[Outpatient care of children following cataract extraction and intraocular lens implantation].
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Biomedical subjects
Publications and source records attributed to L N Zubareva.
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Traumatic cataracts occurring after ocular trauma were removed by phacoemulsification, cryoextraction or extracapsular cataract extraction, depending on the degree of lens absorption. All eyes received sputnik-style iridocapsular lenses. Most cases were complicated by the presence of synechiae and/or the need for iridoplasty. The surgical technique varied with the specific nature of the ocular pathology. Eyes with penetrating injuries has a higher complication rate. Anterior chamber shallowing or collapse was the most frequent intraoperative complication, and was directly related to the incidence of postoperative complications. Most postoperative complications were typical of those associated with cataract surgery in complicated situations.
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The authors suggest a method for assessment of the severity of visual function impairment in obscuration amblyopia (OA) by objective (based on recording the visual evoked potentials--VEP) examination of space contrast sensitivity in low-frequency band. Forty-one normal children and 60 children with ophthalmic diseases (96 eyes, of these 55 with aphakia and artiphakia after removal of congenital cataracts and 41 with congenital partial cataracts) were examined. Three types of VEP were distinguished, with different degrees of manifestation. A correlation was demonstrated between VEP type and OA severity in children with aphakia and artiphakia. Use of this method in patients with partial cataracts helps predict visual outcomes of surgery, provided the intensity of the lens opacity is taken into consideration; the reliability of the estimation of the authors' material has made up 90.0 +/- 4.6%.
The cerebral cortex visual evoked potentials (VEP) to chess pattern reversion have been examined in 41 healthy children (41 eyes) and in 25 children (25 eyes) with artiphakia after traumatic cataract extraction, with macular edemas (ME) in 12 of these and obscuration amblyopia (OA) in 13. Comparison of the amplitude-time parameters of the VEP and of treir relationship with the cell size and the chess pattern contrast has shown a characteristic feature of ME, i. e. an increased peak latency (PL) of the first negative deviation (H1 peak) of the VEP to reversion of the chess pattern with 90% contrast. The mean values of PLHI (M +/- m) have been as follows: 107.1 +/- 3.9 ms in children with ME, 93.1 +/- 2.3 ms in those with OA, and 84.9 +/- 0.8 ms in the controls. An elevation of PLHI over 100ms has been recorded in 9 of the 12 patients with ME and only in 1 child with OA. Involvement of the ganglion cells of the central area of the retina is considered as a possible reason of the detected VEP disorders in ME.
A total of 488 operations of cataract extraction with implantation of intraocular lenses have been performed in children aged 7 mos to 14 yrs; there were 460 traumatic cataracts and 28 congenital ones. Better functional results have been achieved in children with traumatic cataracts: vision acuity has recovered to 0.3-1.0 in 81.8% and binocular vision in 78.1% of cases. In children with congenital cataracts vision acuity has restored to 0.2-0.5 in 83.3% and binocular vision in 33.3% of cases.
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