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

Cover Page

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

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.

Full Text

Restricted Access

About the authors

Dmitry V. Lipatov

Endocrinology research centre

Author for correspondence.
Email: Glas1966@rambler.ru
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

Email: sny@endocrincentr.ru
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

Email: bessmertnaya.eg@gmail.com
ORCID iD: 0000-0001-5910-6502
SPIN-code: 9601-5678

MD, PhD

Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

Anna A. Tolkacheva

Endocrinology research centre

Email: tolkacheva@ebdocrincentr.ru
ORCID iD: 0000-0003-4176-8473
SPIN-code: 9601-3996

ophthalmologist 

Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

References

  1. Межрегиональная ассоциация врачей-офтальмологов. Федеральные клинические рекомендации по оказанию офтальмологической помощи пациентам с возрастной катарактой. — Офтальмология. 2015. [Mezhregional’naya assotsiatsiya vrachey-oftal’mologov. Federal’nye klinicheskie rekomendatsii po okazaniyu oftal’mologicheskoy pomoshchi patsientam s vozrastnoy kataraktoy. Oftal’mologiya. 2015. (In Russ.)].
  2. Липатов Д.В. Диабетическая глаукома. / Под ред. Дедова И.И., Шестаковой М.В. — М.: Медицинское информационное агентство; 2013. [Lipatov DV, Dedov II, Shestakova MV, editors. Diabeticheskaya glaukoma. Moscow: Meditsinskoe informatsionnoe agentstvo; 2013. (In Russ.)].
  3. Липатов Д.В., Бессмертная Е.Г., Кузьмин А.Г., и др. Атлас по диабетической ретинопатии. Практическое руководство для врачей. / Под ред. Дедова И.И., Шестаковой М.В. — М.: Медицинское информационное агентство; 2017. [Lipatov DV, Bessmertnaya EG, Kuzmin AG, et al. Atlas po diabeticheskoy retinopatii. A practical guide for doctors. Moscow: Meditsinskoe informatsionnoe agentstvo; 2017. (In Russ.)].
  4. Свириденко Н.Ю., Беловалова И.М., Шеремета М.С., и др. Болезнь Грейвса и эндокринная офтальмопатия. / Под ред. Дедова И.И., Мельниченко Г.А. — М.: МАИ-Принт; 2012. [Sviridenko NYu, Belovalova IM, Sheremeta MS, et al. Pod. red. Dedov II, Mel’nichenko GA. Bolezn’ Greyvsa i endokrinnaya oftal’mopatiya. Moscow: MAI-Print; 2012. (In Russ.)].
  5. Бровкина А.Ф., Аубакирова А.С. Зрительные расстройства при оптической нейропатии у больных эндокринной офтальмопатией. / IX научно-практическая нейроофтальмологическая конференция «Актуальные вопросы нейроофтальмологии». Москва январь 26, 2007. [Brovkina AF, Aubakirova AS. Zritel’nye rasstroystva pri opticheskoy neyropatii u bol’nykh endokrinnoy oftal’mopatiey. In: proceedings of the 9th scientific and practical neurophthalmology conference «Aktual’nye voprosy neyrooftal’mologii». Moscow jan 26 2007. (In Russ.)].
  6. European group on Graves O, Wiersinga WM, Perros P, et al. Clinical assessment of patients with graves’ orbitopathy: the European group on graves’ orbitopathy recommendations to generalists, specialists and clinical researchers. Eur J Endocrinol. 2006;155(3):387-389. doi: 10.1530/eje.1.02230
  7. Национальное руководство по эндокринологии. / Под ред. Дедова И.И., Мельниченко Г.А. — М.: ГЭОТАР-Медиа; 2016. [Dedov II, Mel’nichenko GA, editors. Natsional’noe rukovodstvo po endokrinologii. Moscow: GEOTAR-Media; 2016. (In Russ.)].
  8. Mourits MP, Bijl H, Altea MA, et al. Outcome of orbital decompression for disfiguring proptosis in patients with graves’ orbitopathy using various surgical procedures. Br J Ophthalmol. 2009;93(11):1518-1523. doi: 10.1136/bjo.2008.149302

Supplementary files

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

Download (1MB)
2. Fig. 2. The appearance of the patient after pulse therapy with methylprednisolone.

Download (880KB)
3. Fig. 3. Right eye (side view).

Download (1MB)
4. Fig. 4. Left eye (side view).

Download (1MB)
5. Fig. 5. The moment of implantation of semi-rigid acry- LOVE IOL.

Download (1MB)
6. Fig. 6. The imposition of a corneal suture at the end nii operations.

Download (1MB)
7. Fig. 7. Implantation of the IOL “MIOL-HD” through special cartridge.

Download (1MB)
8. Fig. 8. The end of the surgical intervention the second eye.

Download (1MB)

Statistics

Views

Abstract: 28

PlumX


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

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies