Russian MedicineRussian Medicine0869-21062412-9100Eco-Vector10996710.17816/medjrf109967Research ArticleSurgical treatment of patients with visually stressful work from the standpoint of the occurrence of postoperative anisometropia: clinical casePokrovskyDmitry F.<p>MD, Cand. Sci. (Med.), assistant professor</p>dfpokrovskiy@gmail.comhttps://orcid.org/0000-0001-6153-2463OvechkinNikolai I.<p>MD, Cand. Sci. (Med.)</p>n.ovechkin@gmail.comhttps://orcid.org/0000-0002-1056-5422Pirogov Russian National Research Medical UniversityHelmholtz National Medical Research Center of Eye Diseases231120222854094132308202224082022Copyright © 2022, Eco-Vector2022<p><strong><em>BACKGROUND:</em></strong> To date, several debatable aspects of cataract phacoemulsification (PEC) in the literature exist, one of which is the study of the surgical features in patients with visually stressful work (VLT) and binocular cataract.</p>
<p><strong><em>CLINICAL CASE DESCRIPTION:</em></strong> In this case, we evaluated the effectiveness of surgical treatment of binocular cataract in a patient with VLT from the standpoint of the occurrence of postoperative anisometropia (A). The patient complained of decreased visual acuity in both eyes. The patient is a chief accountant, and the time of daily visual work is at least 6 h a day. The results of the examination were as follows: A 0.1 relative units; quality of life (QOL) according to the questionnaire KZS-22 152 points, which corresponds to the compensation stage of asthenopia. The patient underwent a standard PEC, and the target refraction was 0.5 diopters. The operation on the second eye was performed on day 18 after the operation on the first. The results of the examination 7 days after the first operation were A of 0.2 relative; units and QOL of 176 points (normal). The results of the examination before the second operation (18 days after the first) were A of 0.4 relative units and QOL of 138 points decompensation of asthenopia). The results of the examination 7 days after the second operation were A of 0.1 relative units and QOL of 189 points (normal).</p>
<p><strong><em>CONCLUSION:</em></strong> The surgical treatment of binocular cataract in patients with VLT is based on an earlier (710 days) operation on the second eye to reduce the adverse effects of anisometropia, manifested by severe asthenopia. If a second operation is possible within the specified timeframe, a one-stage binocular PEC should be considered.</p>cataract phacoemulsificationvisually intense workanisometropiathe quality of lifeфакоэмульсификация катарактызрительно-напряжённый труданизометропиякачество жизни[Federal’nye klinicheskie rekomendatsii po okazaniyu oftal’mologicheskoi pomoshchi patsientam s vozrastnoi kataraktoi. Ekspertnyi sovet po probleme khirurgicheskogo lecheniya katarakty. Moscow: Oftal’mologiya; 2020.][Available from: https://diseases.medelement.com/disease/катаракта-старческая-кп-рф-2020/16855 Accessed: 25.08.2022. (In Russ).][Mahmud I, Kelley T, Stowell C, et al. A proposed minimum standard set of outcome measures for cataract surgery. JAMA Ophthalmol. 2015;133(11):1247–1252. doi: 10.1001/jamaophthalmol.2015.2810][Iqbal M, Said O, Ibrahim O. Visual sequelae of computer vision syndrome: a cross-sectional case-control study. J Ophthalmol. 2021;2021:6630286. doi: 10.1155/2021/6630286][Dessie A, Adan F, Nega A, et al. Computer vision syndrome and associated factors among computer users in Debre Tabor town, Northwest Ethiopia. J Environ Public Health. 2018;2018:4107590. doi: 10.1155/2018/4107590][Ovechkin IG, Yudin VE, Kovrigina EI, et al. Methodological prin ciples for the development of a questionnaire «Quality of Life» in patients with computer visual syndrome . Ophthalmology in Russia. 2021;18(4):926–931. (In Russ). doi: 10.18008/1816-5095-2021-4-926-931][Talukder AK, Zakia S, Khanam M, et al. Binocular visual discomfort after first eye cataract surgery: an inattentive burning issue. Mymensingh Med J. 2019;28(2):302–305.][Krarup TG, Nisted I, Christensen U, et al. The tolerance of anisometropia. Acta Ophthalmol. 2020;98(4):418–426. doi: 10.1111/aos.14310][Amsden LB, Shorstein NH, Fevrier H, et al. Immediate sequential bilateral cataract surgery: surgeon preferences and concerns. Can J Ophthalmol. 2018;53(4):337–341. doi: 10.1016/j.jcjo.2017.10.034][Reis T, Lansingh V, Ramke J, et al. Cataract as a cause of blindness and vision impairment in Latin America: progress made and challenges beyond 2020. Am J Ophthalmol. 2021;225:1–10. doi: 10.1016/j.ajo.2020.12.022]