Diagnosis of Grade I Weakness of the Zonular-Capsular Apparatus of the Lens Using Comparative Pneumotonometry
Abstract
Objective. To evaluate the effectiveness of intraocular pressure (IOP) measurement in different body positions as a diagnostic method for Grade I weakness of the zonular-capsular apparatus of the lens (ZCAL).
Material and methods. The study included 34 patients (59 eyes) diagnosed with age-related cataracts. All patients underwent IOP measurement in sitting and supine positions using a Keeler Pulsair IntelliPuff non-contact pneumotonometer. A difference in IOP ≥ 4 mmHg between measurements was considered a diagnostic criterion for Grade I ZCAL weakness. Patients with detected ZCAL weakness underwent additional anterior segment OCT and ultrasound biomicroscopy (UBM) examinations.
Results. Grade I ZCAL weakness was identified in 17 patients (25 eyes). The average IOP difference in these patients was 5.7±1.2 mmHg (p<0.001), whereas in patients with normal lens stability, it was 1.7±0.8 mmHg. Additional diagnostic methods confirmed zonular instability in 84% of cases according to OCT and in 88% according to UBM.
Conclusion. Comparative pneumotonometry is a simple, accessible, and informative method for diagnosing Grade I ZCAL weakness.
About the Authors
E. N. Bilalov
Ташкентская медицинская академия
Russian Federation
Russian Federation
A. E. Nozimov
Ташкентская медицинская академия
Russian Federation
Russian Federation
O. I. Oripov
Ташкентская медицинская академия
Russian Federation
Russian Federation
References
1. Potyomkin V. V., Ageeva E. V. Instability of the lens zonular apparatus in patients with pseudoexfoliation syndrome: analysis of 1000 consecutive phacoemulsifications. Ophthalmological Bulletin. 2018;11(1):41–46. (in Russ)
2. Bilalov E. N., Nozimov A. E., Oripov O. I. Method for assessing Grade I weakness of the zonular-capsular apparatus of the lens. Advanced Ophthalmology. 2024;10(4):17–22. (in Russ)
3. Takhchidi K. P. Zonular apparatus insufficiency: modern approaches to diagnosis and treatment. Bulletin of RSMU. 2024; 6(9):45–52. (in Russ)
4. Kaprin, A. D. Modern diagnostic methods for lens zonular-capsular apparatus weakness. Medical Education and Professional Development. 2023;14(2):33–38. (in Russ)
5. Ivanov P. A., Smirnova E. V. Phacoemulsification of cataract in cases of lens zonular apparatus insufficiency. Russian Ophthalmological Journal. 2022;15(3):109–115. (in Russ)
6. Ekspress-metod otsenki sostoyaniya tsinnovoi svyazki (Express method for assessing the state of the ciliary zonule): patent № RU2609048C1 Ros. Federatsiya; zayavl. 19.01.2016; opubl. 30.07.2017. Byul. № 4:7. (in Russ)
7. Johnson A. W., Smith R. T. Advances in the management of zonular weakness during cataract surgery. Journal of Cataract & Refractive Surgery. 2020; 46(5):698–705. (in Engl)
8. Lee C. Y., Chen Y. H. Novel techniques in assessing zonular integrity preoperatively. Ophthalmology and Therapy. 2019; 8(4):499–510. (in Engl)
9. Martinez-Torres J. A., Lopez-Marin L. Outcomes of capsular tension ring implantation in patients with zonular weakness. International Ophthalmology. 2019;39(2):345–352. (in Engl)
10. Garcia G. A., Rodriguez F. J. Evaluation of zonular stability using ultrasound biomicroscopy in pseudoexfoliation syndrome. Clinical Ophthalmology. 2018;12:1231–1237. (in Engl)
Review
For citations:
Bilalov E.N., Nozimov A.E., Oripov O.I. Diagnosis of Grade I Weakness of the Zonular-Capsular Apparatus of the Lens Using Comparative Pneumotonometry. Bashkortostan Medical Journal. 2025;20(2):59-62. (In Russ.)
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