КЛИНИЧЕСКИЙ АНАЛИЗ ОСЛОЖНЕНИЙ ФАКОЭМУЛЬСИФИКАЦИИ С ФЕМТОЛАЗЕРНЫМ СОПРОВОЖДЕНИЕМ И ОСОБЕННОСТИ ПРОВЕДЕНИЯ ФАКОЭМУЛЬСИФИКАЦИИ ПОСЛЕ ФЕМТОЭТАПА

Purpose. To estimate the number and type of complications during the femtosecond laser assisted cataract surgery and to develop methods of decreasing them. Material and methods. The operation was performed in the period from October 2012 to August 2014. The study included 815 patients (1239 eyes). The mean age was 69.1±6.1 years (M±m). The femtosecond laser assisted step was realized using the Victus femtolaser, Valeant Co. (USA). Cataract phacoemulsification was carried out by standard techniques by means of the Stellaris device of Valeant Company,USA. Results. Complications associated with the femtosecond laser cuts: corneal femto cuts depressurization during the transition of the patient from one operating room to another – 0%, during phacoemulsification cataract surgery: detachment of Descemet’s membrane in the paracentesis – 2 (0.2%), in the main section – 9 (0.7%), thermal burns in the main section – 3 (with the nucleus density: grade 4+ cataract) (0.2%). Postoperative hypotension – 3 (0.2%) in the combined intervention with glaucoma surgery. Milling or absence of the anterior chamber of 0%. During the anterior capsulotomy 1133 (91%) a floating track, 101 (8%) clued fragment with a complete capsulotomy, radial gaps of capsulotomy 0%. 3 (0.2%) as a result of lens subluxation starting the technique mastering. There were 5 cases (0.4%) of capsulotomy forming 3 bridges (0.2%). Loss of vacuum occurred in 3 cases. Intraand postoperative IOP elevation was not significant. Capsular blockage – 0%. Posterior capsular tear – 2 (0.2%). Choroidal detachment – 18 (1.5%), iridocyclitis – 19 (1.5%). There was no case of endophthalmitis (0%), hyphema (0%), nuclear or lens fragments dislocation into vitreous cavity (0%). The macular area of the retina showed no significant thickening. Conclusion. 1. It is important to use an NSAID drugs and individual mydriatics groups already one day before the surgery to prevent the narrowing of the pupil in response to the femtosecond laser impact. 2. Exclusion too restless patients with very narrow eyelid margin and deep-set eye. We also recommend to cancel the femtosecond laser step when mydriasis is less than 5mm. 3. Prevention of formation of capsular block syndrome using intra-operative release of gas bubbles before the hydrodissection or its exception.