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CATARACT SURGERY AND IOL IMPLANTATION DEPARTMENT
Five Components of Successful Cataract Surgery
Scientific school of Academician S.N.Fyodorov on cataract extraction and intraocular lenses (IOL) implantation exists 40 years and more.
S.N.Fyodorov realized the first IOL implantation in the USSR in 1960. It was his creation – an IOL model of domestic production.
The staff of the S. Fyodorov Eye Microsurgery State Institution possesses the greatest and unique experience of 1.000.000 and more cataract extractions and intraocular lenses implantation.
The right for the hundreds patents including patents of the USA and Europe belong to the staff of the S. Fyodorov Eye Microsurgery State Institution.
At the Cataract Surgery and IOL Implantation Department work highly qualified specialists having an experience of operating abroad.
All kinds of diagnostic and consulting aid in any types of cataract and eye pathology with intraocular lens taking into account individual peculiarities of the patient’s eye are preformed at the Cataract Surgery and IOL Implantation Department.
At the Cataract Surgery and IOL Implantation Department are used the most up-to-date technologies of cataract removal through a small incision by the method of phacoemulsification for the patients of any age with implantation of the Academician Fyodorov original models or foreign IOL (produced in USA and Europe) as well as imported expendable materials. All the mentioned IOL and expendable materials have certificates of the Health Ministry of the Russian Federation and the S. Fyodorov Eye Microsurgery State Institution is supplied by them due to the directly by the state that guarantees 100% reliability and quality. All types of operations are performed with use of the most effective anesthetic methods.
The priority trends of the scientific and clinical activity of the Department are as follows:
- Phacoemulsification of uncomplicated cataract – when the opaque lens is removed through a small incision by the phacoemulsificator of the 5th generation Storz Millennium and a unique IOL is implanted providing a good resolution of the operated eye and a reliable protection from the damaging impact of the UV-light.
- Phacoemulsification of cataract complicated by the corneal astigmatism (non-spherical shape of the cornea). Uneven corneal curvature in different meridians or astigmatism in combination with cataract creates some certain difficulties for the surgeon. The fact is that if to simply remove the cataract then due to the residual astigmatism the patient will be unable to gain high vision without cylindrical glasses. In the majority of cases it demands to perform the next operation on the cornea.At the Department 2 original methods of simultaneous astigmatism correction during the cataract phacoemulsification were suggested: 1st method – after the cataract removal sphero-cylindrical IOL are implanted that simultaneously replace the optic power of the removed opaque lens and correct the initial corneal astigmatism;
2nd method – after the cataract removal and IOL implantation a circulatory keratotomy is performed (a special micro incision on the cornea) correcting the initial corneal astigmatism. The idea of this method is the use of the property of the small incision itself through which the cataract is removed to change the corneal curvature. In this case its impact is strengthened by the addition of the micro incision on the cornea on the opposite side of the meridian. Thus, before the operation the patient’s strongest meridian of the cornea is determined and in its projection the operation – phacoemulsification with circulatory keratotomy is performed.Both types of operation allow the patients to gain the maximal visual acuity right after the cataract removal.
- Phacoemulsification of cataract complicated by glaucoma. Cataract often may be complicated by glaucoma. In this case two-stage method is the tactics of choice. Glaucoma surgery is the first stage, and cataract removal is the second. Cataract surgery is often performed through a large incision with the dissection of the pupil (in glaucoma as a rule occurs a medications induced myosis – constriction of the pupil due to he long-term use of Pilocarpine that prevents from the cataract removal).
At the Department a technique of simultaneous cataract phacoemulsification with antiglaucomatous operation is suggested. The essential advantage of this technique is that both operations are performed through the same small incision. In this case in order to dilate the narrow pupil special elastic microsurgical hooks are used allowing to accurately extend the pupil to the necessary size without rupture. In case when the puil is failed to be dilated without use of micro hooks a novel pharmaceutical composition “Viscomydricatic” is used to support the demanded width of the pupil during the whole operation. In order to make all manipulations painless for the patient we inject pharmaceutical composition “Viscoanesthetic” into the eye. Initially high intraocular pressure is a contraindication for this surgical procedure.
- Phacoemulsification of cataract complicated by the subluxation of the lens. In norm the lens, or, precisely its exterior capsule is fixed to the eye wall (ciliary body) by the circular zonule. In eye injuries or as a consequence of the age-related degenerative processes the strength of the zonule may be damaged and, thus lead to pathologic mobility of the lens. If such a patient undergoes cataract phacoemulsification of and intraocular lens implantation into the capsular sac of the lens (where the opaque lens has been already removed from), then IOL staying in capsular sac also can be moveable. To avoid this at the Department original capsular rings are used: placed into the capsular sac they strain it and prevent its shrinking and extra mobility. If necessary special models of capsular rings are used with small ringlets for suturing them to the eye wall.
- Phacoemulsification of cataract complicated by myopia and hyperopia. Unique technology of cataract removal through a small incision also allows to implant individually calculated intraocular lenses that gives an opportunity to release patients from the earlier being present shortsightedness (myopia) or long-sightedness (hyperopia) and to do without glasses for far after the operation.
- Surgical interventions in various dislocations of the earlier implanted intraocular lenses. In eye injuries or due to the age-related degenerative processes in patients with earlier implanted intraouclar lenses may occur an IOL dislocation and decrease of the vision. In this case surgical intervention is necessary – IOL fixation in correct position inside the eye. Every such case is individual therefore only the great experience accumulated at the Department can allow to choose the proper tactics of treatment for the patient and to gain maximal result.
- Optico-reconstructive operations with artificial iris implantation. Aniridia is the severest form of ocular pathology. Aniridia is the absence of the iris. Aniridia can be a congenital defect and acquired (as a result of injury) as well. Aniridia often is combined with the cataract (opacity of the lens) and with aphakia (absence of the lens). If the retinal functions remain, the patient with aniridia is unable to gain high visual acuity due to the absence of the diaphragm effect created by the iris that forms the pupil. In aniridia a great quantity of light beams with variety of directions penetrate into the eye. They create large circles of the light dispersion, and make the vision “foggy”. Besides, the absence of the iris is a cosmetic defect. At the Department an artificial iris – prosthesis of the iris is successfully used. Created on the basis of biocompatible material it is available in several color gammas that allows to take into account the color of the fellow eye in correction. Implantation of artificial iris can be combined with IOL implantation in aphakia and after cataract removal. Artificial iris implantation can be performed even into the blind eyes for cosmetic defect removal.
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