Combined laser optical-reconstructive surgery of the anterior segment of the eye

Purpose. To demonstrate the effectiveness of laser optical reconstructive surgery using a clinical example. Methods. Patient M., 74, came to S. Fyodorov Eye Microsurgery Federal State Institution (Moscow) with complaints of decreased vision in the OS. Diagnosis: OS – pseudophakia. Secondary cataract. Chronic uveitis in remission. Moderate amblyopia. Carried out: autorefractometry, visometry, perimetry, biomicroscopy, indirect ophthalmoscopy, gonioscopy, pneumotonometry. A step-by-step combined laser exposure which included: dissection of the fibrous film on the anterior surface of the intraocular lens, posterior lens capsule, goniosynechia in the area of surgical coloboma, gonioplasty, coreoplasty and coagulation of newly formed vessels. Results. Examination and testing one week after surgery: Visus 0.2 sph 0 cyl +1.5 Ax 5° = 0.4. IOP (pneumotonometry) = 18 mm Hg; biomicroscopy: the eye is calm, the cornea is transparent, the anterior chamber is of medium depth, the iris pattern is blurred, non-structural, an anterior chamber IOL with pupillary fixation T-03 (21D) was implanted, it is transparent, the capsulotomy hole is formed, slight destruction of the vitreous body; indirect ophthalmoscopy: the macula and optic disc are without visible pathology, the peripheral part of the fundus is without visible pathology. Gonioscopy: there are no goniosynechiae in any segments, in the upper one – the surgical coloboma is expanded. Conclusion. Optical reconstructive surgery was performed using various laser operations. This combined approach made it possible to improve visual acuity and restore the anatomical and topographic relationships of the anterior segment of the eye