Taranukha O. Prevention of exudative response after extracapsular senile cataract extraction with implantation of an intraocular lens by medicamental correction of autonomic disturbances

Object of the study: patients with senile cataract. Purpose of the study: increasing effectiveness of surgical treatment of patients with senile cataract by means of prevention of exudative response after extracapsular senile cataract extraction with implantation of an intraocular lens by medicamental correction of autonomic disturbances. Methods of research: clinical: standard ophthalmologic (visiometry, biomicroscopy, ophthalmoscopy, ophthalmometry, ocular tonometry), as well as determining cornea sensitivity according to Radzihovsky, diaphanoscopy; methods of autononomic nervous system evaluation: tabular procedure and variational pulsometry, cold test, biochemical method (determining adrenalin and noradrenaline in daily urine), neuropharmacologic method (instillation of 0.1% adrenalin solution), statistical methods. Theoretical and practical outcomes: substantiation of the necessity of examining the status of autononomic nervous system, revealing autononomic dysfunction in patients with senile cataract before extracapsular cataract extraction with implantation of an intraocular lens. Treating patients with revealed autononomic dysfunction (increased tension of the sympathoadrenal system and decreased autononomic responsiveness) before surgery with a sympatholytic called Hemiton (until normalizing of autononomic characteristics) allows for decreasing the exudative response by 56.7%. Innovation: for the first time it is established that satisfactory course of postoperative period after extracapsular senile cataract extraction with implantation of an intraocular lens is observed in patients with senile cataract with normal condition of autonomic nervous system. For the first time it is revealed that autonomic dysfunction - increased tension of the sympathoadrenal system and decreased autononomic responsiveness - results in development of exudative responses of the ІІ-ІІІ degree of severity (in 1-5 days) as well as in atrophy of the iris with disseminated precipitates on the corneal endothelium (the syndrome) within 4-6 months following the cataract extraction. It is established that pre-surgical autonomocorrective therapy with sympatholytic Hemiton allows to recover broken functions of autonomic nervous system in patients with senile cataract thus contributing to a better course of postoperative period after extracapsular cataract extraction with implantation of an intraocular lens. Degree of application: outcomes of the thesis have been introduced in the medical institutions in the form of an in-formation letter of the Ministry of Healthcare of Ukraine (№12-02), applied at Kharkiv Ophthalmological Clinic № 14 named after Professor L. L. Girshman, ophthalmologic department of Kharkiv Regional Clinic; they are used in training processes at the subfaculty of eye diseases of Kharkiv State Medical University and at the subfaculty of ophthalmology of Kharkiv Medical Academy of the Postgraduate Studies. Application field: medicine, ophthalmology.