Saratov JOURNAL of Medical and Scientific Research

Balalin S.V.

S. Fedorov Eye Microsurgery Federal State Institution, the Volgograd Branch, Head of the Science Section, DSc.

To the question of the interrelation between accommodation disorders and features of the structure of the angle of the front camera of the eye in patients with myopia

Year: 2020, volume 16 Issue: №2 Pages: 591-594
Heading: Ophtalmology Article type: Original article
Authors: Breev V.A., Solodkova E.G., Kuznetsova O.S., Balalin S.V.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is to evaluate the relationship between the structures of the anterior chamber, disorders of the hydrodynamics of the eye and the work of the accommodation apparatus in patients with myopia. Material and Methods. The study involved 235 patients (235 eyes) with various degrees of myopic refraction. Patients are divided into 3 observation groups depending on the degree of myopia. Group 1 consisted of 103 patients (103 eyes) with mild myopia; group 2 consisted of 92 patients (92 eyes) with moderate myopia; group 3 consisted of 40 patients (40 eyes) with high myopia. Results. It was found that 95 patients with varying degrees of myopia (40.4%) had anterior chamber depth of more than 3.6 mm. During gonioscopy, goniodisgenesis was detected: in group 1 on 6 eyes (13%); in the 2nd group on 8 eyes (25%); in the 3rd group on 11 eyes (57%). A combination of increased corneal-compensated IOP of more than 21.0 mm Hg and habitual excess accommodation voltage (PINA) was recorded in group 1 in 1 case (2.3%), in group 2 in 3 cases (9.4%); in group 3 in 6 cases (31.5%). Conclusion. In myopic refraction, there is a syndrome of stretching of the anterior segment of the eyeball, which is more pronounced in high-grade myopia and is more often accompanied by ophthalmohypertension syndrome of overstrain of accommodation.

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Choroid thickness dependending on the anteroposterior eyeball size and age in healthy persons

Year: 2020, volume 16 Issue: №2 Pages: 575-578
Heading: Ophtalmology Article type: Original article
Authors: Balalin A.S., Khzardzhan Yu.Yu., Fokin V.P., Balalin S.V., Sarkisyan A.S.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is to define the dependence of choroid thickness (CT) from age and anteroposterior eyeball size (APES) in healthy persons. Material and Methods. We analysed data on 62 patients (62 eyes) aged 25 to 78 without retina and/or optic nerve pathology (45.5±1.7, M±m). Anteroposterior size of the eyeball was from 21.39 to 28.75 mm (23.97±0.18 mm, M±m). The examination included determination of the best corrected visual acuity, optical coherence tomography and optic biometry. Choroidal thickness was measured on two B-scans (vertical and horizontal) in the projection of the fovea and at 24 points from the fovea (in the superior, inferior, nasal and temporal sections) with an interval of 500 urn from each other. Results. CT is predominantly thinner peripapillary and in the inferior section of retina (p<0.01). CT is inversely proportional to the anteroposterior eyeball size (p<0.01). Calculation formula and a chart map of normal values of the choroid thickness depending on APES are proposed. Dependence on age was statistically unreliable (p=0.68). Conclusion. A method for calculating individual values of the choroidal thickness depending on the anteroposterior eyeball size is proposed. This method can be applied in practice in the diagnosis of pachychoroid diseases.

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Clinical and functional assessment of accommodation disorders at ametropy

Year: 2020, volume 16 Issue: №1 Pages: 227-231
Heading: Ophtalmology Article type: Original article
Authors: Kuznetsova O.S., Solodkova E.G., Fokin V.P., Balalin S.V.
Organization: S. Fedorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is to evaluate major accommodation disorders in patients with ametropy. Material and Methods. Analysis of the accommodation and hydrodynamics eye state was carried out on 235 people (235 eyes) with myopia (1 group) and 52 people (52 eyes) with hyperopia. The age of patients ranged from 18 to 35 years. Results. Accommodation disorders were observed in 82% of myopia cases; they were expressed through weakness of accommodation (49.2%), habitual excess tension of accommodation (HETA) (18.6%), and combined disorders (14.2%). Accommodation disorders were observed in 86.5% of hyperopia cases, which were expressed through accommodation weakness (51.9%), combined disorders (23.1 %), and HETA(11.5%). At myopia, ophthalmic hypertension was observed in 16.4% of cases with HETA and combined accommodation disorders. Ophthalmic hypertension was detected in 5.4% of hyperopia cases against the background of accommodation weakness. Conclusion. HETA and weakness of accommodation are more often observed with an increase in myopia degree, the rigidity values of the corneoscleral membrane and corneal hysteresis decrease. Weakness of accommodation is more often observed with an increase in the hyperopia degree, the rigidity values of the corneoscleral membrane and corneal hysteresis increase.

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Efect of FemtoLASIK on the condition of accomodation and vis-coelastic properties of the cornea in patients with myopic refraction

Year: 2019, volume 15 Issue: №2 Pages: 555-559
Heading: Ophtalmology Article type: Original article
Authors: Fokin V.P., Solodkova E.G., Kuznetsova O.S., Balalin S.V.
Organization: S. Fedorov Eye Microsurgery Federal State Institution, the Volgograd Branch
Summary:

The purpose is to study the efect of FemtoLASIK operation on the state of accommodation, intraocular pressure and viscoelastic properties of the cornea in patients with myopic refraction. Material and Methods. Examined 84 patients (84 eyes) with myopia degrees before and after the operation Femtolasik. Results. In patients with mild myopia after Femtolasik, there was a decrease in the coefcient of accommodation microfuctuation (CAM) by 3.6 % and an increase in the coefcient of accommodation response (CAR) by 28.6 %, in patients with moderate myopia there was a decrease in the values of CAM to 11.1 % and an increase in CAR to 30 %, in patients with myopia of high degree of CAM increased by 14.4 %, and CAR 34 %, respectively. The decrease in the values of corneal-compensated intraocular pressure (IОPcc) was statistically signifcant. In the frst group decrease IОPcc amounted to 17.1 % in the second group 17.3 %, in the third of 25.8 %. Conclusion. An improvement in the state of accommodation is observed against the background of a decrease in the indicators of corneal- compensated intraocular pressure after performing the operation FemtoLASIK.

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Revisiting the question on the role of trabeculocleaning in surgical treatment of glaucoma with concomitant cataract and pseudoexfoliation syndrome

Year: 2019, volume 15 Issue: №2 Pages: 451-456
Heading: Ophtalmology Article type: Original article
Authors: Dzhashi B.G., Balalin S.V.
Organization: S. Fedorov Eye Microsurgery Federal State Institution, the Volgograd Branch
Summary:

Trabeculocleaning (TC) in the cataract extraction process is the procedure of debris aspiration from the drainage angle, one of the components inducing hypotensive efect after phacosurgery. When being preceded with selective laser trabeculoplasty (SLT) at suprathreshold values which provides a pigment granules' splatter, the described procedure makes it possible to clean the anterior chamber angle (ACA) of the released trabecular debris including pseudo-exfoliation material and pigment granules. Purpose: to study the efciency of trabeculocleaning performed in course of femto-laser assisted cataract surgery (FLACS), with a preliminary suprathreshold SLT. Material and Methods. The study included 26 patients (32 eyes) with a complicated cataract and primary open angle glaucoma with concomitant pseudoexfoliation syndrome. All patients underwent a suprathreshold SLT preceding FLACS and hydrodynamic tra-beculocleaning, in course of which trabecular debris were removed with the help of aspiration-irrigation tips. Results. One month postoperatively mean IOP value decreased by 9.5 mm Hg from initial values (40.95 %), the outfow facility coefcient improved to 0.21±0.002 mm3 / mm Hg*min (t=14.3; p<0.001). In 24 cases (77 %) IOP was compensated without application of antihypertensive drugs, in 7 cases (22.4 %) it reduced under medication. Conclusion. Hydrodynamic trabeculocleaning in course of FLACS with preliminary suprathreshold SLT ensures ACA detersion from trabecular debris: pseudoexfoliation material and pigment granules, therefore aiding to preserve and activate natural pathways to the outfow of intraocular fuid.

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