helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2021-14-4-154-157helmholtzeyeinstitute-801Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSБинокулярная факоэмульсификация катаракты: отношение зарубежных офтальмологовBilateral phacoemulsification of cataract: the opinion of foreign ophthalmologistsМедведевИ. Б.MedvedevI. B.

Игорь Борисович Медведев — д-р мед. наук, профессор, заведующий кафедрой офтальмологии

ул. Островитянова, д. 1, Москва, 117997

Igor B. Medvedev — Dr. of Med. Sci., professor, head of chair of ophthalmology

1, Ostrovityanova St., Moscow, 117997

ПокровскийД. Ф.PokrovskyD. F.

Дмитрий Федорович Покровский — канд. мед. наук, доцент кафедры офтальмологии

ул. Островитянова, д. 1, Москва, 117997

Dmitry F. Pokrovsky — Cand. of Med. Sci., associate professor of chair of ophthalmology

1, Ostrovityanova St., Moscow, 117997

dfpokrovskiy@gmail.comФГАОУ «ВО РНИМУ им. Н.И. Пирогова» Минздрава России, факультет дополнительного профессионального образованияРоссияPirogov Russian National Research Medical University, Faculty of Continuous Professional EducationRussian Federation202104012022144154157Copyright © Медведев И.Б., Покровский Д.Ф., 20222022Медведев И.Б., Покровский Д.Ф.Medvedev I.B., Pokrovsky D.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/801

Цель — на основании данных литературы представить отношение зарубежных офтальмохирургов к одномоментной бинокулярной факоэмульсификации катаракты (БФЭК). Проведен анализ статей, опубликованных на базе платформы Pubmed в 2000–2020 гг. и посвященных экспертной оценке проведения БФЭК на основе специального анкетирования. Предложенные офтальмохирургам опросники были достаточно однотипны и направлены на определение рейтинга значимости факторов, влияющих на решение о проведении/непроведении БФЭК. Полученные данные свидетельствуют о том, что от 13,9 до 86,0 % офтальмохирургов в разных странах в настоящее время практикуют проведение БФЭК, в то же время 14,0–67,2 % опрошенных не применяют данную технологию в своей практической деятельности. Анкетирование выявило 3 основных фактора в пользу БФЭК: сокращение числа посещений клиники, удобство пациента с точки зрения реабилитации и высокий риск осложнений после второго наркоза. Основными факторами, приводящими к решению о непроведении БФЭК, признается риск эндофтальмита (69–73 % опрошенных), отсутствие информации о послеоперационном рефракционном результате на первом глазу, который определял бы выбор интраокулярной линзы на втором глазу (74–80 %), риск двусторонней потери зрения (73–79 %), а также возможные судебно-медицинские проблемы (52–58 %). Заключение. Результаты анкетирования выявляют некоторые негативные факторы, которые необходимо преодолеть, чтобы БФЭК получила более широкое распространение. Повышение осведомленности о практике БФЭК и одобрение офтальмологического сообщества необходимы для изменения устойчивой культуры в отношении к данной технологии. Для этого требуется стандартизация процедуры БФЭК с последующей разработкой учебных материалов и протоколов оперативного вмешательства. 

Рurpose: to present the opinion of foreign ophthalmic surgeons on simultaneous bilateral phacoemulsification of cataract (SBPEC) by analyzing literature data. We performed an analysis of papers listed by Pubmed in 2000–2020 which contained expert assessments of SBPEC effectiveness based on polling. Ophthalmic surgeons were offered special questionnaires largely close in content, which were designed to establish the rating of factors that affected the respondents’ decision for or against the surgery. Our results indicate that, depending on the country, from 13.9 to 86 % of ophthalmic surgeons practice SBPEC, while from 14.0 to 67.2 % refrain from using this technology. The surveys revealed three major factors in favor of SBPEC — reduced number of clinical visits, the patient’s convenience during rehabilitation, and a high risk of complications after a second general anesthesia. The main factors against SBPEC are the risk of endophthalmitis (noted by 69–73 % of respondents), the absence of information on the postoperative refractive result in the first eye, which could determine the choice of the intraocular lens on the second eye (74–80 %), the risk of bilateral vision loss (73–79 %), as well as possible forensic problems (52–58 %).Conclusion. The surveying highlights certain negative factors that need to be overcome in order for SBPEC to become more widespread. Raising the awareness of SBPEC practice and approval by the ophthalmic community is essential for a sustainable culture change regarding this technology. To achieve this aim, standardization of the SBPEC procedure is needed, followed by the development of training manuals and protocols for surgical intervention.

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The authors declare that there are no conflicts of interest present.