RATIONALIZATION OF LASER CAPSULOTOMY IN CHILDREN: THE ROLE OF INDIVIDUAL PARAMETERS AND MEDICINAL SUPPORT

Аннотация

Secondary cataracts remain one of the most common complications after surgical treatment of congenital or acquired cataracts in children. Nd:YAG laser capsulotomy is the main method for removing clouding of the posterior capsule, however, its effectiveness and safety depend on the individual anatomical and functional characteristics of the patient, the type of aphakia/artiphasia, as well as the medicinal preparation. The purpose of this study was to rationalize the approach to Nd:YAG-capsulotomy in children, taking into account the differentiated selection of impact parameters and the use of drug support before and after the procedure. The study included 160 children aged 6 months to 12 years. It has been shown that the use of individual parameters of laser exposure (energy, impulse count, capsular diameter) and drug prophylaxis of complications can significantly improve visual results and reduce the frequency of side effects. The most pronounced increase in visual acuity was achieved in the group of children with artifacia and optimal aperture diameter (3-3.5 mm). The use of NSAIDs and steroids reduced the risk of inflammatory reactions from 20% to 4.6%. The developed algorithm allows for standardizing the approach to capsulotomy in pediatric ophthalmology and improving the quality of ophthalmo-surgical care.