления, хрусталиковыми массами. В отдаленном периоде после факоэмульсификации у пациентов с глаукомой отмечается снижение внутриглазного давления до 74% случаев. Снижение плотности эндотелиальных клеток у данных пациентов происходит в результате флюктуации внутриглазного давления, длительного применения гипотензивных капель, хирургических вмешательств, а так же наличия дренажей после антиглаукомных операций. Это приводит к повышению воспалительной реакции роговицы в виде отека до 16,9% после факоэмульсификации пациентов с сочетанием глаукомы и катаракты. Так же ФЭК даёт значимый гипотензивный эффект (до 34%) и является профилактическим мероприятием острого приступа у пациентов с закрытоугольной глаукомой. Однако, состояние острого приступа глаукомы приводит к трудностям проведения ФЭК в виде высокого ВГД, отека роговицы и мелкой камеры. Экстракция катаракты при данных обстоятельствах сопровождается увеличением послеоперационного отека роговицы и воспалением глаза до 22,85%.
About the Author
Евгений ИвачёвRussian Federation
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