Saratov JOURNAL of Medical and Scientific Research

keratoconus

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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Minimally invasive methods of keratoconus surgical treatment (review)

Year: 2020, volume 16 Issue: №1 Pages: 298-302
Heading: Ophtalmology Article type: Review
Authors: Tereshchenko A.V., Trifanenkova I.G., Vishnyakova E.N., Demyanchenko S.K., Timofeev M.A.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The review is devoted to minimally invasive methods of surgical treatment of keratoconus. Typical clinical manifestations of keratoconus are patients' young age and progressive course of the disease. Therefore, the problem of increasing keratoconus treatment effectiveness, especially at the early stages using minimally invasive techniques, does not lose its relevance, that determines the variety of the proposed methods and technologies and their modifications. Scientific literature review showed high activity of researchers aimed at developing new and improving the existing minimally invasive methods for surgical treatment of keratoconus. A significant number of publications is devoted to intrastromal keratoplasty (ISKP) with implantation of corneal segments. The ongoing studies touch upon both ways of forming the intrastromal tunnel, and the design of new models of the corneal segments, as well as the comprehensive analysis of their clinical application results. Special attention should be paid to the precision of performing ISKP to achieve high functional results and patient satisfaction with the quality of vision. In our opinion, this direction of research is especially promising and requires further development.

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Keratoconus (review)

Year: 2020, volume 16 Issue: №1 Pages: 293-297
Heading: Ophtalmology Article type: Review
Authors: Tereshchenko A.V., Demyanchenko S.K., Timofeev M.A.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The article covers the main aspects regarding prevalence, pathogenesis, diagnosis and treatment of progressive, degenerative, non-inflammatory corneal disease, i. e. keratoconus. Characteristic features of this pathology affect people of a young and working age, and cause high rates of visual disability. Keratoconus is a multifactorial disease that requires individual approach in each clinical case. Existing methods of diagnosis and treatment allow to achieve stabilization of the ectatic process at an early stage and increase the visual functions of the patient. New methods of this disease treatment are alternative and high-tech methods that allow to expand the arsenal of corneal surgery without donor material use.

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Femtolaser intrastromal implantation of segments using a digital marking device in surgical treatment of keratoconus

Year: 2020, volume 16 Issue: №1 Pages: 287-293
Heading: Ophtalmology Article type: Original article
Authors: Tereshchenko A.V., Demyanchenko S.K., Vishnyakova E.N.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is the clinical-functional evaluation and development of intrastromal keratoplasty using a digital marking device in patients with keratoconus. Material and Methods. 60 patients (60 eyes) diagnosed with second degree keratoconus were included in the study. The patients were from 19 to 35 years old. 30 patients (30 eyes) were included in the main group and underwent femtolaser intrastromal keratoplasty controlled by the Verion Digital Marker digital marking device (Alcon, USA). 30 patients (30 eyes) were included in the control group and underwent standard femtolaser intrastromal keratoplasty. Results. By the end of the observation period we recorded an increase in uncor-rected visual acuity from an average of 0.25 to 0.6, as well as corrected visual acuity from an average of 0.5 to 0.7 in the main group. Visual acuity was lower in control group, which was probably due to the fact that cyclotorsia was not taken into consideration during surgery. In the course of dynamic observation, we recorded a decrease in keratometry indices in the main group in the course of 3 months, next, in the following 12 months their stabilization was observed. In the course of dynamic observations in the main group, we recorded a decrease in keratometry indices in the course of 3 months, next, in the following 12 months their stabilization was observed. Conclusion. Application of Verion navigation system during intrastromal keratoplasty using a femtosecond laser with consideration of eye cyclotorsia has shown high efficiency in achieving precise positioning of the corneal segments.

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Surgical treatment of the patient with keratectasia after keratotomy followed by LASIK

Year: 2019, volume 15 Issue: №2 Pages: 544-546
Heading: Ophtalmology Article type: Case report
Authors: Syrykh I.Yu., Gavilovskaya V.A., Fabrikantov O.L.
Organization: S. Fedorov Eye Microsurgery Federal State Institution
Summary:

A clinical case of treating a patient with keratoectasia after keratotomy followed by LASIK is presented

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Experience of modified procedure treatment of progressive keratoconus based on corneal collagen cross-linking with femtosecond formation of intrastromal pocket

Year: 2017, volume 13 Issue: №2 Pages: 431-434
Heading: Ophtalmology Article type: Original article
Authors: Solodkova E.G., Fokin V.P.
Organization: "Eye Microsurgery" n.a. academician S. N. Fedorov, Volgograd branch
Summary:

Aim: analysis of clinical and functional results, histomorphological changes of corneas in the application of the method of corneal collagen crosslinking with the formation of a femtosecond intrastromal pocket. Material and Methods. We studied 20 patients (20 eyes) that were operated for progressive keratoconus (1-2 stage) with a peripheral zone of maximum ectasia arrangement via corneal collagen cross-linking with femtosecond formation of intrastromal pocket for introduction of a photosensitizerand local ultraviolet radiation. Results. The result was a decrease of surgery duration and reduction of the severity of pain in the early postoperative period. Conclusion. This method allows to increase the safety of the treatment of keratoconus, reducing the risk of postoperative complications.

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