helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2022-15-1-133-139helmholtzeyeinstitute-900Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSХирургия катаракты у пациентов с возрастной макулярной дегенерацией: вопросы и противоречияCataract surgery in patients with age-related macular degeneration: questions and controversiesДмитриеваЕ. И.DmitrievaE. I.

Елена Игоревна Дмитриева - ассистент кафедры офтальмологии

Красный проспект, д. 52, Новосибирск, 630091

Elena I. Dmitrieva - assistant professor of chair of ophthalmology1

52, Krasny Prospect, Novosibirsk, 630091

ФурсоваА. Ж.FursovaA. Zh.

Анжелла Жановна Фурсова - д-р мед. наук, зав. кафедрой офтальмологии, зав. офтальмологическим отделением

Красный проспект, д. 52, Новосибирск, 630091

ул. Немировича-Данченко, д. 130, Новосибирск, 630087

Anzhella Zh. Fursova - Dr. of Med. Sci., head of chair of ophthalmology,head of ophthalmology department

52, Krasny Prospect, Novosibirsk, 630091

130, Nemirovich-Danchenko St., Novosibirsk, 630087

anzhellafursova@yandex.ruНикуличИ. Ф.NikulichI. F.

Ида Фаритовна Никулич - канд. мед. наук, ассистент кафедры офтальмологии, врач-офтальмолог

Красный проспект, д. 52, Новосибирск, 630091

ул. Немировича-Данченко, д. 130, Новосибирск, 630087

Ida F. Niculich - Cand. of Med. Sci., assistant professor, chair of ophthalmology, ophthalmologist

52, Krasny Prospect, Novosibirsk, 630091

130, Nemirovich-Danchenko St., Novosibirsk, 630087

КимТ. Ю.KimT. J.

Татьяна Юрьевна Ким - канд. мед. наук, доцент кафедры офтальмологии

Красный проспект, д. 52, Новосибирск, 630091

Tatyana J. Kim - Cand. of Med. Sci., assistant professor, chair of ophthalmology

52, Krasny Prospect, Novosibirsk, 630091

ГамзаЮ. А.GamzaYu. A.

Юлия Александровна Гамза - канд. мед. наук, ассистент кафедры офтальмологии, врач-офтальмолог

Красный проспект, д. 52, Новосибирск, 630091

ул. Немировича-Данченко, д. 130, Новосибирск, 630087

Julia A. Gamza - Cand. of Med. Sci., assistant professor, chair of ophthalmology, ophthalmologist

52, Krasny Prospect, Novosibirsk, 630091

130, Nemirovich-Danchenko St., Novosibirsk, 630087

ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава РоссииРоссияNovosibirsk State Medical UniversityRussian FederationФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России; ГБУЗ НСО «Государственная Новосибирская областная клиническая больница»РоссияNovosibirsk State Medical University; Novosibirsk State Regional HospitalRussian Federation202226032022151133139Copyright © Дмитриева Е.И., Фурсова А.Ж., Никулич И.Ф., Ким Т.Ю., Гамза Ю.А., 20222022Дмитриева Е.И., Фурсова А.Ж., Никулич И.Ф., Ким Т.Ю., Гамза Ю.А.Dmitrieva E.I., Fursova A.Z., Nikulich I.F., Kim T.J., Gamza Y.A.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/900

Проблема хирургического лечения катаракты у пациентов с возрастной макулярной дегенерацией (ВМД) является актуальной в связи с высокой распространенностью коморбидного течения этих заболеваний. Вопросы эффективности выполнения факоэмульсификации катаракты (ФЭК) у лиц с ВМД, ее влияния на течение ВМД, характеристики зрительных функций, качества жизни пациентов продолжают оставаться дискуссионными. Изучение факторов риска развития хориоидальной неоваскуляризации, влияния особенностей хирургического лечения, а также количества инъекций на частоту интраоперационных осложнений представляется достаточно актуальным для понимания возможных механизмов прогрессирования ВМД после ФЭК. Оно поможет разработке мероприятий по предупреждению реактивации патологического процесса, улучшению зрительных функций и качества жизни пациентов после оперативного лечения катаракты. Спектр противопоказаний для выполнения ФЭК у пациентов с неоваскулярной ВМД (нВМД) достаточно узкий, а продолжение анти-VEGF терапии останавливает активную экссудацию и увеличивает остроту зрения у пациентов с нВМД. Сохранение функциональных показателей, улучшение периферического зрения, контрастной чувствительности, улучшение качества визуализации при оптической когерентной томографии дают значимые преимущества как для зрения пациента, так и для контроля заболевания и повышения точности его мониторинга.

The issue of surgical treatment of cataracts in patients with age-related macular degeneration (AMD) is important due to a high incidence of the comorbid course of the two diseases. The effectiveness of phacoemulsification of cataract (FEC) in patients with AMD, its influence on the course of AMD, the characteristics of visual functions, and the quality of life of these patients are still controversial. The study of risk factors for the development of choroidal neovascularization, the influence of the characteristics of surgical treatment and the number of injections on the incidence of intraoperative complications seems to be quite relevant for understanding the possible mechanisms of AMD progression after FEC. This study is instrumental in the development of measures preventing the reactivation of the pathological process, improving visual functions and the quality of life of patients after surgical treatment of cataracts. The range of contraindications for FEC in patients with neovascular AMD is rather limited , and continuation of anti-VEGF therapy stops active exudation and increases visual acuity in patients with neovascular AMD. Maintaining functional parameters, improving peripheral vision, contrast sensitivity, improving the quality of OCT imaging provides both significant benefits for the patient and boosts the control of the disease, increasing the accuracy of monitoring.

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