2026, volume 22

Objective: to evaluate changes in contrast sensitivity after implantation of a fully refractive extended depth-of-focus (EDOF) intraocular lens (IOL) using binoptometry in Decimal and logMAR scales before surgery and at 1 and 3 months after surgical treatment. Material and methods. The study included 12 patients (23 eyes) who underwent phacoemulsifcation with implantation of an EDOF IOL. Contrast sensitivity was assessed using the Binoptometer® 4P visual function analyzer at contrast levels of 80, 40, 20, 10, and 5% in Decimal and logMAR scales. Examinations were performed preoperatively and at 1 and 3 months after surgery. Statistical analysis included Friedman and Wilcoxon tests. Results. Statistically signifcant improvement in contrast sensitivity was observed for most parameters in both the logMAR and Decimal systems. The most pronounced positive changes were found at 80 and 20% contrast levels without correction. The main diferences were detected between the preoperative examination and the postoperative follow-up periods at 1 and 3 months. In most cases, no signifcant diferences were observed between 1 and 3 months, indicating stability of the achieved functional outcome. Conclusion. Implantation of a fully refractive EDOF IOL was associated with improved contrast sensitivity under diferent contrast conditions. Comparison of Decimal and logMAR scales demonstrated consistency between the two methods in assessing functional visual outcomes. Binoptometry appears to be an informative method for assessing contrast sensitivity after cataract surgery.

A clinical case of postoperative endophthalmitis caused by hyalohyphomycetes in a 75-year-old patient with type 2 diabetes mellitus and chronic kidney disease is presented. The disease developed 10 days after routine cataract phacoemulsifcation with intraocular lens implantation and was accompanied by severe infammation that was resistant to antibiotic therapy and repeated vitreoretinal interventions. Progression of the process to panophthalmitis required enucleation of the eyeball. The etiology of the identifed disease (septated hyphae and conidial structures characteristic of hyalohyphomycetes) was confrmed by the review of histological preparations in the mycological reference center.

Objective: to determine the key prognostic factors for functional and anatomical outcomes of vitrec-tomy in post-traumatic endophthalmitis (PTE). Review writing methodology. A literature search was performed in PubMed, Scopus, eLibrary, and CyberLeninka databases for the period 2016–2026 using the keywords: “post-traumatic endophthalmitis”, “vitrectomy”, “visual outcomes”, “prognostic factors”, “retinal detachment”, “intraocular foreign body” (and their Russian-language counterparts). After screening and eligibility assessment, 12 original cohort studies were included in the fnal qualitative analysis, selected in accordance with the PRISMA (Preferred reporting items for systematic reviews and meta-analyses) fow diagram. Conclusion. Vitrectomy is a highly effective treatment for PTE, improving visual acuity in 80% of patients; however, ambulatory vision (≥20/200) is achieved in only one-third of them. Key independent predictors of a favorable prognosis are early treatment initiation (within 24 hours), small wound size, absence of an intraocular foreign body, and initial visual acuity better than light perception.

Objective: to develop and experimentally evaluate an interpretable fundus image classifcation method for primary ophthalmic screening based on the joint use of a deep learning model and visual explanation techniques. Material and methods. The study was conducted on a dataset of 2,500 fundus images balanced across 5 classes (500 images per class): degenerative retinal changes, macular pathology, neuro-ophthalmic pathology, retinal vascular pathology, and the absence of clinically signifcant pathology. A convolutional neural network with a ConvNeXt-like architecture was used as the classifer. Classifcation performance was assessed using Accuracy, while interpretability quality was evaluated using the Intersection over Union (IoU) metric. Results. The baseline model achieved Accuracy values ranging from 0.74 to 0.77, whereas the model incorporating the interpretability component achieved values between 0.79 and 0.82. The interpretability quality of the baseline model reached an IoU of approximately 0.79, while the proposed method achieved IoU values of 0.98–0.99. Conclusion. The proposed method provides not only fundus image classifcation but also a visual explanation of the obtained results. Incorporating expert annotations into the training process improves the correspondence between attention maps and clinically relevant image regions and may increase trust in clinical decision support systems for primary ophthalmic screening.

The article presents the scientific and practical contribution of Professor Fyodor Ya. Kitaev to the development of bacteriology, epidemiology, and cardiology, as well as to the production of vaccines and serums for the prevention of infectious diseases during his work at the bacteriological institutes in Kazan and Perm, and at Saratov University (since 1931, at the Medical Institute). The results of his scientific research have been implemented in the practical healthcare of our country. The review reflects the main issues of research and medical and diagnostic activities during his work at the Departments of Infectious Diseases and Hospital Therapy at Saratov University and the Medical Institute.

The article is dedicated to the 70th anniversary of the birth of the Saratov surgical school representative, a talented scientist and teacher, professor of the Department of General Surgery, doctor of Medical Sciences, Professor Yuri V. Chalyk.

Objective: to evaluate morphogenic changes in surrounding tissues at the recipient site during lipofilling modeling and the use of hyaluronic acid-based fillers. Material and methods. The study was performed on 50 sexually mature Wistar rats. The group 1 (intact animals) included 5 animals. The group 2 (single injection of 0.9% sodium chloride solution in the withers area) included 15 animals. In the group 3 (n=15), minced fat was injected intradermally in the withers area, and in the group 4 (n=15), a hyaluronic filler was injected. After 30, 90, and 180 days, 5 animals in the groups 2 to 4 were euthanized and the changes in the recipient tissues were evaluated. The sections were stained using the Mallory method and hematoxylin and eosin. Results. On the 30th (p<0.001) and 180th (p=0.018) days in group 3, the thickness of the cellular epidermis was significantly lower than in group 4. The thickness of the dermis was significantly higher on the 30th day in group 3 (milled fat) and on the 180th day in group 4 (hyaluronic filler; p<0.001). The area of the sebaceous glands in group 4 on the 90th and 180th days increased compared to the 30th (p=0,02). Fat graft thickness significantly decreased on the 90th postoperative day compared to day 30 (p=0.041). In group 4, gel integration with surrounding tissue was noted after 90 days, while after 180 days, the thickness of the implanted hyaluronic acid-based gel in this same group varied, as the gel was often unevenly distributed. Cavities frequently formed after gel implantation, which were not due to gel degradation. Conclusion. Thus, the use of lipofilling leads to a more uniform distribution of adipose tissue and a decrease in the area of sebaceous glands, compared to hyaluronic acid filler, which contributes to an increase in the thickness of the cellular epidermis and dermis.

Objective: to provide a topographical-anatomical rationale for the safety and efficacy of a new surgical technique for treating patients with impression fractures and deformities of the posterolateral aspect of the proximal tibial epiphysis. Material and methods. The study was conducted on 11 non-fixed preparations of the lower extremities, obtained from 6 corpses that died at the age of 52 to 64 years. The experimental study was conducted in two series. In the first series, the proposed surgical technique was simulated on 3 cadaveric specimens, followed by dissection to assess the risk of damage to anatomical structures. In the second series, the procedure was performed on 8 specimens, after which horizontal sections were made and processed using epoxy plastination according to the established method, followed by morphometric analysis. Results. In the first experimental series, the technique of the proposed treatment method was refined, confirming the absence of risk to major neurovascular structures. In the second series, the shortest distances from the fixation screw to the neurovascular structures were determined. The popliteal vein was located at a distance of 20.1–24.8 mm, the popliteal artery at 16.2–23.2 mm, the tibial nerve at 17.8–24.5 mm, and the common peroneal nerve at 13.2–24.1 mm. Conclusion. An effective technique for the proposed method was experimentally developed. The anatomical safety of the intervention was confirmed: the tibial nerve and popliteal vessels are situated outside the risk zone. The identified risk of injury to the common peroneal nerve during mobilization of the fibular head is minimized by the correct execution of the technique.

Objective: to identify features of typical morphology of gastroesophageal junction structures. Material and methods. Anthropometric and videoendoscopic data of 75 patients without esophageal and gastric pathology were analyzed. Subjects were divided into 3 groups according to their body type by V.N. Shevkunenko and 3 groups according to their abdominal shape by V.M. Zhukov. Shape of cardia opening, its diameter, and size of mucous membrane fold at junction of left esophageal wall and stomach’s fundus (Gubarev's fold) were assessed by videoendoscopy. Results. In meso- and dolichomorphic types, slit-shaped cardia opening was most often observed in closed state (59.5 and 57.1%), and oval in open state (81.1 and 78.6%). In brachymorphic type, round shape was predominant (78.9% in closed, 94.7% in open state). Diameter of opening was larger in subjects with brachymorphic type (median – Me=7.0 vs Me=2.0 and 3.0 in the closed state; Me=18.0 vs Me=11.0 and 12.0 in the open state) and in individuals with an upward-expanding abdomen (Me=6.0 vs Me=2.5 and 3.0; Me=17.0 vs Me=11.5 and 11.0). Gubarev's fold had the smallest dimensions in brachymorphic type (Me=22.0 and 10.0) and in subjects with an upward expanding abdomen (Me=24.0 and 13.0). Conclusion: Structural features of gastroesophageal junction have pronounced typical differences. Subjects with brachymorphic body type and an upward expanding abdomen have the largest diameters of cardia opening and the smallest dimensions of Gubarev's fold.

Objective: to determine the bilateral variability of the morphometric parameters of the crowns of the lower dental arch of young men depending on the type of dental arch. Material and methods. The study was conducted on plaster models of the lower dentitions obtained from 140 17- to 21-year-old young men. The dental arches were classified as microdont (n=9), normodont (n=23) and macrodont (n=108). The height and mesiodistal size of the teeth on the lingual surface of their crowns, as well as the bucco-lingual size of the crowns were measured. The influence of the dental arch type on the odontometric parameters was performed using the Kruskal – Wallis one-factor analysis. The strength of the influence of the studied factor was determined by calculating ε2. The Holm method was used to adjust p-values for multiple comparisons. Results. The mesio-distal size of the crowns of all teeth of the lower dentition largely depends on the type of the dental arch. The influence of the studied factor on the specified parameter of the crown of tooth 35 was determined as strong (ε2=0.390), and on teeth 34, 36 and 42 – as relatively strong (ε2=0.220, ε2=0.244 and ε2=0.163, respectively). Conclusion. Bilateral variability in the morphometric parameters of dental crowns not pronounced. However, the dental arch type factor has a statistically significant effect on odontometry parameters.