№2, 2021, volume 17

Purpose: to assess the effect of intraoperative panretinal laser coagulation on the macular region status of the retina within one month after vitreoretinal surgery. Material and Methods. 26 patients (30 eyes) were examined. The study protocol included standard ophthalmological examination methods, spectral optical coherence tomography (ОСТ) of the retina, microinvasive subtotal vitrectomy with or without intraoperative panretinal laser coagulation (PLC). The first group consisted of 16 patients (18 (60%) eyes) who underwent intraoperative PLC. The second group included 11 patients (12 (40%) eyes) who did not undergo intraoperative PLC. Results. The analysis of the results obtained during the examination of groups of patients before surgery and in the early postoperative period did not reveal a significant decrease in the central retinal thickness (CRT) and the volume of the macular region in patients of the first group. A significant decrease in these indicators was observed only in patients of the second group. Comparative analysis of the morphometric parameters of the retina between the two groups of patients did not reveal significant differences. Correlation analysis revealed a moderate relationship between the CRT, macular volume and changes in these indicators between planned visits. Conclusion. In the course of the study, was demonstrated the absence of a significant effect of intraoperative PLC on the anatomical status of the macular region.

Purpose: to identify the morphological aspects of the replacement of transplanted preserved and modified xenogenic elastin biomaterials in the rat eye socket defect. Material and Methods. Wistar rats were given a 7x4 mm defect in the upper wall of the eye socket. Wistar rats were treated with a 7x4 mm defect in the upper edge of the orbit. In the first experimental group (n=30), a preserved xenogenic elastin biomaterial (pXEBM) was placed in the defect zone, and in the second experimental group (n=30), a modified porous xenogenic elastin biomaterial (mXEBM) was placed. In the control group (n=30), soft tissues were sutured in layers. The tissues were excised after 1, 3, 6 and 12 months. Histological methods were used. Results. Grafts have osteoinductive, osteoconductive properties and are replaced by a full-fledged bone regenerate. After implantation, the mXEBM was replaced 2 times fasterthan the pXEBM. In the con- trol group, after 1 year, the bone defect did not spontaneously recover. Conclusion. Xenogenic biomaterials based on elastin are ultimate biomimetics. The porosity of the graft significantly accelerates the course of bone repair processes.

Purpose: to analyze the dynamics of quality of life (QoL) indicators during the primary open-angle glaucoma surgical treatment. Material and Methods. The study group consisted of 25 patients with primary open-angle glaucoma (POAG) aged 51 to 80 years. They have performed an antiglaucomatous operation — sinusotrabeculectomy. Before surgery and 1 month after, the quality of life indicators were assessed using the following questionnaires: MOS SF-36, visual analogue scale, VFQ-25, GQL-15, and hospital scale of anxiety and depression. Results. Intraocular pressure (IOP) decreased from 37.9±11.0 to 15.6±5.0 mm Hg. The analysis of the results of the SF-36 and the visual analogue scale did not reveal any changes in the dynamics (p>0.05). According to the VFQ-25 questionnaire, improvements in indicators were recorded on the following scales: "social functioning" from 75±20.0 to 83.75±17.5 points, "mental health" from 47.5±25.0 to 65±15,0 points, "role limitations" from 50.0±37.5 to 76.6±17.5 points (p<0.05). According to GQL-15, the indices before treatment were 33.6±22.0 points, 1 month after the treatment, the indices deteriorated to 38.8±23.0 points (the norm was not more than 15 points, p<0.05). According to the questionnaire of the hospital scale of anxiety and depression, clinically expressed forms of anxiety (13.0±6.0 points) and depression (12.0±3.0 points) were found, which did not change significantly overtime. Conclusion. QoL analysis during the glaucoma surgical treatment revealed no changes in parameters overtime, despite the clinical improvement in the course of the disease (decrease in IOP). Improving the quality of life of patients is considered an important component in the evaluation of glaucoma therapy, therefore, it is necessary to develop methods to improve the QoL of patients with POAG receiving surgical treatment.

Purpose: analysis of the clinical and functional results of astigmatism correction using the developed algorithm during femtolaser-assisted cataract extraction. Material and Methods. 25 patients were operated on by femtolaser-assisted cataract phacoemulsification with arcuate keratotomy according to the proposed astigmatism correction algorithm. On the 3rd day, after 3, 6 and 12 months, the indicators of uncorrected (UCVA) and maximally corrected visual acuity (MCVA), refractive and corneal astigmatism were determined. After 12 months, a graphical vector analysis was performed, efficiency, predictability and safety were evaluated. Results. 12 months after the operation, the indicators of UCVA were 0.60±0.16, MCVA0.65±0.35 (pw<0.05). The cylindrical refraction component decreased from -1.89±0.87 to -0.85±0.26 (pw<0.05). The correction efficiency within the range of >0.5 was 90%. The predictability of the cylindrical refraction component ±0.5 diopters was 68%; ±1.0 diopters was 92%. Graphic vector analysis revealed a decrease in the centroid size (0.24 ax 129° to 0.18 ax 103°). Conclusion. Correction of corneal astigmatism according to the proposed algorithm, including the calculation of parameters to the developed nomogram and compensation of cyclotorsia, allows to effectively correct astigmatism during femtolaser-assisted cataract phacoemulsification.

Purpose: to analyze the results and to evaluate the clinical efficacy of a three-piece MN60AC IOL scleral fixation by the Yamane method in patients with lens luxation into the vitreous body. Material and Methods. 40 patients (40 eyes) with lens luxation into the vitreous body were examined. Mean age was 63±9 years (18-82 years). Surgical treatment with implantation and scleral fixation of a three-piece IOL using the Yamane method was performed. The IOL was calculated using the Lenstar LS 900 Haag-Streit optical biometer. The IOL position was evaluated postoperatively by ultrasound biomicroscopy and the resulting refraction. Results. In the postoperative period, there was a significant improvement in the visual acuity (p=0.001). According to the refractometry data, in the postoperative period, an increase in astigmatism was detected by an average of 1 dptrwith a change in its type. According to ultrasound biomicroscopy 85% of patients in the vertical meridian showed an IOL slope, which averaged 5.0±1.3 degrees (from 3 to 7 degrees). Conclusion. High functional results and a small number of complications prove the clinical effectiveness and safety of the three-piece IOL fixation using the Yamane method in patients with lens luxation into the vitreous cavity. For a detailed explanation of the obtained refractive results, further research is necessary with the inclusion of a larger number of patients and an increase in the follow-up period.

Purpose: to present a clinical case of a rare long-term postoperative complication of scleroplasty performed for progressive myopia. One of the methods of surgical treatment of progressive axial myopia is scleroplasty — strengthening the posterior pole of the sclera with grafts. The operation is simple to perform, does not require special equipment and rarely causes postoperative complications. The clinical case demonstrates a complication that appeared in the long-term period after scleroplasty — the darkening of the dislocated graft. It developed after hemosiderin imbibition of the graft material based on the subconjunctival hemorrhage caused by a blow to the eye. The graft was removed and replaced with a new one. Three months after the operation, it retains its correct position and color. This clinical case focuses on the interrelated complications of a technically simple operation: a change in the color of the graft due to subconjunctival hemorrhage occurred due to its displacement to the area of frequent localization of the hyposhagmus.

Objective: using clinical examples, to analyze the connections and features of the course of ophthalmic pathology in COVID-19 patients. We observed changes on the part of the visual organ in patients who had previously been ill with COVID-19 in various degrees of severity who sought ophthalmological help. The report is illustrated by the most striking clinical examples, on the basis of which we proposed the following mechanisms of the effect of coronavirus infection on the eye tissue: 1) activation and generalization of viral infections of the eyes, in particular herpetic, adenovirus, mollusk contagious; 2) ocular vascular disorders in the form of hemophthalmos, cavernous sinus thrombosis with corresponding ophthalmological manifestations; 3) oculomotor disorders due to neuropathy (we present a case of the development of non-friendly strabismus); 4) aggravation of chronic diseases; 5) visual disorders against the background of asthenic syndrome; 6) side effects from the organ of vision against the background of therapy for COVID-19. Based on the demonstrated examples, it is shown that the functional and organic disorders of the visual organ caused by COVID-19 are quite diverse.

Objective: to study the microflora of the conjunctival cavity in adults in normality and in different inflammatory diseases of the anterior eye segment of patients in the Kirov region. Material and Methods. In the course of experimenting, two groups were identified: the first group consisted of 24 people (25 eyes) who were treated for different infectious and inflammatory pathologies of the ocular surface. The control group (the second group) consisted of 29 people (29 eyes) without infectious and inflammatory pathology of the organ of vision. The material was taken and then seeded on nutrient media. Results. The composition of the microflora in the patients was the same, but in different proportions. The exception was a patient who was seeded with a single microorganism that caused conjunctivitis, Proteus vulgaris; in two patients, the only microorganism in a concentration of more than 105 CFU/ml was Anaerococcus prevotii. In the first group, the most frequently isolated microorganisms were Candida sp., Staphylococcus aureus, Streptococcus pyo-genes, Peptostreptococcus, Propionibacterium granulosum, Klebsiella sp., Staphylococcus epidermidis, Escherichia coli. In the second group, microorganisms were more common: Candida sp., Klebsiella sp., Staphylococcus aureus, Propionibacterium granulosum. Conclusion. In general, the composition of the microflora in the patients was the same, but in different proportions, which indicates the conditional pathogenicity of the microflora of the conjunctival cavity. Most of patients have a high frequency and large concentrations of Candida sp., which can be explained by the peculiarities of the conjunctival microflora of the residents of the Kirov region and the impact of the COVID-19 pandemic.

Purpose: to evaluate the safety and effectiveness of the myopia correction by corneal lenticule refractive extraction. Material and Methods. A prospective study included 24 patients (24 eyes) (26.8±4.6 years old) who were operated at the S. Fedorov Eye Microsurgery Federal State Institution for myopia correction by corneal lenticule refractive extraction. Results. One week after the operation, there was an improvement in visual acuity (VA) (up to 0.9 (0.7; 1.0)), which remained throughout the observation period. After a month, the uncorrected VA was 1.0 (1.0; 1.0). There were no in-traoperative or postoperative complications. Loss of the maximum corrected VAwas observed in 20.8%. There was a decrease in the average corneal thickness from 555.9±28.2 urn before surgery to 464.8±26.9 urn a week after surgery (p<0.05). The cost of tissue per 1 diopter was 17 microns. Conclusion. Correction of myopia by the method of corneal lenticule refractive extraction meets modern concepts about the effectiveness and safety.

Purpose: to determine the effectiveness of selective laser trabeculoplasty in the complex treatment of open-angle glaucoma. Material and Methods. Study group: 47 patients (53 eyes), mean age 70.0±9.1 (Cl 69.8-73.1) years; men 44.7% (n=21), women 55.3% (n=26). Patients with stages 1-3 of open-angle glaucoma underwent tonometry, computed perimetry and ОСТ of the optic nerve disc at the beginning of the study and at least 6 months after the SLT Decrease in IOP was defined as the difference between the pressure obtained within at least 6 months of observation and the initial level of IOP. Results. IOP before SLT was Me=24.0 mmHg (Q1-Q3: 21.0-28.0 mmHg), after Me=20.0 mmHg (Q1-Q3: 17.0-21.0 mmHg). Decrease in IOP was Me=4.0 mmHg (Q1-Q3: 3.0-8.0 mmHg). IOP after SLT significantly decreased (p<0.05) in 88.7% of cases. There was no statistically significant association between the variable "IOP decrease" and the stage of glaucoma (p=0.215), as well as between the decrease in IOP and previous glaucoma surgery (p=0.664). The correlation between the baseline value and the magnitude of the decrease in IOP is statistically significant (p<0.05, r =0.73). A linear dependence was obtained, at which, with an increase in the initial IOP by 1 mmHg decrease in IOP level will increase by 0.75 mmHg. Conclusion. SLT is an effective and safe method for lowering IOP, which makes it possible to recommend this procedure more often for all patients with open-angle glaucoma.