The features of cataract surgery in a patient with Graves’ disease and endocrine ophthalmopathy

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After the phacoemulsification technique was implemented in ophthalmic practice surgeries to replace the clouded lens have become routine for ophthalmologists. Today, over half a million phacoemulsification surgeries are annually conducted in Russia. Cataract combined with endocrine ophthalmopathy poses a significant challenge for an operating surgeon because of the unusual anatomical presentation of the orbit and the eyeball, as well as the elevated intraocular pressure caused by edema of the orbital tissues (i.e., retrobulbar tissue and extraocular muscles) rather than by primary glaucoma.

We analyze the features of surgical treatment of the cataract involving intraocular lens implantation in a patient with Graves’ disease and endocrine ophthalmopathy complicated by secondary ocular hypertension, optical neuropathy, and lagophthalmos.

After restoring the euthyroid state and reducing the severity of endocrine ophthalmopathy, phacoemulsification was performed in both eyes, with an interval of 2 months. Neither intra- nor postoperative complications of the patients’ organ of vision were observed. The maximum corrected visual acuity achieved on both eyes was 0.4–0.5 in the Snellen eye chart.

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About the authors

Dmitry V. Lipatov

Endocrinology research centre

Author for correspondence.
ORCID iD: 0000-0002-2998-3392
SPIN-code: 9601-3993

MD, PhD, Professor

Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

Natalya Yu. Sviridenko

Endocrinology research centre

ORCID iD: 0000-0002-8538-5354
SPIN-code: 5889-6484

MD, PhD, Professor

Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

Elena G. Bessmertnaya

Endocrinology research centre

ORCID iD: 0000-0001-5910-6502
SPIN-code: 9601-5678


Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

Anna A. Tolkacheva

Endocrinology research centre

ORCID iD: 0000-0003-4176-8473
SPIN-code: 9601-3996


Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11


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Supplementary files

Supplementary Files
1. Fig. 1. The appearance of the patient upon admission to hospital

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2. Fig. 2. The appearance of the patient after pulse therapy with methylprednisolone.

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3. Fig. 3. Right eye (side view).

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4. Fig. 4. Left eye (side view).

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5. Fig. 5. The moment of implantation of semi-rigid acry- LOVE IOL.

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6. Fig. 6. The imposition of a corneal suture at the end nii operations.

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7. Fig. 7. Implantation of the IOL “MIOL-HD” through special cartridge.

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8. Fig. 8. The end of the surgical intervention the second eye.

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Copyright (c) 2021 Lipatov D.V., Sviridenko N.Y., Bessmertnaya E.G., Tolkacheva A.A.

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