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The features of cataract surgery in a patient with Graves’ disease and endocrine ophthalmopathy

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Abstract


After the phacoemulsification technique was implemented in ophthalmic practice surgeries to replace the clouded lens have become routine for ophthalmologists. Today, over half a million phacoemulsification surgeries are annually conducted in Russia. Cataract combined with endocrine ophthalmopathy poses a significant challenge for an operating surgeon because of the unusual anatomical presentation of the orbit and the eyeball, as well as the elevated intraocular pressure caused by edema of the orbital tissues (i.e., retrobulbar tissue and extraocular muscles) rather than by primary glaucoma.

We analyze the features of surgical treatment of the cataract involving intraocular lens implantation in a patient with Graves’ disease and endocrine ophthalmopathy complicated by secondary ocular hypertension, optical neuropathy, and lagophthalmos.

After restoring the euthyroid state and reducing the severity of endocrine ophthalmopathy, phacoemulsification was performed in both eyes, with an interval of 2 months. Neither intra- nor postoperative complications of the patients’ organ of vision were observed. The maximum corrected visual acuity achieved on both eyes was 0.4–0.5 in the Snellen eye chart.


Dmitry V. Lipatov

Endocrinology research centre

Author for correspondence.
Email: Glas1966@rambler.ru
ORCID iD: 0000-0002-2998-3392
SPIN-code: 9601-3993

Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

MD, PhD, Professor

Natalya Yu. Sviridenko

Endocrinology research centre

Email: sny@endocrincentr.ru
ORCID iD: 0000-0002-8538-5354
SPIN-code: 5889-6484

Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

MD, PhD, Professor

Elena G. Bessmertnaya

Endocrinology research centre

Email: bessmertnaya.eg@gmail.com
ORCID iD: 0000-0001-5910-6502
SPIN-code: 9601-5678

Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

MD, PhD

Anna A. Tolkacheva

Endocrinology research centre

Email: tolkacheva@ebdocrincentr.ru
ORCID iD: 0000-0003-4176-8473
SPIN-code: 9601-3996

Russian Federation, 117036 Moscow Dmitry Ulyanov str. 11

ophthalmologist 

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Supplementary files

Supplementary Files Action
1. Fig. 1. The appearance of the patient upon admission to hospital View (1MB) Indexing metadata
2. Fig. 2. The appearance of the patient after pulse therapy with methylprednisolone. View (880KB) Indexing metadata
3. Fig. 3. Right eye (side view). View (1MB) Indexing metadata
4. Fig. 4. Left eye (side view). View (1MB) Indexing metadata
5. Fig. 5. The moment of implantation of semi-rigid acry- LOVE IOL. View (1MB) Indexing metadata
6. Fig. 6. The imposition of a corneal suture at the end nii operations. View (1MB) Indexing metadata
7. Fig. 7. Implantation of the IOL “MIOL-HD” through special cartridge. View (1MB) Indexing metadata
8. Fig. 8. The end of the surgical intervention the second eye. View (1MB) Indexing metadata

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Copyright (c) 2018 Lipatov D.V., Sviridenko N.Y., Bessmertnaya E.G., Tolkacheva A.A.

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