DETERMINATION OF THE EFFECTIVENESS OF CATARACT TREATMENT IN DIABETES MELLITUS PATIENTS BY RISK ASSISTANCE ANALYSIS

Steblovska I., Bezkorovayna I.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

One of the modern methods of cataract surgical treatment is phacoemulsification, as well as FEC using a femtosecond laser. Unfortunately, these methods are associated with the development of surgical and postoperative complications, which contributes to the reduction of postoperative functional results. One of which is macular edema. The long-term existence of CMN leads to irreversible changes in the pigment epithelium and retinal photoreceptors, and, as a consequence, to a decrease in visual functions. Consequently, the optimization of surgical treatment of age-related cataracts based on the study of the features and mechanisms of postoperative macular edema, as well as the development of a new method of its prediction is an urgent problem of modern ophthalmology. The dependence of dichotomous variables on independent variables was studied using the binary logistic regression method. To assess the degree of influence of factorial signs on the treatment result, the method of constructing logistic regression models was used. Therefore, our goal is to determine the effectiveness of treatment of patients with diabetic cataract by phacoemulsification, using the analysis of risk factors in the framework of single-factor logistic regression models. The risk factors considered were gender and age of patients, the degree of density of the lens nucleus by Buratto, maximum output korrigum visual acuity prior to surgery. Under our observation there were 83 patients (83 eyes) with cataract with the degree of density of the lens nucleus by Buratto I-III. During cataract removal, all patients were taken intraocular fluid, which determined the level of thromboxane B2 and prostacycline (6-keto-Pgf1a). When assessing the effectiveness of surgical treatment of patients with cataracts, the result was considered negative in the case of macular edema otherwise the result of surgical treatment positive. In our study, it was found that the value of the 6-keto-Pgf1a/Thromboxane B2 ratio can be used as a marker of macular edema development after phacoemulsification in cataract patients. A direct correlation between the value of the ratio 6-keto-PGF1α/Thromboxane B2 ratio and the prediction of the risk of not achieving the highest possible visual acuity in patients with cataract 1 year after FEC was established. 6-keto-Pgf1a / Thromboxane B2crit.= 0.86, if this threshold is exceeded, visual acuity is predicted to reach 0.8-1.0 1 year after FEC.

regression models, cataract, macular edema, femtosecond laser

1. Astakhov SYu, Gobedzhishvili MV. Posleoperatsionnyy makulyarnyy otek, sindrom Irvina-Gassa. Klinicheskaya oftal’mologiya. 2010;11(1):5-8. [in Russian].
2. Batmanov YuYe, Yevgrafov VYu. Katarakta. M.: Meditsina; 2005. 368 s. [in Russian].
3. Gobedzhishvili MV, Astakhov SYu, Kugleyev AA. Makulyarnyy otek pri psevdofakii. Oftal’mologicheskiye vedomosti. 2011;IV(4):57-9. [in Russian].
4. American Academy of Ophthalmology. Cataract in the Adult Eye. Cataract and Anterior Segment Preferred Practice Pattern (PPP) Panel. Accessed June 2, 2015. Available from: www.aao.org/preferred-practice-pattern/cataract-in-adult-eye-ppp--october-20
5. Lebraud P, Adenis JP, Franco JL. Cystoid macular edema of pseudophakic patients (retrospective study with 300 pseudophakic patients). Bull. Soc. Ophthalmol. Fr. 1987;87(12):1437.

«Bulletin of problems biology and medicine» Issue 4 part 1 (146), 2018 year, 125-127 pages, index UDK 617.741-004.1-08

10.29254/2077-4214-2018-4-1-146-125-127