Saratov JOURNAL of Medical and Scientific Research

Tambov State University n. a. G.R. Derzhavin

Analysis of the results of implanting intraocular lens with low-addition power and asymmetric optics

Year: 2020, volume 16 Issue: №2 Pages: 628-632
Heading: Ophtalmology Article type: Original article
Authors: Nenasheva Yu.V., Fabrikantov O.L.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose of the study is to analyze clinical and functional treatment outcomes and usefulness of visual rehabilitation in patients implanted with IOL Lentis Comfort. Material and Methods. 64 patients were examined. Patients of group one underwent cataract phacoemulsification with IOL Lentis Comfort implantation, patients of group two were implanted with IOL Acrysof Restor. Non-corrected and corrected distance visual acuity, for intermediate distance (70 sm) and near visual acuity (30-40 sm) were examined on the 2nd day, in a month and in 6 months postoperatively. In 6 months after surgery subjective assessment of patients' satisfaction with the quality of vision was conducted using a questionnaire. Results. High distance visual acuity was revealed in both groups, visual acuity for intermediate distance was significantly higher in patients of group one, near visual acuity was higher in patients of group two. According to the questionnaire results patients of both groups did not experience difficulties in working and driving during the day, at night, patients of group two were much more likely to report difficulties in driving a car and undesirable light phenomena. Conclusion. Implantation of IOL with low-addition power and asymmetric optics provides high quality vision at various distances. The low level of undesirable light phenomena contributes to rapid adaptation of patients in the postoperative period.

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Deep anterior keratoplasty in the treatment of keratoconus

Year: 2020, volume 16 Issue: №2 Pages: 619-623
Heading: Ophtalmology Article type: Original article
Authors: Lev I.V., Fabrikantov O.L.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose of the study is to estimate the results of deep anterior keratoplasty in the treatment of keratoconus during the period of time from 2016 to 2020 based on Tambov branch data. Material and Methods. The main group included 26 patients (28 eyes) diagnosed with III-IV degree keratoconus and undergone deep anterior lamellar keratoplasty (DALK). The control group included 11 patients (12 eyes) with penetrating keratoplasty (PK). All patients underwent ophthalmologic examination before and after surgery, including routine and special (keratotopography, keratopachym-etry, endothelial biomicroscopy) methods of examination. Results. The prevalence of keratoconus in Tambov region is 0.59%, moreover keratoconus occurs in men 2 times more often than in women. Transparent engraftment of the transparent cornea was obtained in 100% of DALKs and only in 84% of PKs. In the group of patients with PK all changes in corrected visual acuity were statistically insignificant, while in the group of patients with DALK they were significant at all stages of examination. One year after surgery the corrected visual acuity was 0.64±0.23 and 0.57±0.27 in the main and control groups correspondingly (p<0.05). The endothelial cell loss one year after surgery was 10.5 and 5.1% following DALR and PK correspondingly (p<0.05). Conclusion. The analysis of DALK and PK outcomes in patients with keratoconus shows that DALK is characterized by shorter period of rehabilitation, absence of rejection reaction, stable visual acuity restoration, and lower rate of endothelial cell loss.

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Effect of solar activity and gestational age on the development of retinopathy of prematurity

Year: 2020, volume 16 Issue: №2 Pages: 605-609
Heading: Ophtalmology Article type: Original article
Authors: Kutimova E.Yu., Fabrikantov O.L., Matrosova Yu.V., Shutova S.V.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose of the investigation is to analyze prevalence and progression of retinopathy of prematurity depending on gestational age and solar activity at the time of birth. Material and Methods. 229 cases of premature babies born from 2017 to 2019 were randomly selected. They were divided into two groups: group I — children with retinopathy of prematurity (1, 2 and 3 degree) and group II —without any retinopathy (pre retinopathy). The disease outcome was taken into account in children with retinopathy of prematurity: children undergone laser coagulation (LK) and spontaneous regression. Based on the date of birth all children were divided according to seasons (winter, spring, summer and autumn) and periods of solar activity: reduced (winter-autumn) and increased (spring-summer) solar activity. Results. The study revealed a strong direct relationship between the outcome of retinopathy and gestational age and seasonal solar activity. Conclusion. In children born in spring and summer, the rate of spontaneous regression of retinopathy is significantly lowerthan in children born in the winter-autumn period. Reliable correlations were obtained: the longerthe gestational age and birth weight, the less likely it is to require laser coagulation.

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Heidelberg edge perimetry and retinal tomography in diagnosis of initial open-angle glaucoma

Year: 2020, volume 16 Issue: №1 Pages: 280-287
Heading: Ophtalmology Article type: Original article
Authors: Sukhorukova A.V., Fabrikantov O.L., Tovmach L.N.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose of the study is to develop an algorithm that increases the accuracy of diagnosing initial open-angle glaucoma using Heidelberg edge perimetry and retinal tomography. Material and Methods. The study involved 624 patients (624 eyes): 236 males and 388 females. The mean age was 63.4±9.3 years old. All patients underwent routine ophthalmic examination, Heidelberg edge perimetry (HEP), and Heidelberg retinal tomography (HRT) depending on the results achieved. Results. The study revealed both direct and inverse relationships between the disease and particular HRT parameters. We established quantitative characteristics of the optic disc parameters, where pathological alterations were revealed receiver operating curve (ROC-analysis) mathematical method. We analyzed the data from the positions of attribution of a patient's individual parameters to the risk factor according to the received cut-off point limit values. Seven main parameters, which received the best evaluation of diagnostic informativity according to ROC-analysis, were assessed. Then we compared the number of risk factors and the real value of the sick/healthy characteristic. Conclusion. We have developed a new algorithm to diagnose the initial open-angle glaucoma. According to this algorithm, the most applicable diagnostic practice is to set the diagnosis in the presence of five risk factors in the individual optic disc values with 95% specificity.

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Determination of properly sized capsulorhexis in lens sub-luxation to perform the best capsular bag fixation

Year: 2020, volume 16 Issue: №1 Pages: 253-258
Heading: Ophtalmology Article type: Original article
Authors: Pirogova E.S., Fabrikantov O.L., Nikolashin S.I., Kurbatova V.A.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose of the study is to determine the appropriate anterior capsulorhexis size for the best capsular bag fixation in lens subluxation using iridocapsular retractors. Material and Methods. The patients were divided into three groups: group 1 included 48 eyes, group 2-50 eyes, group 3-46 eyes. A total of 144 patients (144 eyes) had lens subluxation of the first and second degree according to Pashtaev's classification. In group 1 we performed manual capsulorhexis with the mean diameter of 5.5 mm. In group 2 the diameter was 5.0 mm, and in group 3-4.5 mm. Nuclear density was classified as that of the second and fourth degree according to Buratto's classification. All patients underwent phacoemulsification with implantation of iridocapsular retractors and capsular ring. Results. The largest share of postoperative complications at 5.6% was observed in group 2, it was at 4.0% in group 3, and at 1.3% in group 2. The postoperative visual acuity increased significantly in all groups both at discharge and one year after surgery. Intraocular pressure was normalized in all patients at discharge and one year after surgery. Conclusion. The best capsular bag fixation in lens subluxation is achieved with a 4.5 mm capsulorhexis. However, the risk of anterior capsule damage increases. A 5.0 mm capsulorhexis is the most appropriate one for the best capsular bag fixation and comfort phacoemulsification.

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Informativity of microperimetry in retinal pathology diagnosis

Year: 2020, volume 16 Issue: №1 Pages: 249-253
Heading: Ophtalmology Article type: Original article
Authors: Pilyagina А.А., Nenasheva Yu.V., Fabrikantov O.L.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose of the study is to estimate the functional status of central retinal zone with microperimetry method in patients with retinal pathology. Material and Methods. Microperimetry was performed on 16 patients (18 eyes) with different kinds of retinal pathology including thrombosis of central retinal vein branches, age-related macular degeneration, myopic maculopathy, lamellar macular hole, tapetoretinal degeneration, ocular albinism, central serous chorireti-nopathy, proliferative diabetic retinopathy. Mean age was 52.4 years old; male — 8, female — 8. Results. The average light sensitivity of central retinal zone was reduced in the majority of patients. The decrease in the index of retinal light sensitivity in the pattern point corresponding to fixation point did not correspond to the decrease in the best-corrected visual acuity in all cases. Central defects and depression zones topographically corresponded to pathological alterations on the eye fundus. In a patient with ocular albinism fixation was characterized as unstable, in the rest of cases we observed stable fixation. The analysis of fixation allowed receiving additional information about visual quality and the degree of visuomotor coordination in patients with retinal pathology. Conclusion. As a result of the study we showed high informativity of microperimetry for assessing central retinal zone's functional status in retinal pathology.

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Influence of optic disc size on the results of morphometric examinations at glaucoma

Year: 2020, volume 16 Issue: №1 Pages: 231-236
Heading: Ophtalmology Article type: Original article
Authors: Lvov V.A., Machekhin V.A., Fabrikantov O.L.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose of the study is to analyze morphometric parameters of the optic disc, peripapillary retina and ganglion cells complex of the retinal macular area in eyes with different disc area. Material and Methods. 150 patients (294 eyes) aged 62.1 ±9.6 years old were examined (male — 69, female — 81). The eyes were divided into two groups according to the optic disc area (OD): eyes with average disc area (1.63-2.43 mm2) and eyes with small disc area (less than 1.63 mm2). Analysis of the morphometric structure of the OD, peripapillary retina and ganglion cells complex of macula was performed with Heidelberg laser retinal tomography HRT-3 and optical coherence tomography RTVue-100 (Optovue, USA). Computed perimetry of the central visual field was conducted using Carl Zeiss (USA) device with HFA30-2 software. Results. In the group of eyes with small discs according to HRT we revealed the significant difference in the OD parameters (cup area, rim area, cup/disc area) between normal eyes and eyes with preperimetric glaucoma, as well as in the group with average discs (p<0.001). We detected a significant difference of the peripapillary retina parameters (RNFL) between all stages of glaucoma, including normal limits, preperimetric and advanced stages of glaucoma in the group with small discs according to OCT. Conclusion. Both HRT and ОСТ have identical capability in early diagnosis of glaucoma, however, HRT evaluates the optic disc parameters better, while the ОСТ is preferable at peripapillar retina parameters evaluation. Preperimetric glaucoma, being the principal part of diagnosing glaucoma suspect, provides for accumulation of structural alterations of the optic disc and thus early detection of glaucoma.

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Polymer micro-shunt Reper-NN in combined glaucoma and cataract surgery

Year: 2020, volume 16 Issue: №1 Pages: 223-227
Heading: Ophtalmology Article type: Original article
Authors: Kolpakova О.А., Fabrikantov O.L., Nikolashin S.I.
Organization: Tambov State University n. a. G.R. Derzhavin, S. Fedorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is to estimate the efficacy of polymer micro-shunt Reper-NN in combined glaucoma and cataract surgery. Material and Methods. The examination group consisted of 34 patients (34 eyes) with cataract and glaucoma of different stages. All patients were divided into 2 groups: 1)16 patients underwent micro-shunt Reper-NN implantation with simultaneous phacoemulsification with IOL implantation; 2) 18 patients underwent micro-invasive non-penetrating deep sclerectomy with simultaneous phacoemulsification with IOL implantation. The diagnosis was made based on the anamnesis and data of objective and instrumental examinations. Preoperatively all patients underwent examination of visual acuity, intraocular pressure, perimetry, ophthalmometry, ultrasound scanning. Results. Intraocular pressure was normalized in all patients. Conclusion. Combined cataract and glaucoma surgery using polymer micro-shunt Reper-NN is an effective and safe method of treating open-angle glaucoma and cataract.

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Comparative analysis of the application of the above- threshold laser coagulation and micropulse laser exposure in central serous chorioretinopathy

Year: 2019, volume 15 Issue: №2 Pages: 532-536
Heading: Ophtalmology Article type: Original article
Authors: Popova N.V., Fabrikantov O.L., Goydin A.P.
Organization: S. Fedorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

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

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Tactics of delivery and diagnostic evaluation in pregnant women with peripheral vitreoretinal dystrophy

Year: 2019, volume 15 Issue: №2 Pages: 528-532
Heading: Ophtalmology Article type: Original article
Authors: Popova N.V., Goydin A.P., Fabrikantov O.L., Goydin D.A.
Organization: S. Fedorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

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.

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