For the study of anatomical and morphological characteristics of indicators were examined 94 eyes (94 patients with cataract with the average age from 50 to 99 years, 41 men, 53 women). After biomicroscopy the determination of the morphometric parameters of the eye (AL AC, L and V) was carried out by the method A-Scan, AC parameters were determined on “Orbscan”, optical coherent tomography and gonioscopy 3 groups of eyes were allocated: Group 1-AL> 24 mm - 7 eyes, (7 patients);Group ІІ- AL < 24 mm; at the depth of the anterior chamber (AC) > 2,8 mm - 52 eyes (52 patients); Group ІІІ -AL < 24 mm; at a AC depth < 2,8 mm -37 eyes (37 patients). Comparison Group - 20 eyes of healthy patients of the same age. The parameters of the eyes of group І (large eyes) differed from the control group (p < 0,05). In group ІІ (eyes proportional) only the size of the lens was different - L (p < 0,05) from the control group. In group ІІІ (SSAC) biometric indices differed significantly from the control group, group І and group ІІ (p < 0,05). AL in groups ІІ, ІІІ, control essentially not differed (p > 0,05), thus, according to the average data, was not defined "short" eyes. To characterize proportions that present in the eyes of patients with cataracts, and may have been formed in the process of cataractogenesis, correlated in group ІІІ in the eyes of the SSAC ratio the depth of the AC (AC) and the lens (L) with the depth of the vitreal cavity (V). Most significant the difference in relation to the depth of the cavity of the vitreum was observed in group ІІІ. It is noted that the depth of the cavity of the vitreum (V) was in 5,73 times greater, than the depth of the AC. This is significantly higher (P <0,05) than in other groups: group І- in 4,70, group-ІІ- in 4,75, control group -in 4,65 times. As the cause anatomical imbalance due to an increase in the parameter V (vitreum), we can assume the accumulation of liquid behind the iridocrystalline diaphragm, which is pathogenetically associated with the possible development of phacomorphic glaucoma. But this factor - a non-compressible liquid substance –can affect the performance of the PEC in the eyes with the shallow AC. The parameters of opening AAC are determined by the OCT method. The value in the eyes of the SSAC groups ІІІ, on the average, - 13.07 ± 4,30 degrees, in the eyes of group ІІ – 17,20 ± 5,30 degrees (P < 0,05) (by 20,6% differed in group ІІ (p <0,05)). In the patients of ІІІ group the AAC was marked as closed in 83% of eyes, open narrow AAC - in 17%, goniosynechias were in 26%. The dependence of the endothelia layer postoperative density on the depth of the anterior chamber is determined – r = 0,54 (p<0,05), density of the cornea’s endothelial layer before surgery – r = 0,63 (p<0,05), and endothelial cells losses of the endothelial layer before operation - r = 0,51 (p<0,05). At the second stage of the study, the group ІІІ (SSAC) was supplemented by 128 (129 eyes) and divided into 2 groups: group ІІІ A, which has been surgically interfered with proposed method of combined operation of the posterior microvitrectomy and phacoemulsification (COPMIVEPEC) - (60 patients (61 eyes), and group ІІІ K, in which removal of cataracts by the generally accepted method phacoemulsification (PEC) - 68 patients (68 eyes). Functional ones and the clinical parameters were determined before and after surgery in patients of 2 groups. So for the operation of VA in group ІІІ A was 0,17 ± 0,03, after 1 week –0,68 ± 0,07, and after 3 months - to 0,75 ± 0,06. In group ІІІ K the same dynamics of VA was observed. In the group ІІІ A VA 0,7 – 1,0 was achieved by 19 (31,1%) eyes, and in the group ІІІ K - by 12 (17,6%) eyes (p <0,05); in the remote period in the group ІІІ A - at 37 (60,7%) eyes, and in the group ІІІ K-28 (41,2%) eyes (p <0,05). Data on the normalization of the IOP match the data on the positive impact of the developed operation on parameters of the structures of the AC: marked deepening of the AC to 3,32 ± 0.32 mm (P <0,05), expansion of the AAC to 25.30 ±4,3 degrees(P<0,05), and reduction the percentage of closed ACC from 83% to 4% (P<0,05).In the group ІІІ K, negative changes in the EC cornea were noted, and namely: a decrease in the density of EC from 2238,4 ±77,3 to 1795,0 ±95.6 cells/ mm², cell loss -21.3%, increase in the minimum size, maximal size, average size (P <0,05), the hexagonality from 54,8 ± 1,9 decreased to 36,0 ±2,9% (P <0,05). In group ІІІ A only a decrease in the indicator is noted hexagonality with 54.84 ±1.9% to 48.51 ±2,8% (P <0,05). The other the morphometric indices of the EC cornea did not differ (P> 0,05). The study complemented the scientific information on the safety of the operation: at comparing the number and nature of the complications shown that application COPMIVEPEC operation in the eyes of the cataract with SSAC reduces 3,5 times the number of intraoperative complications to 3,3%, against 11,8% (P <0,05).
