home Folk remedies What is the treatment for secondary cataracts after lens replacement? Secondary cataract on an artificial lens Black spots after cataract surgery

What is the treatment for secondary cataracts after lens replacement? Secondary cataract on an artificial lens Black spots after cataract surgery

Secondary cataract after lens replacement, which is treated both surgically and medically, is the result of postoperative complications that arise on the posterior wall of the capsule.

The ability to treat cataracts was a breakthrough in ophthalmology, and operations to eliminate them have restored sight to thousands of people who would otherwise have been doomed to complete or partial blindness. But not a single, even the most proven and successful technology guarantees the absence of postoperative complications, and this happens for various reasons.

Secondary cataract after surgery occurs due to compaction of the posterior capsule of the lens and manifests itself due to the property of the compacted wall of the capsule not to transmit sunlight. The plastic bag into which the artificial lens is placed during surgery becomes a new one.

Conservative and surgical treatment of the eye in which secondary vision pathology occurred and developed is a well-developed technology that allows you to return vision to its original levels of acuity.

Causes of postoperative complications

Secondary cataract, diagnosed after lens replacement, occurs after exposure to negative factors of various etiologies, which are not always possible to predict.

The most common causes in such cases do not always depend on the surgeon who performed the operation. There is an objective group of reasons leading to the development of postoperative repeated deterioration of vision:
individual characteristics of the body;
the presence of chronic and systemic diseases (diabetes mellitus, vascular pathologies, trophic ulcers):
the natural aging process, which has become a provocateur of the primary disease;
scar formation at the site of the surgical opening associated with accelerated tissue regeneration;
complication of the postoperative period;
formation of knots from tissue fibers remaining on the surface of the lens:
wrinkling of the capsule is the result of thinning of its walls;

If a secondary cataract is detected after lens replacement, the reasons for which may be non-compliance with medical instructions in the postoperative period, the disease is re-treated. It is carried out surgically or conservatively. Therapy can provide the maximum guaranteed percentage of return of visual acuity to its previous level. The method of treatment is selected not only based on the provoking cause, but also taking into account the general condition of the patient.

Cloudiness of the lens is a private accompaniment of age-related changes in the body, and repeated surgical intervention is not performed due to the general condition of the patient’s body, if there are contraindications.

Recurrent pathology, signs and symptoms

It is not immediately possible to recognize the onset of pathology, and it gradually progresses, initially without showing any pronounced signs or pain. Over time, vision deteriorates, accompanied by characteristic signs of loss of visual acuity:

visual interference (dots, );
the appearance of light glare;
partial loss of color perception;
blurring of objects in the field of vision;
general deterioration in the clarity of displayed objects;
inability to perform usual actions (reading, watching TV).

Recurrent cataracts after lens replacement can be diagnosed after a standard slit-lamp examination, but this requires that the patient seek medical help as soon as he notices signs of deterioration in his visual abilities. The replaced lens, the usual cause of the primary disease, is no longer susceptible to pathology, and the need for a therapeutic process arises in relation to the capsule in which it is placed.

Relatively rarely, the causes of a secondary complication lie in damage to the tissue epithelium or an inflammatory process in the eye. Autoimmune diseases, hereditary pathologies of the eye structure, diseases of the endocrine system are more frequent provocateurs of recurrent eye damage, requiring repeated intervention.

Surgical treatment of pathology

Until recently, the occurrence of a recurrent disease was possible only through surgical intervention, which, due to the fragility and delicacy of the operated organ, led to postoperative complications or could not be used due to the physical condition of the patient. Surgical intervention could lead to retinal detachment, corneal edema, displacement of the intraocular lens, and inflammatory diseases.

There has always been a risk of injury to the eyeball, the formation of a hernia, and the development of strabismus. The situation has changed significantly after the introduction of laser correction into practice.

The advent of the ophthalmic laser has allowed modern medicine to make significant progress in the treatment of eyes with repeated deterioration of vision after lens replacement.

Laser treatment of secondary cataracts has reduced the risk of injury during surgical treatment to a minimum, avoided pain, hospitalization, and long-term postoperative rehabilitation, and ensured high efficiency.

Laser dissection of secondary cataracts has been successfully used over the past 3 decades. It does not require general anesthesia, is characterized by rapid implementation, a short rehabilitation period, and a relatively low risk of injury.

After applying a drug that reduces eye pressure to the cornea, a drug that dilates the pupils is instilled, and the clouded segment is removed through a hole made with laser pulses. In this case, the healthy part of the capsule remains intact.

Secondary cataracts, laser treatment of which has become the prevailing surgical method, do not require any additional action other than the introduction of anti-inflammatory drops into the eye and a drug that stabilizes intraocular metabolic processes. Compared to conventional surgery, the risks of complications are minimized and remain in a very small percentage.

Retinal detachment and increased intraocular pressure appear with it, compared to surgical intervention, in negligible quantities. Secondary cataracts, which are treated using a laser device, are treated without incisions, anesthesia and a rehabilitation period.

Prices for such treatment are relatively affordable and largely depend on which clinic and which specialists will perform the laser treatment. Ordinary specialists who practice and constantly carry out the process can do it no worse than highly paid elite clinics.

Contraindications for surgery

Repeated intervention cannot be prescribed in several cases, of which several reasons relate to the patient’s health condition. Treatment for high blood pressure, epilepsy, cancer, and some diseases of the kidneys and cardiovascular system cannot be performed.

Such treatment is strictly contraindicated after recent head injuries or surgery of any complexity, during which general anesthesia was used and the rehabilitation process has not been completed.

For the use of a laser or a simple operation, the recent period after lens replacement (at least 3-6 months in different cases), glaucoma, inflammation in the anterior segment, problems with the pupil membrane may be an obstacle. In these cases, conservative therapy or correction of the pathological condition to parameters allowing surgery is carried out. Secondary cataracts require no less thorough treatment, but present fewer complications.

Conservative treatment of secondary cataracts

Diagnosis of pathology at an early stage of development allows for conservative treatment using drug therapy. In this case, the patient is prescribed a complex of medications that can restore the patient’s visual abilities. Hardware treatment is carried out using special devices and is based on color therapy and pneumomassage.

Pankov Glasses or Sidorenko Glasses are often used for this purpose, the action of which is based on improving blood flow, supplying the eyes with oxygen and nutrients due to its increased intensity.

Traditional medicine is widely used in the treatment of secondary cataracts, and this is due to the simplicity and affordability of medicines. Modern medicine widely uses time-tested folk recipes as an auxiliary method of general conservative therapy. They are possible with the approval of the attending physician, but as a separate method of treatment they are weakly effective.

Traditional methods use plant and animal components, bee products, prepared in the form of decoctions, infusions, alcohol tinctures, used internally and as a means for compresses on the eyes.

An infusion of calendula, sprouted potato sprouts, clover, wood lice, honey, mumiyo and aloe juice is taken orally after appropriate preparation. Compresses for the eyes are prepared from dill seeds. Blueberry juice is dripped into the eyes, first squeezed and diluted with water. It is believed that a mixture of celery and carrot juices has a positive effect. However, all this should be taken only against the background of appropriate drug therapy.

Drug therapy involves 2 areas of treatment, and for this purpose uses different groups of drugs: improving metabolic processes, affecting the metabolic process and stimulating it. There are various groups of vitamins that help optimize vision during aging: Catain, Quinaps in drops, Vicein, Vitaiodurol, vitamins C, B2, B6, PP. Domestic ophthalmology for senile changes recommends Nicotinamide with cocarboxylase and reflexology.

Conservative treatment is not very effective, although the pharmacological industry offers a significant selection of drugs. Eye drops containing plant and animal components and synthetic substances provide initial progress and can be used to correct the condition at an early stage. But the prevailing method is laser treatment.

Video

Secondary cataract is a pathology that develops in patients after extracapsular extraction of a primary cataract, that is, after removal of the lens of the eye with signs of opacification. In patients with secondary cataracts, a slow decline in visual function is observed, which gradually reduces the positive results achieved from the operation to nothing. This complication usually occurs in 10-50% of patients who have undergone extracapsular extraction.

This disease has many causes. But, as a rule, they act together. This means that for the development of secondary cataracts, not only surgery in the area of the lens is required, but also any other accompanying factor. By identifying and eliminating it, you can significantly reduce the intensity of the processes that occur in the lens capsule. In this case, treatment should be started immediately, as this will preserve up to 90% of visual function.

Causes

The primary reasons are quite simple: natural changes in the organ of vision due to aging, external influences. Secondary glaucoma is caused by several other factors, including:

Incomplete resorption of the lens masses, if one has been injured;
Incomplete extraction of parts of the lens during the operation;
Metabolic disorders and endocrine pathologies;
Autoimmune processes;
High degree of myopia;
Retinal disinsertion;
Inflammation in the area of the choroid of the eyes.

Only an ophthalmologist can determine the specific cause. Self-medication of secondary cataracts can lead to complete loss of vision.

Important! What is secondary cataract, only a doctor can tell you. But you should understand that despite the progression of the disease, there is a chance to maintain visual function if you consult a doctor in time.

Types of secondary cataracts

In general, secondary cataracts are divided into the same types as primary cataracts:

Posterior and anterior subcapsular cataract. The anterior one is located under the capsule. The posterior one is characterized by an anterior location under the posterior capsule. Because of this location, this type most often results in vision loss. When compared with cortical or nuclear cataracts, it has a greater impact on visual acuity in general. However, patients experience residual vision. They see worse with constricted pupils, bright light and headlights. The ability to see suffers to a greater extent in relation to nearby objects.
flutters in cases where age-related changes occur abnormally. The nucleus of the lens is involved in the process. This type of pathology is almost always accompanied by myopia. In this case, nuclear sclerosis at first may have a yellowish tint, which is caused by pigment deposition. As the pathology progresses, it becomes brownish.
With cortical cataracts, the posterior, anterior and equatorial parts are covered completely or partially.
Herringbone cataract occurs in a rather rare form. The deep layers of the lens suffer from the deposition of multiple multi-colored needle-like masses that resemble spruce. This is where the name came from.

How quickly the secondary cataract will progress, as well as how cloudy the lens will become, are played by many factors. In particular, the most significant are the patient’s age, concomitant pathologies and the severity of inflammatory processes.

Important! After IOL implantation, secondary cataracts can significantly affect visual function against the background of improved vision. At the same time, doctors refuse to change the lenses again, since this will not solve the problem. It is possible to say which treatment will help only after an examination.

Clinical stages and different scenarios for the development of pathology

If we talk directly about the pathological processes that occur during the development of secondary cataracts, then they occur in four stages:

Initial;
Immature or swelling;
Mature;
Overripe.

initial stage

The initial stage involves delamination of the lens fibers. Gaps form between them. Under the capsule itself, vacuoles gradually form and fill with liquid.

It is noted that in patients with the cortical form, complaints are extremely rare. They may indicate a slight decrease in vision, the presence of spots in front of the eyes, dots or streaks. Nuclear cataracts progress quite quickly, impairing central vision. As a result, clouding of the lens occurs. At the same time, distance vision may also deteriorate. If signs of myopia appear, they only appear for a short period of time.

This course leads to the development of ocular hypertension, which in turn further worsens the condition of the visual apparatus and provokes the accelerated development of pathology. Moreover, if there is no therapy, glaucoma may develop. In such cases, there is only one treatment - complete removal of the lens. Areas in which turbidity is present gradually cover an increasingly larger area and, over time, close the pupillary opening. It is at this time that the color begins to change to gray-white. At this stage, visual function declines very quickly.

Mature stage

The mature stage is characterized by a decrease in the lens. Its layers become completely cloudy. It itself shrinks, loses moisture and gradually takes on the shape of a star. The pupil appears cloudy white or bright gray. At this stage, patients cease to distinguish objects. The whole function comes down to light perception, that is, the patient can see a ray of light, determine where it comes from and distinguish colors.

Overripe

Overmature cataracts are characterized by complete destruction of the fiber structure of the lens body. The whole mass becomes homogeneous. The cortex becomes milky and liquid. Over time it dissolves. The core shrinks, becomes dense and heavier. Because of this, it sinks to the bottom of the chamber, which increases. If the operation is not performed at this stage, then as a result only a small nucleolus will remain, and the lens capsule itself will be covered with cholesterol plaques.

In another variant of the development of pathology, the proteins of the lens are destroyed, creating conditions for liquefaction of the lens. The osmotic pressure in the capsule will begin to increase. The core also sinks to the bottom of the chamber, but it does not harden, but rather softens until it completely disintegrates and dissolves.

Secondary cataract

Secondary cataracts are essentially the growth of fibrous tissue in the posterior capsule of the lens. These processes do not begin immediately, but some time after third-party intervention - injury, surgery. Since doctors try to preserve the lens chamber for implantation or IOL surgery, over time it may begin to produce lens cells on its own. After installation of an IOL, secondary cataracts are often observed due to clouding of these very cells with which the body tried to restore the lens fibers. Over time, they begin to become cloudy, which provokes a pathological course of the period after surgery.

In simpler terms, these cells, which are called Amaduke-Elshing cells, begin to move. They move into the central part of the optical region. After this, an opaque film is formed. It is this that reduces visual acuity.

Important! This course of pathology after surgery is not the result of the surgeon’s negligence and unprofessionalism. This is an individual feature of a particular organism, the result of cellular reactions occurring in the lens capsule.

Signs of secondary cataracts

If we talk about specific symptoms, secondary cataracts manifest themselves:

Deterioration of vision, which occurs gradually;
A veil before the eyes;
Light exposure near light sources;
Blurred vision.

These symptoms may take years to develop or progress over the course of a month. It depends on the form and concomitant diseases. Only a doctor can tell a more accurate picture and predict the course of the pathology.

Important! Symptoms of secondary cataracts may be similar to other eye pathologies. Therefore, before starting treatment, consult your doctor. Often the disease is hidden behind other diseases, and incorrect or inadequate treatment will only worsen the condition of the visual system.

Diagnosis and treatment

Diagnosis involves conducting a series of studies that will help identify the form of the disease. Based on these data, it is possible to decide which treatment will help preserve the patient’s vision and eliminate pathological processes. Diagnostic procedures for secondary glaucoma include:

Biomicroscopy;
Examine through a slit lamp.

Based on the data obtained, it will be possible to determine the type of treatment. Typically, laser or surgical treatment is used, depending on what tools and equipment the clinic has, as well as which method is preferable. Laser treatment is more common because it is safer and has fewer contraindications and consequences than conventional surgery.

Laser treatment, or discision, allows the posterior capsule of the lens to be incised. This intervention is considered the safest and most effective. You just have to take into account that the laser can damage the IOL. Therefore, doctors first conduct a diagnosis, examination and decide which type of procedure is best to use.

It is noted that laser discision is an outpatient intervention in which the patient does not even need to be given general anesthesia. It is enough to instill the anesthesia dropwise into the treated eye and the operation can begin. The process uses a high-precision laser to selectively target tissue. The cloudy part of the capsule is removed from the back wall.

Important! Before agreeing to an operation, make sure that the clinic has the appropriate facilities and equipment, as well as the experience of the specialists. Otherwise, no one can guarantee the successful course of the operation and the recovery period after it.

The possibility of restoring original visual acuity is minimal. Usually about 90% of the original vision is restored. After such exposure, patients noted an immediate improvement in visual function. With surgery, some recovery time is required.

For the surgical type of operation, local anesthesia is also used. In this case, through a micro-incision, doctors act on the clouded part of the lens capsule, removing it. In general, when choosing between surgical and laser methods, doctors, if possible, try to choose the second option, since it shows greater effectiveness, fewer side effects and contraindications.

Drug treatment

Many people want to do without surgery for primary and secondary cataracts. In such cases, doctors prescribe medications based on:

This type of treatment, at best, slows down the process. It is not possible to eliminate the formation of the film with medication due to the anatomical inaccessibility of this area. Therefore, no one was able to be cured with such medications.

Important! For a complete cure, you should consult a doctor and decide whether to undergo surgery. Modern techniques are minimally invasive and, when performed correctly, are as painless as possible. As a result, vision is significantly improved without massive impact on tissue.

Prognosis for secondary cataracts

Prognosis for secondary cataracts largely depends on how quickly the patient seeks help. If therapy was started at the very beginning, when vision just began to decline, then there is a chance to stop the pathology with medication or eliminate the resulting protein film surgically.

If the patient applied when the symptoms began to manifest themselves more intensely, then a positive outcome of the operation is guaranteed, but drug treatment no longer gives results in such cases. Surgical or laser treatment can restore up to 90% of visual function.

When applying in the later stages, it should be understood that the pathological processes have progressed for too long. In such cases, doctors, as a rule, can slightly improve visual function using surgical or laser methods, but it will not be possible to completely restore vision. Drug therapy will be relevant only in the presence of concomitant pathologies. At the last stage, complications such as glaucoma often develop, and therefore there is a risk of complete loss of visual function.

It is worth noting that secondary cataracts do not have any preventive measures. The only thing a person can do in such cases is to regularly visit a doctor for medical examinations. If secondary cataracts are detected in the early stages, then there is a chance to stop the pathological process with medication without developing complications.

It is worth noting that in such cases you will have to use medications almost constantly, changing them periodically. A replacement is made so that tolerance to the composition of the product does not develop. The correct approach to rehabilitation and treatment will preserve vision for a long period after surgery. After surgery, consult with your doctor about what steps to take to prevent this from happening in the future.

Recurrent cataracts can also develop after surgical removal of the lens and implantation of an intraocular lens (IOL). In this case, the disease occurs several years after the operation and leads to a noticeable deterioration in vision. According to statistics, 15-40% of patients who undergo phacoemulsification have to deal with secondary cataracts.

Causes

There is an opinion that the cause of secondary cataracts is the inexperience or lack of skill of the surgeon who performed the operation. However, such an assumption is not entirely correct. In fact, the pathology develops due to the active proliferation of the epithelium that covers the posterior capsule of the lens. The exact reason for this phenomenon is still unknown.

The likelihood of developing a secondary cataract depends to some extent on the quality of the intraocular lens that is implanted in a person. For example, the installation of silicone IOLs more often leads to the development of complications than acrylic ones. The shape of the lens used is also of certain importance. Artificial lenses with square edges are best tolerated by patients.

Surgical

Nowadays, a clouded lens is most often removed by phacoemulsification (PEC). The surgeon enters the eye cavity through small incisions in the cornea. Using ultrasound, he breaks the lens into pieces. He removes the resulting lens masses and implants an intraocular lens into the capsule.

FEC is considered the least traumatic and safest operation. It is performed under local anesthesia and takes only 15-20 minutes. After surgery, vision is restored almost immediately. On the second or third day the person is discharged from the hospital.

If there are contraindications to phacoemulsification, the patient may undergo another operation. Intra- and extracapsular extractions are more traumatic and require a long recovery period. Fortunately, they are rarely made these days.

Laser

Laser treatment of cataracts is carried out on an outpatient basis. In modern ophthalmology, YAG lasers are used for these purposes. Anesthetic drops and pupil dilation agents are instilled into the patient's eyes. Then, using a special device, the doctor removes the cloudiness from the posterior capsule of the lens.

Today, laser dissection of secondary cataracts is considered the most modern, safe and effective method of treating the disease. Unfortunately, it cannot be used in all cases. If there are contraindications to laser treatment of secondary cataracts, the patient undergoes a mechanical capsulotomy.

Capsulotomy

To carry out the manipulation, the doctor uses special surgical instruments. With their help, the ophthalmologist removes the film that has formed on the posterior lens capsule. The disadvantages of such an operation include the need to insert instruments into the eye cavity, which is associated with the risk of infection and the development of infectious complications.

Rehabilitation

Treatment of secondary cataracts after lens replacement also includes a rehabilitation period. During this time, the person must use the prescribed drops and follow all the doctor’s recommendations.

To avoid the development of anterior uveitis (a common complication of laser discision), the patient is prescribed antibacterial and anti-inflammatory drugs. A person should instill them into the operated eye daily, 3-4 times a day. Medicines help relieve inflammation, which often occurs after surgery.

A common complication of laser discision is increased intraocular pressure (IOP). In order to identify and eliminate the problem in time, the patient undergoes tonometry 30 and 60 minutes after the manipulation. Doctors prescribe antihypertensive drops to all patients with concomitant or prone to ocular hypertension.

Possible postoperative complications

During the day after surgery, the patient may experience a transient increase in intraocular pressure. Usually it is not dangerous, and the person’s condition quickly returns to normal without outside help. If high IOP persists for a long time, the patient begins to suspect glaucoma.

Possible complications after surgery:

Damage to the intraocular lens . The reason may be the surgeon’s inattention or the IOL fitting too tightly to the posterior capsule of the lens. Due to damage to the implant, a person develops spots in front of his eyes, preventing him from seeing normally.
Rhegmatogenous retinal detachment. A very rare but extremely dangerous complication. If not detected and treated promptly, it can lead to complete and irreversible loss of vision.
Cyst-like edema of the retina. It usually develops if the removal of a secondary cataract was performed earlier than six months after the previous surgical intervention.
IOL displacement. Occurs more often after mechanical capsulotomy than after laser discision. Dislocation of the intraocular lens leads to a noticeable deterioration in the patient's vision.
Infectious complications. They can develop after surgical removal of the lens or its capsule. The infection is introduced into the eye cavity along with the instruments used during the intervention.

Contraindications

Sometimes doctors refuse to perform the operation, explaining that there are contraindications. Since the risks are too great, the patient has to refuse surgery or wait for a more suitable time.

Absolute

If there are absolute contraindications, a person is strictly prohibited from undergoing surgery. Neglecting this rule can lead to sad and dangerous consequences.

Absolute contraindications include:

clouding of the cornea, preventing the surgeon from seeing the internal structures of the eye;
acute or chronic inflammation of the iris;
membrane thickness on the posterior capsule is more than 1.0 mm;
the presence of macular edema, detachment or.

Relative

If the patient has relative contraindications, the operation must be performed with great caution. The final decision on the advisability of surgical intervention is made by the attending ophthalmologist. He assesses the likely risks and warns the patient about possible complications.

Relative contraindications for surgery:

less than six months from the date of phacoemulsification;
inflammatory processes in the anterior segment of the eye;
presence of decompensated glaucoma;
neovascularization of the newly formed membrane;
tight contact of the intraocular lens and the posterior capsule of the lens.

It must be remembered that timely consultation with a doctor and compliance with recommendations will help avoid complications.

Useful video about the treatment of secondary cataracts using capsulotomy

Floaters before the eyes are single or multiple dark spots, especially clearly visible against a uniform light background (white, blue). As a rule, people notice them only at the beginning of their appearance, but over time, having gotten used to the presence of spots, they completely stop paying attention to them. But in vain, because such seemingly harmless flies in some cases can become a real problem for vision!

One of the reasons for the appearance of flying flies may be the destruction of the vitreous body; it is the opacities that arise in it that cast shadows on the retina. Such opacities, as a rule, consist of blood clots, dead cells, protein, crystals, and pigment. Moreover, the closer the opacities are to the surface of the retina, the more noticeable their shadows are for a person and the more clearly he sees the floaters. In response to eye movements, the flies quickly move, and then slowly (about 10 seconds) return back.

Elderly people, as well as patients who have undergone cataract surgery and people with myopia, especially often suffer from floaters in their eyes.

Other causes of floaters before the eyes

Destruction of the vitreous body (which results in the appearance of floaters) can also be caused by a number of other reasons:

Low or high blood pressure;
Cerebrovascular accident;
Spasms of blood vessels in the head or eyes;
Fragility of the walls of blood vessels;
Consequences of injuries and operations of the head or eyes;
Stroke;
Intraocular infections and inflammation processes;
Metabolic disease;
Long-term eye strain;
Severe emotional or physical stress;
Prolonged hypoxia (lack of oxygen);
Deficiency of certain vitamins;
Bad habits (smoking, alcohol, drugs);
Liver and gastrointestinal diseases.

Often the appearance of flying flies is caused by a rupture or detachment of the retina or vitreous body. In this case, so-called “lightning flashes” are added to the flying floaters, which arise due to voids formed in the vitreous body. If floaters appear before your eyes, you should consult an ophthalmologist. After conducting an examination, the specialist will definitely suggest a way to solve the problem or give a referral for a full medical examination if the cause of the floaters lies in the pathology of other organs.

What do flies look like?

The type of vitreous destruction is directly related to the appearance of fly flies:

Filamentous destruction. It is caused by necrosis and compaction of individual collagen fibers due to deterioration of metabolic processes and the development of pathology in the vitreous body. In this case, a person sees cobwebs, stripes and threads. Liquefaction of the vitreous can cause its fibers to stick together, forming branched weaves that look like spiders, octopuses, jellyfish, etc.
Granular destruction. It occurs due to the penetration of hyalocytes - cells that form the fibers of the vitreous body into its internal space. Over time, hyalocytes become denser and die, taking on clear outlines, visible as black dots, circles, rings, etc.

Treatment for flying flies

Practice shows that drug treatment for floaters before the eyes is not particularly effective. In the case of small opacities, visible as small black dots, absorbable drops containing potassium iodide, as well as drops with vitamins (for example, Taufon or Quinax), are usually prescribed. If there are a large number of flies that interfere with vision, complex therapy may be required to accelerate the metabolic processes of the vitreous body (using drugs such as Wobenzym and Emoxipin).

Often floaters go away spontaneously, in some cases drug treatment helps, but usually they still remain.

What is truly effective in combating floaters is surgical treatment. This treatment is not widespread everywhere and is associated with a number of possible complications that can lead to blindness. To get rid of the destruction of the vitreous body, 2 types of operations are used:

Vitreolysis is a procedure performed using a YAG laser, the beam of which is targeted at opaque fragments, literally breaking them into very small particles that can no longer interfere with vision.
Vitrectomy is an operation of complete or partial removal of the vitreous body and floaters along with it. However, to carry out this serious operation there must be very strong indications.

It is worth remembering that surgical treatment of vitreous destruction will help get rid of a harmless interference with vision, but can cause much more serious problems, for example, retinal detachment and cataracts.

A much less problematic way to deal with flying flies can be to change your lifestyle. Exercising, giving up bad habits, a balanced diet and certain eye exercises may well help get rid of this annoying hindrance. In addition, you should carefully monitor your health and consult a doctor if you experience any ailments, especially if it concerns your eyes.

One of the leading ophthalmological centers in Moscow where all modern methods of surgical treatment of cataracts are available. The latest equipment and recognized specialists are a guarantee of high results.

is a complication after cataract extraction, characterized by secondary closure of the posterior capsulorhexis area by connective tissue. Clinically, the disease is manifested by a progressive decrease in visual acuity, deterioration of color perception, impaired dark adaptation, diplopia, and blurred vision. To confirm the diagnosis, visometry, eye biomicroscopy, ultrasound, and OPT are performed. Additionally, laboratory diagnostics are performed. To eliminate the clinical symptoms of secondary cataracts, an automated aspiration-irrigation system or a laser discision method is used.

ICD-10

H26.4

General information

Diagnostics

Secondary cataract is a difficult pathology to diagnose, for the detection of which a complex of instrumental and laboratory research methods is used. An ophthalmological examination includes:

Visometry. The technique allows you to determine the degree of decrease in visual acuity with and without correction.
Biomicroscopy of the eye. The procedure is used to visualize clouding of the optical media, degenerative-dystrophic changes in the anterior part of the eyes.
Ultrasound of the eye in A- and B-modes. The method makes it possible to evaluate the anatomical and physiological features of the structure of the organ of vision and the position of the IOL.
Optical coherence tomography (OCT). The technique is used for additional study of the topography of the eyeball and intraorbital structures. The examination is indicated to identify pathological changes in the posterior chamber (dense connective tissue film and accumulation of Semmerring rings, Adamyuk-Elschnig cellular elements).

Instrumental diagnostics are informative only in cases of pronounced changes in the lens capsule. Laboratory methods are used in the early stages or to predict the risk of developing nosology. Additionally, for secondary cataracts the following is indicated:

Measuring anti-inflammatory cytokine levels. The study is carried out using hybridization and immunofluorescence methods. The determination of an increased titer of cytokines in the blood serum correlates with the severity of inflammation at the postoperative stage.
Study of antibody titer to the lens. An increase in antibody titer in the blood or tear fluid is associated with a high risk of secondary cataract formation.
Cytological examination of film. Detection of Adamyuk-Elschnig cells and Semmerring rings is possible no earlier than 90 days after the initial surgical intervention, indicating a long course of the disease.

Treatment of secondary cataracts

Timely treatment measures make it possible to completely eliminate the clinical manifestations of the pathology and restore visual functions. Conservative therapy has not been developed. The following surgical treatment methods are used:

Laser dissection of secondary cataracts. The laser capsulotomy technique involves making small perforations followed by complete removal of connective tissue growths. The surgical intervention is performed under regional anesthesia and does not limit the patient’s ability to work.
Cataract removal using aspiration-irrigation system . The automated bimanual aspiration-irrigation technique allows for the removal of proliferating lens epithelium by forming two paracenteses in the cornea, introducing viscoelastic, and mobilizing the IOL. Additionally, implantation of a capsular ring or capsulorhexis under an intraocular lens can be performed.

Prognosis and prevention

With timely diagnosis and treatment of secondary cataracts, the prognosis for life and ability to work is favorable. The lack of adequate therapy is the cause of frequent relapses; in the future, irreversible loss of visual functions is possible. Surgical prevention comes down to an individual approach to choosing the model, material and design of the edge of the intraocular lens, taking into account the anatomical and physiological features of the eye structure. Drug preventive measures require local and oral use of non-steroidal anti-inflammatory drugs and glucocorticosteroids in the pre- and postoperative period. Modern trends in the prevention of secondary cataracts involve the use of photodynamic therapy and monoclonal antibodies to lens epithelial cells.