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Improving the quality of visualization in phacoemulsification in the “triple procedure”
- Authors: Osipyan G.A.1, Mamikonyan V.R.2, Shakhbazyan N.P.1, Khraistin K.1
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Affiliations:
- M.M. Krasnov Research Institute of Eye Diseases
- Lomonosov Moscow State University
- Issue: Vol 17, No 2 (2024)
- Pages: 95-101
- Section: Case reports
- Submitted: 12.12.2023
- Accepted: 29.03.2024
- Published: 09.07.2024
- URL: https://journals.eco-vector.com/ov/article/view/624311
- DOI: https://doi.org/10.17816/OV624311
- ID: 624311
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Abstract
The so-called “triple procedure,” including penetrating keratoplasty in combination with cataract removal and posterior chamber IOL implantation, is the preferred treatment method for patients with combined pathology of the cornea and lens. Methods to reduce intraoperative complications and ensure rapid visual rehabilitation in patients with concomitant conditions are of particular importance when planning such surgeries. In this article, we describe a clinical case of a triple procedure, which involves a lamellar dissection of the damaged cornea of the recipient followed by exposure of the residual corneal stroma to a 40% glucose solution in combination with a viscoelastic, which allowed for optical clearing of the stroma and improved visualization of the anterior chamber structures for phacoemulsification with posterior chamber IOL implantation. This approach represents a safer alternative to the “cataract stage” of surgery, performed under “open sky” conditions.
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About the authors
Grigory A. Osipyan
M.M. Krasnov Research Institute of Eye Diseases
Email: gregor79@yandex.ru
ORCID iD: 0000-0002-1056-4331
SPIN-code: 1039-0470
MD, Dr. Sci. (Medicine)
Russian Federation, MoscowVardan R. Mamikonyan
Lomonosov Moscow State University
Email: Vartan51@mail.ru
MD, Dr. Sci. (Medicine)
Russian Federation, Moscow
Nare P. Shakhbazyan
M.M. Krasnov Research Institute of Eye Diseases
Author for correspondence.
Email: nare_shakhbazyan@mail.ru
ORCID iD: 0000-0002-1857-6425
MD, Cand. Sci. (Medicine)
Russian Federation, MoscowKhusam Khraistin
M.M. Krasnov Research Institute of Eye Diseases
Email: khrestin89@mail.ru
ORCID iD: 0000-0001-6837-8008
MD, Cand. Sci. (Medicine)
Russian Federation, MoscowReferences
- Raj A, Bahadur H, Dhasmana R. Outcome of therapeutic penetrating keratoplasty in advanced infectious keratitis. J Curr Ophthalmol. 2018;30(4):315–332. doi: 10.1016/j.joco.2018.04.001
- Tuli S, Gray M. Surgical management of corneal infections. Curr Opin Ophthalmol. 2016;27(4):340–347. doi: 10.1097/ICU.0000000000000274
- Keratoplasty, cataract extraction and implantation of synthetic lenses in one procedure. Ber Zusammenkunft Dtsch Ophthalmol Ges. 1978;(75):134–136. (In German).
- Lindstrom RL, Harris WS, Doughman DJ. Combined penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber lens implantation. J Am Intraocul Implant Soc. 1981;7(2): 130–132. doi: 10.1016/s0146-2776(81)80058-4
- Kasparov AA, Subbotina IN. Indications, timing and classification of reconstructive interventions based on penetrating keratoplasty with implantation of a posterior chamber intraocular lens. Vestnik oftal’mologii. 2000;116(6):3–7.
- Inoue Y. Corneal triple procedure. Semin Ophthalmol. 2001;16(3):113–118. doi: 10.1076/soph.16.3.113.4202
- Naumenko VV, Tomilova EV, Dunayev AN. Triple procedure: one-stage through keratoplasty with cataract removal and intraocular lens implantation. Ophthalmosurgery and Therapy. 2004;4(3):8–11. EDN: HVFUID (In Russ.)
- Chen W, Ren Y, Zheng Q, et al. Stabilized triple procedure for management of coexisting corneal opacity and cataract. J Cataract Refract Surg. 2014;40(12):1966–1970. doi: 10.1016/j.jcrs.2014.09.031
- Orlova AS, Bashkatov AN, Genina EA, et al. Influence of 40 %-glucose Solution on a Human Corneal Structure. Izvestiya of Saratov University. New Series. Series: Physics. 2014;14(1):11–19. EDN: TDVEGV
- Artemina EM, Utz SR, Yuvchenko SA, et al. Comparative evaluation of clarifying agents to improve the quality of the far long-wave ultraviolet therapy chronic dermatosis. Saratov Journal of Medical Scientific Research. 2016;12(3):453–458. EDN: YGHIVN
- Ardjomand N, Fellner P, Moray M, et al. Lamellar corneal dissection for visualization of the AC before triple procedure. Eye (Lond). 2007;21(9):1151–1154. doi: 10.1038/sj.eye.6702409
- Patent RU 2600149/ 20.10.2016. Sobolev NP, Izmaylova SB, Gromova EG. Method for surgical treatment of patients with concomitant pathology of anterior segment of eyeball: aniridia, corneal clouding of various degree of manifestation, pathology of lens and ligamentous apparatus.
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