Saratov JOURNAL of Medical and Scientific Research

Lositsky A.O.

S. Fedorov Eye Microsurgery Federal State Institution, Orenburg branch, Deputy Director for Organizational and Methodical Work

Tactical approaches to management of patients with macular pathology

Year: 2020, volume 16 Issue: №2 Pages: 683-687
Heading: Ophtalmology Article type: Original article
Authors: Chuprov A.D., Borshchuk E.L., Voronina A.E., Lositskiy А.О.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose is to evaluate the effectiveness of tactical approaches to macular pathology treatment based on retrospective data analysis. Material and Methods. Between 2014 and 2019, 12007 courses of treatment of patients with macular pathology (1372 patients) were conducted at the S. Fyodorov Eye Microsurgery Federal State Institution, Orenburg branch. 69.5% of patients were diagnosed with "Macular and posterior pole degeneration" (H35.3), "Retinal angiomatosis" (H35.0) was diagnosed in 11.3%, cases with "Other specified retinal disorders" (H35.8) 9.4%. Results. Comparison of the best corrected visual acuity (BCVA) was made and 2 groups were distinguished: group 1 consisted of patients with negative dynamics, group 2 included patients with positive dynamics. Among all patients, the best values of BCVA were in patients diagnosed with "Other specified retinal disorders", while BCVA improved by 0.13 in most patients with this nosology, in case of macular edema (1.8% of the sample), an improvement in BCVA by 0.13 was also noted. Tactical approaches were analyzed in patients with the best BCVA values, and it was found that intravitreal injection of drugs (IVID) more often led to an increase or stabilization of BCVA in patients with various pathologies of the macular zone. In the sample the majority of patients with macular pathology were diagnosed with "Macular and posterior pole degeneration", 65.35% of patients in this nosological group had positive dynamics in BCVA in the course of 3 years. Conclusion. The most effective method of treating patients with the diagnosis "Macular and posterior pole degeneration" was intravitreal injection of angiogenesis inhibitors (Aflibercept and Ranibizumab) according to the regimen described in the instructions for these drugs.

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Comparative evaluation of the efficiency of astigmatism correction methods in cataract surgery

Year: 2020, volume 16 Issue: №2 Pages: 678-683
Heading: Ophtalmology Article type: Original article
Authors: Chuprov A.D., Begun D.N., Lositskiy А.О., Kazakova T.N., Voronina A.E.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study was to compare the effectiveness of methods of astigmatism correction in the surgical treatment of cataract. Material and Methods. Analysis of 157 cases (eyes) of surgical treatment of cataract with concomitant astigmatism was carried out, of which 131 eyes were operated using the ARKUATA method and 26 were operated using the TORIKA method. The age of patients ranged from 40 to 72 years. Results. As a result of the study we obtained statistically substantiated data, which showed that there were no objective differences in the compared methods for correcting corneal astigmatism: the formation of arcuate relaxing incisions and the use oftoric lOLs. Using the classification tree method, a model for predicting positive effect of the outcome of an operation with a value of un-corrected visual acuity of 1.0 was built. Conclusion. Both methods, in the absence of complications, can correct corneal astigmatism with the same statistical probability, allowing to achieve an uncorrected visual acuity of 1.0. However, from an economic point of view, the cataract surgery is most optimally performed using toric lOLs, as the cost of this treatment is 29.83% lower than when using femtosecond technologies.

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Application of multivariate statistical analysis for evaluation of management of ophthalmological care to the population of the Orenburg region

Year: 2019, volume 15 Issue: №2 Pages: 568-572
Heading: Ophtalmology Article type: Original article
Authors: Chuprov A.D., Lositsky A.O., Trubnikov V.A.
Organization: Orenburg branch of S. Fedorov Eye Microsurgery Federal State Institution
Summary:

The purpose of this study was to identify and study clusters (groups) of medical organizations of the Orenburg region with similar parameters, refecting the level of organization of ophthalmic care to the population. Material and Methods. The proposed method of evaluation is based on the use of the method of multivariate statistical analysis of the structure and activity of ophthalmological units of primary health care of the Russian Federation, with the allocation of groups of structures under research with similar evaluation characteristics and graphic representation of the results. Evaluation criteria are: availability of specialized ophthalmological care for the population, stafng level, overall and primary disease incidence, incidence on separate nosological groups, general and primary disability indicators. Results. Based on the data representative of the organization of ophthalmic care 50 medical organizations of the Orenburg region, providing primary health care were divided into 3 clusters. Indicators of the ophthalmic care management for each of the clusters were characterized. Conclusion. The results of the study allow us to identify groups of medical organizations that require diferent approaches in management decision-making in order to improve the ophthalmological service of an individual subject of the Russian Federation.

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