Technology of phacoemulsification in extensive zonular defects of zinn ligament fibers

Aim. To describe the technique and to assess the results of phacoemulsification in eyes with extensive zonular defects of Zinn ligament fibers. Methods. Phacoemulsification was performed through a 2.2- mm corneal tunnel incision on adhesive viscoelastic bed. The lens was stabilized with a capsular tension ring. The operation was finished with intraocular implantation and its suturing to the iris. The study included 36 patients [42 eyes, 23 males (63.9%), 13 females (36.1%)] in whom phacoemulsification has been performed. Visual acuity before surgery ranged from 0.01 to 0.7 (mean 0.2±0.18). Intraocular pressure ranged from 15 to 25 mm Hg (mean 19.2±4.5 mm Hg). Corneal astigmatism value before surgery ranged from 0 to 2.25 D (mean 0.87±0.63 D). Results. Postoperatively the following complications were observed: an inflammatory reaction in 3 eyes (7.1%), inflammation of Descemet’s membrane in 3 (7.1%) cases, ocular hypertension in 9 (21.4%) eyes. All the complications were drug treated within 3-5 days. On the second day mean visual acuity was assessed as 0.56±0.12,1 month after surgery - 0.70±0.16,6 months after surgery - 0.75±0.21, and 1 year after surgery - 0.74±0.19. Corneal induced astigmatism 1 year after the surgery ranged from 0.0 to 1.5 D (mean 0.39±0.16 D). Conclusion. The presented technology of phacoemulsification is relatively safe, effective and provides a possibility to rehabilitate patients with cataract combined with extensive zonular defects of Zinn ligament fibers in minimal terms.

phacoemulsification, Zinn ligament defects