2019, volume 15

The purpose of the study is to evaluate the results of femtolaser sclerotomy in the experiment on isolated eye of animal, as well as the prospects of applying the method of laser transscleral puncture of the sinus canal of sclera. Material and Methods. We performed a series of experiments on fresh scleral tissue of isolated pig eyes using industrial femtosecond laser PH-1SP with a wavelength of 1028 nm, pulse energy of 0.5–1.5 MJ, frequency of 1–20 kHz. Series of 10–15 pulses with duration less than 100 FS were performed. In order to assess the depth of femtosecond laser exposure to scleral tissue, as well as the quality of the obtained punctured holes, histological preparations were made, studied using routine light microscopy with multiplicity of magnifying up to ×400. Serial sagittal and frontal sections 15 µm thick and hematoxilin eosin staining were used. Results. Puncture channels of diferent confgurations with a minimum marginal coagulation of no more than 5 microns were obtained due to the efect of ablation of the scleral tissue. The maximum depth of the formed channels is 500 microns at a power of 1.5 MJ and a frequency of 10 kHz. Since the thickness of the scleral tissue of the human eye in the limbal zone is 600–800 µm, there is prospect of using a femtosecond laser for the laser transscleral puncture of the schlemm channel. Conclusion. The infuence of femtosecond laser on tissue of sclera is characterized by the almost complete absence of heat, the coagulation efect and the pronounced depth of the ablation, thus it is possible to discuss the use of femtosecond laser for the laser transscleral puncture of the sclera sinus channel.

Purpose: to determine the efectiveness of above-threshold (focal) laser coagulation and micropulse laser exposure (MPLV) in patients with central serous chorioretinopathy (CCA). Material and Methods. 91 people with a diagnosis of CCA were examined. The median age was 35.2 years. Patients of the 1st group (n=19) was performed MPLV a wavelength of 810 nm; group 2 (n=31) — about threshold photocoagulation with the wavelength of 810 nm. Control group — 50 people with a natural course of the process. Results. After 1 month after treatment in group 1, visual acuity increased from 0.5±0.08 to 0.8±0.03. According to optical coherence tomography (OCT), the neuroepithelial detachment decreased from 446 to 341.3 MK. With the chronic course of the process after laser treatment, recurrence of the disease was revealed, which required an additional session of MPLV. In group 2, after 1 month, visual acuity increased from 0.6±0.20 to 0.8±0.03, neuroepithelial detachment decreased from 365 to 269 MK. Relapse of the disease in chronic form required an additional session of MPLV. After 3 months, both groups showed complete adhesion of the neurosensory retina and increased visual acuity to 0.9±1.0. Conclusion. Laser coagulation (above- threshold laser coagulation, micropulse laser exposure) is minimally invasive and highly efective in the treatment of central serous chorioretinopathy. The choice of laser treatment method depends on the

Purpose: to develop recommendations on delivery tactics based on the analysis and terms of detection of various forms of peripheral vitreoretinal dystrophies in pregnant women with myopia. Material and Methods. 44 women were examined with a mean age of 31 years. Peripheral vitreochorioretinal dystrophy was detected in 82 %. All patients underwent the following studies: visometry using device TOPCON CV-5000 (Japan), autorefractometry using TOPCON KR-8900 (Japan), ultrasound biometry using TOMEY AL-3000 (Japan), eye fundus was examined by Goldman three-mirror lens using the slit lamp TAKAGI SM-70N. When severe peripheral vitreochorioretinal dystrophy is detected, it is recommended to perform peripheral laser coagulation using laser device IRIDEX IQ-810 (USA). Results. In most cases (68 %) peripheral retinal laser photocoagulation was performed with subsequent recommendations on the possibility of natural delivery, and in 32 % of cases caesarean section delivery was recommended to these women. Conclusion. Decision on delivery tactics in pregnant women with myopia should not be determined by the degree of myopia, but by the severity of pathological changes on the periphery of the retina. Medical examination of pregnant women with obligatory examination of the eye fundus with mydriasis medicamentosus in 30–34 weeks allows to identify patients at risk of retinal detachment and conduct early treatment, thereby initially reducing the frequency of operativedelivery according to the ophthalmological indications.

Purpose: the analysis of the informativeness of optical coherence tomography as an additional method in the diferential diagnosis of central chorioretinitis and age-related macular degeneration. Material and Methods. Studies conducted in 44 patients. The frst group included 20 patients with central chorioretinitis. The second group consisted of 24 patients with diferent forms of age-related macular degeneration. The informativeness of optical coherence tomography was analyzed in the diferential diagnosis of central chorioretinitis and AMD. Results. Uncomplicated forms of AMD and central chorioretinitis have a diferent tomographic picture. Using the OCT method it is possible to judge the change in the thickness of the choroid which increases in the acute phase of chorioretinitis. In the atrophic form of AMD, the thinning of the choroid extends over a considerable distance. OCT provides additional information on the localization of the infammatory focus. Conclusion. OCT-diferences were found at the level of the pigment epithelium, retinal photoreceptors and choroid in infammatory processes and degenerative diseases, which can help in difcult cases of diferential diagnosis. However, secondary choroidal neovascularization does not have specifc OCT signs in various diseases, since it is a complication of the main process.

Purpose: comparative analysis of the results of implantation of bifocal refractive-difractive IOLs and new trifocal single-piece aspherical difractive IOLs. Material and Methods. A prospective open study included 193 patients (291 eyes) with presbyopia. The average age of patients was 58.4±11.3 years. Group I consisted of 71 patients (108 eyes) with implantation of the AcrySof PanOptix trifocal IOL; Group II — 122 patients (183 eyes) with the AcriSof Restor bifocal IOL with addidation 3 Dioptr. Results. After 6 months of follow-up in group I, an increase in UCNVA from 0.2±0.09 to 0.85±0.17, an UCFVA from 0.2±0.07 to 0.78±0.13, and a UCIVA from 0.3±0.1 to 0.84±0.2, BCNVA from 0.58±0.24 to 0.98±0.21, BCFVA from 0.68±0.26 to 1±0.1 and BCIVA with 0.59±0.28 to 0.95±0.18 (p<0.05 in all cases). In group II, signifcantly lower values of UCNVA (0.62±0.09), UCIVA (0.31±0.14) and BCIVA (0.6±0.19) were observed when compared with group I (p<0.05). In all groups, a decrease in the spherical and cylindrical component of refraction was observed. Level of contrast sensitivity after implantation of the AcrySof Restor was higher for all frequencies. According to the results of the survey on a scale of VF-14 in group I, the average value was 97.9±1.2 points, and in group II — 80.1±6.4 (p<0.05). Conclusion. In this paper an advantage of a new trifocal IOL for vision correction at an average distance under various lighting conditions is shown, as well as the best indicators of vision quality on the VF-14 scale.

Purpose: to assess preliminary results of modifed cryogenic scleroplasty efcacy in patients with progressing myopia. Material and Methods. Modifed cryogenic scleroplasty was developed by us in order to decrease the risk of deformation, torsion and displacement of scleroplastic material during its implantation. 38 children (72 eyes) aged 7–17 years with diagnosis of acquired progressing medium and high myopia with documented annual gradient of progressing more than 1 D were operated. 35 children (64 eyes) were the control group. They underwent standard scleroplasty by Pivovarov — Pristavko method. Results. No complications and adverse reactions to the transplantation material were observed during modifed cryogenic scleroplasty. Due to exposition in liquid nitrogen solution transplant keeps form and is not deformed during immersion and its partial location under the muscle. Stabilizing efect of the studied method (according to clinical refraction and axial length) is comparable to other types of scleroplasty. Conclusion. The developed technology of surgical treatment of progressing myopia is characterized by technological simplicity, convenience in material implantation, exclusion of transplant deformation and torsion on episclera surface, high stabilizing efect during the frst year after the surgery.

Purpose: using HRT and OCT to compare the outcomes of the examination of optic disc parameters in normal eyes and glaucomatous eyes with discs of standard (average) and large size. Material and Methods. 306 eyes of 160 patients (71 male, 89 female) aged 61.1±10.0 years old were analyzed retrospectively. All eyes were divided into 2 groups: group I included 162 eyes with the disc area of 1.63–2.43 mm2; group II — 144 eyes with the disc area of 2.44– 3.5 mm2. Both groups were divided into fve subgroups (healthy eyes, eyes with preperimetric glaucoma and with different stages of glaucoma). Disc parameters were analyzed using HRT 3 and RTVue-100 simultaneously in the same eyes. Results. In the group of eyes with average discs both methods (HRT and OCT) revealed the same examination outcomes of all disc parameters indicating high statistical signifcance of the diference between groups of healthy eyes and eyes with preperimetric glaucoma. In the group with large discs the parameters of peripapillar retina (RNFL) play a signifcant role. Conclusion. Preperimetric glaucoma is a valuable indicator to detect early glaucoma in the group of eyes with average discs. However, in large discs according to either HRT or OCT data peripapillar retinal parameters are the most sensitive, whereas the alterations of the internal structure of the disc itself appear later.

Purpose: to analyze the position of toric intraocular lens Acrys of IQ Toric in the vertical and horizontal plane and rotational stability during cataract phacoemulsifcation in patients with astigmatism. Material and Methods. The results of implantation of toric intraocular lens (TIOL) (Acrys of IQ Toric model) in 38 patients (38 eyes) after cataract phacoemulsifcation were studied. Parameters of rotational stability and the position of TIOLs (decentration and tilt) in the capsule bag relative to the vertical and horizontal plane 2 months after the operation were also studied. Results. Average values of uncorrected visual acuity were 0.8 in more than 50 % of cases. Values of decentration and tilt of the TIOL in the capsular bag did not exceed the clinically signifcant value and amounted to an average of 0.4±0.1 mm and 0.6±0.2° respectively in the horizontal plane, and 0.3±0.1 mm and 0.5±0.1° in the vertical plane. The average rotation angle of TIOL after 2 months of observation was 4.8±4.1°, with a maximum rotation angle of 19°. Correlation analysis revealed the presence of a statistically signifcant relationship of average force between the residual cylinder and the horizontal slope (r=0.52; p=0.02) and the residual cylinder and vertical decentralization (r=0.52; p=0.03). Conclusion. In most cases the parameters of TIOL position in the capsule bag (decentration and tilt) and rotational stability did not exceed clinical signifcance providing high functional results. The residual cylinder correlated with the angle of inclination and decentralization of the optical part of the intraocular lens.

Purpose: to conduct a retrospective analysis of the initial state of the indicators of systemic hemostasis in women during a complicated pregnancy, to determine its likely relationship with the formation of vascular retinal pathology in the long-term period after childbirth. Material and Methods. The 1st main group consisted of 47 women whose pregnancy proceeded against the background of gestational hypertension. The 2nd main group is represented by 48 women, whose pregnancy was complicated by pre-eclampsia. The control group was formed by 50 women with normal ongoing pregnancy. In women of all groups, the initial state of hemostasis was assessed in the third trimester of pregnancy, according to medical records. Results. It turned out that in women with hypertensive disorders in the third

Purpose: to study in the experiment the properties of three diferent types of synthetic polyester matrices, to conduct their comparative assessment and determine the optimum as a carrier for the cultivation and transplantation of limbal stem cells while eliminating limbal insufciency. Material and Methods. Transparency, mechanical properties (strength, elongation at break, modulus of rigidity), biocompatibility with cell cultures of the cornea, as well as the study of the timing of matrix biodegradation in vivo were carried out. Results. The study examined the optical and mechanical properties of matrices made from polylactide-glycolide (PLG), polylactide-caprolactone (PLC) and poly-e-caprolactone (PCL). It was experimentally shown that human and rabbit limbal stem cells, as well as human corneal epithelium cells, adhered on the surface of all types of matrices under investigation, and during cultivation they retained the typical structure of actin cytoskeleton, the ability to proliferate and migrate. Diferences in the interaction of diferent cell cultures with diferent types of carriers were revealed. The terms of biodegradation of PLC matrices with a thickness of 5 μm was about 30 days. Conclusion. The results indicate that it is possible to use 5 μm thick PLC matrices as a carrier of cultured limbal stem cells.