CLINICAL CASE OF COMPLICATED CATARACT DUE TO PSEUDOEXFOLIATIVE SYNDROME

According to statistics, more than half of patients seeking surgical care in the ophthalmology department have signs of pseudoexfoliation syndrome. The development of cataracts in this syndrome is accompanied by degeneration of the capsule of the sac, weakness of the ligamentous apparatus can contribute to the abnormal position of the lens, the density of the lens increases, which complicates its normal functioning, insufficient cycloplegia can also aggravate the situation. This article describes a clinical case of a patient with complicated cataract and concomitant general somatic pathology. The aim of the work is to evaluate the visual results in a patient with complicated cataract against the background of pseudoexfoliation syndrome, who suffered thrombosis of the central retinal vein. Materials and methods. For the first time in 2011, patient T., was born in 1946, sought ophthalmological care in the department of the State Budgetary Healthcare Institution "City Clinical Hospital named after V.M. Buyanova" with complaints of a sharp decrease in vision in the right eye. The patient was diagnosed with the following on the right eye: thrombosis of the central retinal vein, senile nuclear cataract, pseudoexfoliation syndrome grade 3, dry form of age-related macular degeneration. A course of conservative therapy was recommended for 30 hospital days, including: anticoagulants, glucocorticosteroids, diuretics, angioprotectors, antioxidants, gemmocorrectors with subsequent phacoemulsification of cataract with implantation of an intraocular lens using the standard technique. Results and discussions: Postoperative observation and the patient's condition were uneventful, minor conjunctival injection, moderate corneal edema, tightness and adaptation of the wound edges were noted. The main incision was located at 12 o'clock, the pupil was under medicinal mydriasis, transparency of the anterior chamber fluid and the correct position of the centered intraocular lens were observed. The fundus was behind the phlerum. Taking into account the transferred processes and to maintain stable visual functions, the patient was prescribed an additional course of conservative therapy, including antioxidant therapy in courses of instillations for 1 month, angioprotectors, tissue reparation stimulants both intramuscularly and parabulbarly. Conclusions: The main factor in such conditions is emergency medical care, preferably in the first hours, to exclude the development of further complications. In this clinical case, the patient had a history of chronic general somatic pathology subject to dispensary observation. The authors have repeatedly considered the relationship of pseudoexfoliation syndrome with thrombosis of the central retinal vein, but the mechanism of the primary trigger is difficult to trace. The patient initially sought help 10 years ago without signs of exfoliative deposition, but had a history of arterial hypertension. For 10 years, arterial hypertension was compensated, the patient regularly took hypotensive drugs per os. At the time of this examination, the signs of pseudoexfoliation syndrome were maximally diagnosable. According to the literature, pseudoexfoliation syndrome is a risk factor for the central retinal vein, perhaps this syndrome served as a trigger for this condition of the patient. In the future, the patient needs to be monitored by a wide range of specialists. Thanks to the timely assistance, the visual acuity of this patient remained at 30%, further observation by ophthalmologists should certainly be dynamic.