Phacoemulsification in patients after previous implantation of a complete intrastromal ring into a corneal transplant

Abstract

BACKGROUND: The MyoRing implantation into a corneal transplant can significantly compensate for irregular post-keratoplastic astigmatism. However, the cataract that occurs in this category of patients and the lack of information in the literature on its phacoemulsification and the calculation of a toric intraocular lens (tIOL) power in them determines the relevance of our study.

AIM: The aim of the study is to conduct a clinical and functional analysis of phacoemulsification in patients after previously performed implantation of a MyoRing into a corneal transplant.

MATERIALS AND METHODS: We operated on 21 patients (21 eyes) who had previously undergone the MyoRing implantation into a corneal transplant. According to keratotopography, all patients were diagnosed with a regular form of corneal astigmatism. All patients underwent phacoemulsification with tIOL implantation. When calculating the tIOL power, its diopter value was corrected depending on the average value of the corneal transplant keratometry according to the keratotopogram data. The observation period duration was 6 months.

RESULTS: One month after the procedure, there was an increase in uncorrected visual acuity by 0.2 ± 0.9 LogMAR, best corrected visual acuity by 0.3 ± 1.0 LogMAR, the spherical component of refraction — up to –0.4 ± 0.44 D, the cylindrical component of refraction — up to –0.62 ± 0.18 D, all of which did not change later on.

CONCLUSIONS: Phacoemulsification with tIOL implantation, with its power calculated taking into account an additional correction for its diopter value, is an effective, predictable and safe method of treating patients after previously performed MyoRing implantation into a penetrating corneal transplant.

Keywords

postkeratoplastic astigmatism / MyoRing / cataract phacoemulsification

References

[1] Senchenko NYa, Shanturova MA, Mishchenko OP, Zaitseva KA. Results of “Material for cornea restoration” application in various types of keratoplasty. Practical medicine. 2017;1(9):88–91. (In Russ.)

[2] Сенченко Н.Я., Шантурова О.П., Мищенко О.П., Зайцева К.А. Результаты применения «Материала для восстановления роговицы» при разных видах кератопластики // Практическая медицина. 2017. Т. 1, № 9. С. 88–91.

[3] Nuzzi R, Monteu F. Correction of high astigmatism after penetrating keratoplasty with toric multifocal intraocular lens implantation. Case Rep Ophthalmol. 2017;8(2):385–388. DOI: 10.1159/000478518

[4] Nuzzi R., Monteu F. Correction of high astigmatism after penetrating keratoplasty with toric multifocal intraocular lens implantation // Case Rep Ophthalmol. 2017. Vol. 8, No. 2. P. 385–388. DOI: 10.1159/000478518

[5] Lake JC, Victor G, Clare G, et al. Toric intraocular lens versus limbal relaxing incisions for corneal astigmatism after phacoemulsification. Cochrane Database Syst Rev. 2019;12(12): CD012801. DOI: 10.1002/14651858.CD012801.pub2

[6] Lake J.C., Victor G., Clare G., et al. Toric intraocular lens versus limbal relaxing incisions for corneal astigmatism after phacoemulsification // Cochrane Database Syst Rev. 2019. Vol. 12, No. 12. ID CD012801. DOI: 10.1002/14651858.CD012801.pub2

[7] Den S, Shimmura S, Shimazaki J. Cataract surgery after deep anterior lamellar keratoplasty and penetrating keratoplasty in age- and disease-matched eyes. J Cataract Refract Surg. 2018;44(4): 496–503. DOI: 10.1016/j.jcrs.2018.01.024

[8] Den S., Shimmura S., Shimazaki J. Cataract surgery after deep anterior lamellar keratoplasty and penetrating keratoplasty in age- and disease-matched eyes // J Cataract Refract Surg. 2018. Vol. 44, No. 4. P. 496–503. DOI: 10.1016/j.jcrs.2018.01.024

[9] Patent RUS № 2737221/ 26.11.2020. Byul. № 33. Pozdeeva NA, Kulikova IL, Sinitsyn MV, et al. Sposob korrektsii indutsirovannogo postkeratoplasticheskogo astigmatizma i miopii vysokoi stepeni. Available from: https://patenton.ru/patent/RU2737221C1 (In Russ.)

[10] Патент РФ на изобретение № 2737221/ 26.11.2020. Бюл. № 33. Поздеева Н.А., Куликова И.Л., Синицын М.В., и др. Способ коррекции индуцированного посткератопластического астигматизма и миопии высокой степени. Режим доступа: https://patenton.ru/patent/RU2737221C1

[11] Pozdeeva NA, Kulikova IL, Sinicin MV, Terentieva AE. Induced astigmatism and concomitant high myopia correction with femtosecond laser-assisted intrastromal myoring implantation. Fyodorov journal of ophthalmic surgery. 2020;(4):73–76. (In Russ.) DOI: 10.25276/0235-4160-2020-4-73-76

[12] Поздеева Н.А., Куликова И.Л., Синицын М.В., Терентьева А.Е. Коррекция индуцированного астигматизма и сопутствующей миопии высокой степени методом имплантации кольца MyoRing с применением фемтосекундного лазера // Офтальмохирургия. 2020. № 4. С. 73–76. DOI: 10.25276/0235-4160-2020-4-73-76

[13] Application for an invention № 2022111317/ 26.04.2022. Pozdeeva NA, Sinitsyn MV. Sposob rascheta opticheskoi sily intraokulyarnoi linzy pri ehkstraktsii katarakty u patsienta posle implantatsii intrastromal’nogo kol’tsa MyoRing v rogovichnyi transplantat. (In Russ.)

[14] Заявка на изобретение № 2022111317/ 26.04.2022. Поздеева Н.А., Синицын М.В. Способ расчёта оптической силы интраокулярной линзы при экстракции катаракты у пациента после имплантации интрастромального кольца MyoRing в роговичный трансплантат.

[15] Sinitsyn MV, Pozdeyeva NA. Correction of postkeratoplastic ametropia in patients with cataract. Ophthalmology Journal. 2022;15(2):27–33. (In Russ.) DOI: 10.17816/OV109153

[16] Синицын М.В., Поздеева Н.А. Коррекция посткератопластической аметропии у пациентов с катарактой // Офтальмологические ведомости. 2022. Т. 15, № 2. C. 27–33. DOI: 10.17816/OV109153

[17] Lockington D, Wang EF, Patel DV, et al. Effectiveness of cataract phacoemulsification with toric intraocular lenses in addressing astigmatism after keratoplasty. J Cataract Refract Surg. 2014;40(12):2044–2049. DOI: 10.1016/j.jcrs.2014.03.025

[18] Lockington D., Wang E.F., Patel D.V., et al. Effectiveness of cataract phacoemulsification with toric intraocular lenses in addressing astigmatism after keratoplasty // J Cataract Refract Surg. 2014. Vol. 40, No. 12. P. 2044–2049. DOI: 10.1016/j.jcrs.2014.03.025

[19] Pellegrini M, Furiosi L, Yu AC, et al. Outcomes of cataract surgery with toric intraocular lens implantation after keratoplasty. J Cataract Refract Surg. 2022;48(2):157–161. DOI: 10.1097/j.jcrs.0000000000000730

[20] Pellegrini M., Furiosi L., Yu A.C., et al. Outcomes of cataract surgery with toric intraocular lens implantation after keratoplasty // J Cataract Refract Surg. 2022. Vol. 48, No. 2. P. 157–161. DOI: 10.1097/j.jcrs.0000000000000730

[21] Müftüoğlu İK, Akova YA, Egrilmez S, Yilmaz SG. The results of toric intraocular lens implantation in patients with cataract and high astigmatism after penetrating keratoplasty. Eye Contact Lens. 2016;42(2): e8–e11. DOI: 10.1097/ICL.0000000000000147

[22] Müftüoğlu İ.K., Akova Y.A., Egrilmez S., Yilmaz S.G. The results of toric intraocular lens implantation in patients with cataract and high astigmatism after penetrating keratoplasty // Eye Contact Lens. 2016. Vol. 42, No. 2. P. e8–e11. DOI: 10.1097/ICL.0000000000000147

[23] Cung LX, Hang DT, Hiep NX, et al. Evaluation of phacoemulsification cataract surgery outcomes after penetrating keratoplasty. Open Access Maced J Med Sci. 2019;7(24):4301–4305. DOI: 10.3889/oamjms.2019.379

[24] Cung L.X., Hang D.T., Hiep N.X., et al. Evaluation of phacoemulsification cataract surgery outcomes after penetrating keratoplasty // Open Access Maced J Med Sci. 2019. Vol. 7, No. 24. P. 4301–4305. DOI: 10.3889/oamjms.2019.379

[25] Shi W-Y, Zeng Q-Y, Li S-W, Xie L–X. Cataract extraction and intraocular lens implantation after high-risk penetrating keratoplasty. Chin J Ophthalmol. 2003;39(11):678–682.

[26] Shi W.-Y., Zeng Q.-Y., Li S.-W., Xie L.-X. Cataract extraction and intraocular lens implantation after high-risk penetrating keratoplasty // Chin J Ophthalmol. 2003. Vol. 39, No. 11. P. 678–682.

[27] Tolchinskaya AI. Prichiny rogovichnykh oslozhnenii v otdalennom periode nablyudeniya afakichnogo i artifakichnogo glaza i mery ikh profilaktiki [dissertation]. Moscow, 1988. (In Russ.)

[28] Толчинская А.И. Причины роговичных осложнений в отдалённом периоде наблюдения афакичного и артифакичного глаза и меры их профилактики: дис. … канд. мед. наук. Москва, 1988.

[29] Bourne WM, Carey BE, Kaufman HE. Clinical specular microscopy. Trans Am Acad Ophthalmol Otolaring. 1976;81:743–753.

[30] Bourne W.M., Carey B.E., Kaufman H.E. Clinical specular microscopy // Trans Am Acad Ophthalmol Otolaring. 1976. Vol. 81. P. 743–753.

RIGHTS & PERMISSIONS

ECO-vector LLC