Saratov JOURNAL of Medical and Scientific Research

Aznabaev В.M.

Bashkir State Medical University, Head of Department of Ophthalmology with Postgraduate course, Professor, DSc; ZAO Optimedservis, General Director

Thermal imaging characteristics of ultrasonic and pneumatic guillotine 25 gauge vitrectors

Year: 2018, volume 14 Issue: №4 Pages: 916-919
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.N., Mukhamadeev T.R., Vafiev A.S., Shavaliev I.Kh.
Organization: Bashkir State Medical University of the Russian Health Care, ZAO Optimedservis
Summary:

Purpose: to analyze thermal characteristics of ultrasonic and pneumatic guillotine 25G vitrectors in the experiment. Materials and Methods. In vitro studies were performed using Testo 882 thermal imager under various conditions for a more complete assessment of thermal characteristics of 25G ultrasonic vitrector and 25G pneumatic guillotine vitrector. First experiment was carried out in normal saline solution of room temperature, second experiment was performed in air medium. Results. It was found that during operation of ultrasonic and pneumatic guillotine vitrectors, the temperature threshold of 45°C, which is critical for thermal damage to retinal tissue, was not reached in all experiments. Under severe conditions (working in the air medium without cooling of vitrector tip), different localization of the heating zone in ultrasonic (at proximal part of the needle) and pneumatic (at distal part, near the port) vitrectors was detected. Conclusion. In experimental conditions, the thermal safety of ultrasonic and pneumatic guillotine vitrectors of caliber 25G has been proved by the method of infrared thermal imaging.

AttachmentSize
2018_4-2_916-919.pdf716.51 KB

Ретроспективный анализ биометрических характеристик и локализации увеальной меланомы по данным ультразвукового дуплексного сканирования орбиты

Year: 2018, volume 14 Issue: №4 Pages: 900-902
Heading: Ophtalmology Article type: Original article
Authors: Азнабаев Б.М., Александров А.А., Ишбулатова A.M.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Цель: провести ретроспективный анализ биометрических характеристик и локализации увеальной меланомы по данным ультразвукового дуплексного сканирования орбиты. Материал и методы. В Центре лазерного восстановления зрения «Оптимед» г. Уфы за 2017-2018 гг. исследованы 22 пациента с объемным образованием сосудистой оболочки глаза — меланомой. Соотношение больных мужчин и женщин 1:1 (11 мужчин и 11 женщин). Возраст обследованных пациентов варьировался от 46 до 89 лет. Результаты. По данным проведенных ультразвуковых дуплексных сканирований орбиты чаще отмечалась парамакулярная локализация опухоли (72,2%). Высота проминенции объемных образований в среднем составила 7,6±4,6 мм, ширина основания 10,1±4,1 мм. У 20 пациентов (90,9%) определялся кровоток над объемным образованием. В 54,5% случаев наблюдалась вторичная отслойка сетчатки. Заключение. Ультразвуковое дуплексное сканирование орбиты является информативным неинвазивным инструментально-диагностическим методом, позволяющим выявлять увеальную меланому на ранней стадии.

AttachmentSize
2018_4-2_900-902.pdf515.7 KB

Disruption of the microcirculation of the retinal macular zone in a patient who had hemorrhagic fever with renal syndrome according to OCT-angiography of the macula

Year: 2018, volume 14 Issue: №4 Pages: 880-882
Heading: Ophtalmology Article type: Case report
Authors: Aznabaev ВМ, Batyrshin RA, Aleksandrov АА, Idrisova LR, Khakimova NP.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

The article presents the results of a standard diagnostic examination and a description of the impaired microcirculation of the macular retinal area according to optical coherence tomography angiography (ОСТ angiography) in a patient who had hemorrhagic fever with renal syndrome. The survey revealed a violation of the microcirculation of the macula in the form of a decrease in perfusion of the inner layers of the retina. This diagnostic method allows objectively, quickly and without contact to assess the state of the microcirculation of the macula in persons who have had hemorrhagic fever with renal syndrome, and can be recommended for assessing the effects of the disease and preventing complications from the organ of vision.

AttachmentSize
2018_4-2_880-882.pdf1.14 MB

Evidence of the safe period intravitreal tamponade by perfluorodecalin in clinical practice

Year: 2018, volume 14 Issue: №4 Pages: 862-866
Heading: Ophtalmology Article type: Original article
Authors: Arslanov G.M., Aznabaev В.М., Mukhamadeev T.R., Dibaev T.I.
Organization: Saratov State Medical University, The Eye Clinic «Zrenie» (Saint Petersburg)
Summary:

 Purpose: to perform clinical testing of perfluorocarbon liquid on the basis of perfluorodecalin with the possibility of intravitreal postoperative tamponade in patients with vitreoretinal pathology and explain the effectiveness of this practice. Material and Methods. Were evaluated anatomical and clinical results of vitrectomy with PFCL intravitreal tamponade in 105 (113 eyes) patients with severe vitreoretinal pathology. Three observation groups were distinguished: group I (in-traoperative and postoperative intravitreal tamponade by perfluorodecalin, national sample); group II (only intraopera-tive use of perfluorodecalin, foreign sample); group III (only intraoperative use of perfluoro-1.3- dimethylcyclohexane). Results. Retinal attachment in the group of patients with postoperative intravitreal tamponade was 97.1% (visual acuity increased in 71.5% cases). All cases of failure or redetachment, postoperative complications and cataract progression did not have a statistically significant association with postoperative intravitreal tamponade as risk factor (x2=0,316; X2=0,068; x2=0.061; x2=0.403, p>0.05). Conclusion. Clinical testing of perfluorocarbon liquid intravitreal tamponade on the basis of perfluorodecalin in patients with vitreoretinal pathology showed high anatomical and clinical results with a high probability of retinal attachment.

AttachmentSize
2018_4-2_862-866.pdf264.27 KB

The analysis of microcirculation parameters of the macular area after ultrasonic vitrectomy using optical coherence tomography-angiography

Year: 2018, volume 14 Issue: №4 Pages: 856-862
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Ismagilov T.I..
Organization: Saratov State Medical University, ZAO Optimedservis
Summary:

Purpose: to analyze the parameters of the microcirculation of the macular area in patients operated on by the method of ultrasound vitrectomy 25G for idiopathic through macular opening (IMO) and epiretinal fibrosis (ERF). Material and Methods. ОСТ angiograms of 35 patients operated on by ultrasound vitrectomy for idiopathic through macular opening (IMO) and epiretinal fibrosis (ERF) before and for 3 months after surgery were analyzed. The following parameters of microcirculation of the retina were investigated: the area of the foveal avascularzone (FAZ), the density of the foveal vessels in the ring 300 urn around the FAZ, the density of the vessels in the superficial and deep capillary networks of the retina. Results. The FAZ area with IMO decreased within 3 months, while with ERF an increase in this parameter was recorded (p<0.05). In the superficial capillary network in both pathologies there was a decrease in the density of the vascular pattern (p<0.05), in IMH there was a tendency to recovery to the pre-op values. The deep capillary network was characterized by decrease of vascular pattern density to 1 month with following increase to 3 month (p<0.05). Conclusion. Features of the dynamics of the parameters of the microcirculation of the macular area in different periods of the postoperative period largely depend on the nature of the pathology, the stress response of the tissue to the operative traumaand the degree of recovery of the vascular pattern of the retinal neuroepithelium in the superficial and deep capillar networks.

AttachmentSize
2018_4-2_856-862.pdf4.76 MB

Intraoperative OCT-assisted vitreoretinal surgery

Year: 2018, volume 14 Issue: №4 Pages: 849-855
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Husniyarova A.R.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Purpose: comparative analysis of clinical and functional results of surgery of vitreomacular interface and rheg-matogenous retinal detachment with the use of intraoperative optical coherence tomography. Material and Methods. Clinical and morphofunctional data were analyzed in 102 patients with epiretinal fibrosis (ERF), idiopathic macular hole (IMH), and rhegmatogenous retinal detachment (RRD), who were divided into 2 groups. In the main group (n=52), the surgery was performed using intraoperative ОСТ control, in the control group without it. In the main group intraoperative control was performed at 4 stages of the surgery: before vitrectomy, after vitrectomy, during the main stage of the surgery and after completion of endotamponade of the vitreous cavity. During surgery for macular disorders intraoperative complications were assessed, in RRD the intraoperative screening for the detection of undiagnosed pathological changes was performed. In the postoperative period, clinical and functional results were assessed in up to 6 months. Results. The use of intraoperative ОСТ control allowed to reduce the frequency of intraoperative complications, such as capillary retinal bleeding (19.2% in the control group, 11.5% in the main group) and pinching of the inner retinal layers (not observed in the main group, in the control group its incidence was 23.1%) in macular surgery. Intraoperative ОСТ made it possible to better identify concomitant retinal pathology (secondary epiretinal membranes in the main group were found during the surgery in 11.5% of cases, in the control group in 4.2%, while in the postoperative period in 12.5%). In complicated cases of RDD, tomographic control allows to identify microstructural features of the posterior pole of the eye, which are important in achieving stability of the anatomical result, such as retinal defects over staphyloma of the posterior pole in high myopia cases. Conclusion. Intraoperative OCT-assisted vitreoretinal surgery reduces the rate of intraoperative complications during macular surgery and gives valuable diagnostic information in complicated retinal detachment cases.

AttachmentSize
2018_4-2_849-855.pdf1.73 MB

Clinical and functional results of surgical treatment of regmatogenous retinal detachment by ultrasonic vitrectomy 25G

Year: 2018, volume 14 Issue: №4 Pages: 841-845
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.M., Dibaev T.I., Mukhamadeev T.R., Shatunova A.S.
Organization: Bashkir State Medical University of the Russian Health Care, ZAO Optimedservis
Summary:

Objective: to analyze clinical and functional outcomes of surgical treatment regmatogenic retinal detachment by ultrasound vitrectomy. Material and methods. Clinical and functional results of treatment of 70 patients (70 eyes) with regmatogenous retinal detachment (ROS) who received surgical care in the clinic OPTIMIZED from 2015 to 2018 In the main group (n=33) operations were performed by ultrasound vitrectomy 25G, in the control group (n=37) — by traditional guillotine pneumatic vitrectomy using the tools of the same caliber. During surgery, were analyzed: time of vitrectomy stage (sec), total duration of operation (min), achievement planned anatomical result (%). In the postoperative period (up to 12 months) analyzed: stability of anatomical result (%), maximum corrected visual acuity, intraocular pressure, morphometric criteria retinal conditions (OCT, OCT-angiography), incidence of complicated cataract (%). Results. Average value of vitrectomy stage time in the main group (378.3±125.2 sec) lower than in the control (490.9±175.5 sec), p<0.05. Total duration operations in both groups did not differ, but on average was somewhat shorter in the main group. group (53.6±9.4 and 64.2±23.5 min, respectively). Planned anatomical result in retinal adhesion in all sectors was achieved at the end of the operation in 100% of cases in both groups. No intraoperative complications were recorded in any of the cases. Ultrasonic vitrectomy permits the use of smaller values of the vacuum as on the stage initiation of posterior vitreous detachment (333.3±40.1 mm Hg).St) and at the stage of peripheral vitrectomy (203.2±51.5 mm Hg.art.) compared with traditional vitrectomy, where high vacuum was required: 600 mm Hg.art. at the stage of initiation of ZOST, 305,4±66,4 mm Hg.article on stage of peripheral vitrectomy. The anatomical result remained stable in all terms of the postoperative period in the main group in 100% of cases. In control group relapses of retinal detachment were registered in 8.1% of patients and successfully eliminated conducting an audit of the vitreous cavity. In the late postoperative period the most frequent complication was the development of complicated cataracts (27.1 % in the main group, 40.5% in the control). In both groups, by the 12th month of follow-up, high maximum corrected visual acuity (0.5 and higher in 66.6% of patients and in the main 47.3% of patients in the control group). Conclusion. Comparative study conducted the method of ultrasonic vitrectomy in the surgical treatment of rhegmatogenous detachment the retina has shown that this technique is an effective method that provides and stable anatomical and functional result.

AttachmentSize
2018_4-2_841-845.pdf263.35 KB

Glaucoma incidence analysis and prognosis in adult population of Bashkortostan Republic

Year: 2018, volume 14 Issue: №4 Pages: 825-828
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Zagidullina A.Sh., Fakhretdinova E.V.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Purpose: to analyze the general and primary incidence of glaucoma in the adult population in the Republic of Bashkortostan over the 2010-2017 period; make a medium-term forecast for five years. Material and Methods. The analyzed data was based on official statistics of the Ministry of Health of the Russian Federation over the 2010-2017 period. The level of general and primary incidence per 100 thousand population was estimated; the five-year forecast for glaucoma incidence was simulated using mathematical modeling. Results. The Republic of Bashkortostan had the highest rate of general and primary glaucoma incidence in the adult population as compared with the incidence rate in the Russian Federation. The Republic of Bashkortostan ranks first in the absolute number of patient with glaucoma and fourth ranks in general incidence per 100 thousand comparing with Volga Federal District data. The level of general glaucoma incidence in the adult population increased by 23.0% over the 2010-2017 period and primary incidence — by 47.0%. The five-year simulated forecast predicts possible further growth of general and primary glaucoma incidence in the republic by 2022. Conclusion. The performed analysis and simulated forecast of general and primary glaucoma incidence for the adult population in the Republic of Bashkortostan show growth trends.

AttachmentSize
2018_4-2_825-828.pdf609.13 KB

Experimental analysis of destructive ability of vacuum pulsation in cataract phacoemulsification

Year: 2018, volume 14 Issue: №4 Pages: 817-820
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Mukhametov R.G.
Organization: Bashkir State Medical University of the Russian Health Care, ZAO Optimedservis
Summary:

 The purpose of the work. To evaluate the destructive ability of vacuum pulsation in cataract phacoemulsification. Materials and Methods. The experiments were performed on 40 separate pig eyes, in which cataract was induced in 3 stages of density according to the WetLab method. In the study group (n=20), phacoemulsification was carried out using a vacuum pulsation generation unit, in the control group (n=20) by the method of traditional ultrasonic phacoemulsification. For comparison of the two methods in both groups, the time of complete destruction of the lens fragment in seconds was recorded. Results. The average time of destruction of a 5x5 mm fragment of the lens, using vacuum pulsation was 23.6±4.9 seconds, for traditional ultrasonic phacoemulsification 17.7±8.9 seconds (p<0.05). Vacuum pulsation has a destructive power, but at the same time requires further refinements to increase the efficiency of phacoemulsification. Conclusions. Phacoemulsification based on vacuum pulsation is promising for further study, since it has a destructive ability. This method does not imply the use of high-energy effects, due to which there are no prerequisites for heating the tunnel incision and negative effects on the corneal endothelium.

AttachmentSize
2018_4-2_817-820.doc41.88 KB

Lens densitometry in ultrasonic cataract phacoemulsification

Year: 2018, volume 14 Issue: №4 Pages: 815-817
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Munasypova V/V., Khamidov U.B., Mukhamadeeva O.R.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Purpose: to evaluate the effectiveness of using Pentacam HR sheimpflug camera for objective determination of cataract density. Material and Methods. The subject of the study was the method of determining the density of the lens (densitometry) by the Pentacam HR sheimpflug-camera. The object of the study were patients with age-related cataracts (147 eyes). All patients underwent ultrasound phacoemulsification with implantation of various types of intraocular lenses (IOL). Before treatment, the density of the lens was determined by non-contact method using PNS (Pentacam Nucleus Staging). During the surgery, the density of the lens was determined by the surgeon on a set of factors: the color of the nucleus, the mechanical density, the emulsification easiness. The equivalent ultrasound time and the fact of compliance or discrepancy in the degree of density of the lens with two methods of its determination were recorded for each patient. Results. It was found that the density of the lens recorded by the Pentacam HR is in a direct strong correlation with the equivalent ultrasound time. It was shown that the discrepancy between the PNS method and the contact method performed by the surgeon significantly lengthens the surgery time. Conclusion. The Pentacam HR sheimpflug-camera is an accurate method of determining the density of the cataract before the surgery. The advantage of this method is that it is non-contact, quick and relatively easy-to-perform with the possibility of objective assessment.

AttachmentSize
2018_4-2_815-817.pdf242.74 KB