Federal State Institution Research Articles

Оказание медицинской помощи пациентам с острой глазной патологией в условиях пандемии

Purpose. Comparative assessment of frequency and structure of patients who underwent inpatient treatment for acute eye pathology before and during the coronavirus infection (COVID-19) pandemic. Material and methods. A quantitative analysis was carried out in 826 patients treated for various acute eye pathologies in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (the Branch) for the time periods: from May 2018 to February 2020 (the first) and from March 2020 to the end of December 2021 (the second). An assessment of frequency and nosological forms of diseases was carried out, examples of most severe cases of diseases and injuries were given.Results. For the first period, 318 patients were treated, for the second period - 508 patients. In the second period, there was significant increase in number of patients with acute eye pathology by 1.6 times. In both periods, patients with inflammatory lesions of tuveal tract prevailed: before the pandemic - 179 eyes, during the pandemic - 243 eyes. Also in the second period, 29 cases of severe burns of the cornea - II and III degrees were registered. Conclusion. All patients who applied to the Branch during study periods and needed emergency ophthalmic care were provided in timely manner and in full. The COVID-19 pandemic has made significant adjustments to work of the entire Branch, including work of Complex Rehabilitation Treatment Department in form of increase in number of patients with acute eye pathology by 1.6 times.

Наблюдение пациентки с острым некрозом сетчатки в течение длительного периода времени

The medical and social significance of one of the most severe inflammatory diseases of the posterior segment of the eye, which includes acute retinal necrosis (ARN), is determined by the high degree of disability of patients. ARN occurs in somatically healthy people, but occurs more often among people suffering from immunosuppressive diseases or receiving immunosuppressive therapy. The diagnosis of ARN is made on the basis of clinical examination data according to the criteria developed in 1994 by the American Society of Uveitis Specialists. The prognosis of ARN is relatively unfavorable: the pathological process leads to practical blindness in 64 %, in 60 % there is a significant decrease in visual acuity. ARN is complicated by the development of retinal detachment in 65–75 %. Treatment of ARN includes intensive antiviral, anti-inflammatory, immunomodulatory therapy. Purpose: description of the observation of a patient with acute retinal necrosis over a long period of time. Material and methods. A long-term clinical observation of a patient with acute retinal necrosis for the period from 2008 to 2021 is presented. The patient underwent a standard ophthalmological examination, optical coherence tomography of the macular area, and ultrasound. Results. The development of ARN in the patient was observed after ARVI. Antiinflammatory treatment of ARN and surgical treatment of complications were carried out in the conditions of the academician S.N. Fyodorov Federal State Institution National Medical Research Center «Intersectoral Research and Technology Complex «Eye microsurgery» Ministry of Health of the Russian Federation», Novosibirsk Branch. The presented clinical case allows us to demonstrate the severe course of the pathological process and the development of serious complications. Timely conservative, laser and surgical treatment, active dynamic monitoring, despite the unfavorable prognosis for vision, made it possible to maintain residual vision in the patient. Conclusions. ARN is an important problem that requires further study and development of effective methods for early diagnosis, treatment and prevention of recurrence of this disease. Keywords: acute retinal necrosis; anti-inflammatory treatment

Optimization of interdepartmental electronic interaction of the military commissariat in the organization and conduct of medical examination of citizens subject to conscription

The military commissariat requests information characterizing their state of health in order to study the state of health of citizens subject to conscription before the next conscription of citizens for military service. An interdepartmental request for this informations provision to medical organizations and institutions of medical and social expertise is encouraging to be issued in the form of an electronic document using a unified system of interdepartmental electronic interaction, taking into account the trends in the development of the public administration system. Interdepartmental interaction optimization through creation of an electronic interaction mechanism will allow military commissariats to promptly exchange information in real-time characterizing the citizens state of health subject to conscription for military service with medical organizations of the state and municipal health care system, and federal state institutions of medical and social expertise. The direct connection of the military commissariat to the state information system in the field of healthcare of the subject of the Russian Federation by means of cryptographic protection of information will contribute to improving the quality as well as deceasing the medical examination time of citizens subject to conscription, thus improving the efficiency of providing medical services to citizens in medical organizations. The public administration system was successfully reoriented to provide state and municipal services in a remote format during the unstable epidemiological situation caused by the pandemic of a new coronavirus infection. Optimization of interdepartmental electronic interaction will allow military commissariats to take additional preventive measures to avoid infection and avert the spread of a new coronavirus infection during the recruitment campaign. Modern digital technologies and solutions are able to provide a qualitative leap in the organization of conscription of citizens for military service, which can be implemented without significant financial costs in the short term. However, there is a growing need to involve a proper number of participants of the military command and other state authorities in solving this complex problem.

Efficacy and safety of PUVA and UVB-311 nm in psoriasis: single-center retrospective study

BACKGROUND:Psoriasis is a widespread, genetically determined immunemediated dermatosis of a multifactorial nature, characterized by a recurrent course with frequent associative damage to other organs and systems, which significantly reduces the quality of patients lives. For many years, phototherapy (PUVA and UVB-311 nm) has had one of the leading places in the treatment of moderate and severe psoriasis according to the world dermatological communities. However, with the advent of genetically engineered biological drugs, the frequency of its administration has significantly decreased.
 AIM:to evaluate the efficacy and safety of PUVA and UVB-311 nm in the treatment of moderate and severe psoriasis.
 MATERIALS AND METHODS:A retrospective study was conducted on the basis of the Federal State Institution Central polyclinic with the participation of 920 patients with moderate and severe psoriasis who received phototherapy (PUVA and UVB-311 nm) in the period from 2005 to 2021. The initial radiation dose was 0.51 J/cm2at PUVA and 0.10.2 J/cm2at UVB-311 nm with a gradual increase in the dose every 12 sessions by 0.5 J/cm2and 0.1 J/cm2, respectively. The treatment was carried out according to the method of four-time irradiation per week using the UV-7001K cabin (Waldmann, Germany).
 RESULTS:Among 920 patients there were 478 (52%) men and 442 (48%) women (aged 21 to 68 years). The average age of psoriasis onset is 345.2 years. The duration of the disease averaged 10.58.2 years. Vulgar psoriasis was observed in 756 (82%) patients, teardrop-shaped ― in 36 (4%), exudative ― in 73 (8%), inverse ― in 55 (6%). 249 (27%) were diagnosed with psoriatic arthritis. On average, the first phototherapy sessions were prescribed 2.11.6 years after the onset of the disease. The choice of phototherapy method depended on the severity of the process. Thus, with moderate psoriasis, patients were prescribed UVB-311 nm (n=473). The course consisted of 2535 sessions of radiation with a cumulative dose of 35.35.9 J/cm2. Clinical remission was observed in 93% of patients, significant improvement ― in 7%. The achieved clinical remission was maintained for 361194 days. In total, during the studied period, 149 people received 27 courses of UVB-therapy, 132 ― 24 courses, 53 ― 19 courses, 69 ― 15 courses, 58 ― 11 courses, 12 ― 7 courses. Multiple infiltrated plaques and refractory course of severe psoriasis was an indication for PUVA therapy (n=447). The course consisted of 2030 irradiation sessions with a cumulative dose of 81.514.3 J/cm2. Clinical remission was observed in 98% of patients, a significant improvement in 2%. 14 people received 23 courses, 21 ― 20 courses, 12 ― 19 courses, 227 ― 15 courses, 104 ― 13 courses, 33 ― 10 courses, 27 ― 4 courses, 9 ― 2 courses of PUVA. The achieved clinical remission was maintained for 420275 days. 12 (1.3%) patients cancelled PUVA prematurely due to the inability to take a photosensitizer. In other cases, the observed side effects were minor and did not cause discontinuation of therapy.
 CONCLUSION:PUVA and UVB-311 nm have demonstrated high efficacy and safety in the treatment of moderate and severe psoriasis. At the same time, it is necessary to conduct further research to improve the methods of phototherapy for faster achievement of long-lasting clinical remission, which will allow phototherapy to regain its leading position in the treatment of psoriasis, increasing the doctors trust and patients compliance.

Личность преступника в структуре оперативно-разыскной характеристики фальшивомонетничества

The article selectively examines the current state of crimes of counterfeiting, analyzes statistical data of the Federal State Institution of the Ministry of Internal Affairs of Russia and the Central Bank. Attention is paid to operational and investigative characteristics and their importance for organization and tactics of detection, prevention and disclosure of counterfeiting by operational means. 
 The contents of personality of the criminal in operative-investigative characteristic of counterfeiting has been determined on the results of scientific opinion research. The authors present and analyze the data of studying the offender personality according to the programmed materials of criminal cases, initiated under article 186 of the Criminal Code of the Russian Federation.

First results and prospects of the Khabarovsk Branch of Fyodorov Eye Microsurgery Federal State Institution on the provision of organizational and methodological support to ophthalmological clinics in the Far Eastern Federal District

This article evaluates the first results of operation of the Organizational and Methodological Department (OMD) of the Khabarovsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution during the period 2018–2021. The OMD was established in February, 2019 as part of the Khabarovsk Branch in order to ensure effective interactions between the Branch as a national medical research center (NMRC) and affiliated 3rd level medical organizations situated in the Far Eastern Federal District (FEFD). A number of organizational procedures were implemented, including connection of the NMRC to the Unified State Health Information System, monitoring of the level of ophthalmological care in affiliated medical organizations, identification of bottlenecks in the interaction between the NMRC and affiliated medical organizations, establishment of a system of telemedicine consultations concerning difficult medical cases. Over the period 2018–2021, 32 visits to regional clinics were implemented, 24 knowledge transfer projects were realized, a scientific and educational module “Age-related macular degeneration, dry form” was developed. In addition, the effectiveness of implementation and application of clinical recommendations, including quality assessment criteria for the “Ophthalmology” profile in affiliated medical organizations, was assessed. Over this period, 657 telemedicine consultations were held, as a result of which 23.3%, 73%, and 86.3% of patients were admitted to the Khabarovsk Branch in 2019, 2020, and 2021, respectively. Business relations were established with the senior executive authorities of regions where the affiliated medical organizations are located. The OMD activity during the period 2018–2021 resulted in the establishment of a clear system of organizational and methodological support to 3rd level medical organizations located in the FEFD.

Результаты хирургии глаукомы: клапан ahmed и ex-press шунт у пациентов с вторичной глаукомой

Purpose. To increase the efficiency of surgical treatment of patients with secondary glaucoma using microfistulizing and micro-shunting operations: Ahmed valve implantation and Ex-press shunt. Material and methods. 53 patients (53 eyes) with secondary glaucoma underwent surgical treatment in the form of implantation of Ex-press shunt and Ahmed valve (models FP7, FP8) in the Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution. We analyzed the results of surgical treatment of these groups of patients 1, 3, 6 and 12 months after surgery. Results. The Ahmed valve system creates a longer stable hypotensive effect in secondary glaucoma in 26 cases (85.7 %) during follow-up up to 1 year after surgery than Ex-press shunt implantation, suspending the progression of glaucoma neuroopticopathy. The degree of proliferative and scarring changes in the angle of the anterior chamber directly depends on the values of IOP: the lower the IOP level, the less the degree of changes in the angle of the anterior chamber of the eye. Conclusion. Implantation of the Ahmed valve and Ex-press shunt is a low-traumatic operation and is an effective way to compensate for secondary glaucoma due to other eye diseases in these patients, at the same time, both the hypotensive and optical effects persist even one year after the operation. Keywords: unstabilized glaucoma, Ahmed valve, Ex-press valve, true pressure.

Using the provisions of the International Classification of Functioning in the assessment of disability in people with HIV infection aged 18 years and older

To date in Russia continues the spread of HIV/AIDS. At the stage of secondary lesions in HIV infection, the patient has persistent violations of the functions of various organs and systems of the body, which reduce the quality of life, lead to a restriction of human life, which requires assistance from society and the state. The Russian Federation has established a system of economic, legal, and social measures to support disabled people, as well as all citizens with HIV infection. The establishment of a disability group, its causes, timing, time of onset, and the needs of a disabled person in various types of social assistance is assigned to federal institutions of medical and social expertise.
 A retrospective analysis of 100 protocols of medical and social examination of citizens with HIV infection was carried out by random sampling/AIDS in federal state institutions of medical and social expertise of St. Petersburg and other regions of Russia in the period from 2017 to 2020. The purpose of our study was the possibility of including the provisions of the International Classification of Functioning, disability and Health in the assessment of categories of disability in people with HIV-AIDS. The frequency and severity of disability, designated in the form of domains of the international classification of functioning Activity and participation in the group of patients under consideration, were studied, while the most striking or generalizing domain was taken from each section, characterizing the restriction of each category of vital activity established in a disabled person with HIV infection (d599 unspecified Self-care; d450 Walking; d230 Daily routine; d350 Conversation; d710 Basic interpersonal interactions; d859 Work and Employment, other specified and unspecified).
 According to the results obtained, the most common functional disorders lead to restrictions in daily activity (self-care and everyday life) and in the main areas of life (education, work and employment). Violations of physical and cognitive functions as the process progresses have a significant impact on the ability to work of AIDS patients, limiting their choice of occupations and leading to termination of employment.
 The International Classification of Functioning, Disability and health is a convenient tool that reflects the level of functioning of an individual at various stages of the disease.

Структура распространенности врожденного астигматизма слабой степени

Purpose. To evaluate structure of low degree congenital astigmatism prevalence. Material and methods. A retrospective analysis of the biometric parameters of 128,379 patients (256,630 eyes) who underwent diagnostic or treatment care in S. Fyodorov Eye Microsurgery Federal State Institution from 2013 to 2018 was carried out. All results of routine examination were evaluated, including best non-corrected visual acuity and best corrected visual acuity, central corneal thickness and lens thickness, anterior chamber depth, biometry. Results. The structure of congenital astigmatism over the studied period was distributed as follows: astigmatism of more than 1.0 D was diagnosed in 66,610 (25.96%) eyes. The main number of patients had low degree astigmatism – 86.30%, with the rule astigmatism – 56.10%. Simple astigmatism was diagnosed in 5,317 (7.98%) eyes, complex in 52,436 (78.72%) eyes. The most frequent combination of astigmatism was with myopic refraction 40,955 (61.48%), the least with emmetropic 5,317 (7.98%). Conclusions. Patients with corneal astigmatism mostly underwent cataract surgery 10 years earlier than emmetropic patients, still at working age, due to the inability to engage in professional activities. Most of them were female. Astigmatism up to 0.75 D is more common on the right dominant eye, from 2.0 D and more on the left. All the correlation coefficients indicate a barely noticeable relationship between biometric parameters and the degree of astigmatism. Key words: astigmatism, congenital astigmatism, corneal pathology

Reimplantation of a drainage valve device in refractory glaucoma. A clinical case

Background: Implantation of various drainage devices is one of the treatments for refractory glaucoma, resistant to traditional surgical methods. The most commonly used glaucoma drainage device for refractory glaucoma is the Ahmed glaucoma valve. However, the long-term success rate of the surgery may be limited because of the development of complications during the late postoperative period. The complications do not allow the control of the achieved intraocular pressure (IOP) level. In such cases, a repeated implantation of the Ahmed valve may be one of the options for the surgical treatment. Clinical case description: Second Ahmed valves were implanted to two patients with refractory repeatedly operated glaucoma at the Department of surgical glaucoma treatment of the S. Fyodorov Eye Microsurgery Federal State Institution in Moscow. Previously, both patients had the Ahmed valves installed at their places of residence. During the postoperative period, one patient was found to have an encapsulated cyst around the drainage body, and later the revision of the operation area was performed. As a result of the repeated Ahmed valve implantation, the IOP compensation was achieved 9 months after the surgery. Conclusion: A repeated implantation of the Ahmed valve may be an option for the surgical treatment, if the first implant failed to control the IOP, in order to compensate the IOP and preserve the visual functions in patients with refractory repeatedly operated glaucoma.

COMBINATION OF PATHOLOGY OF THE BRAIN AND THE OPTIC NERVE

The relevance of assessing the lesion of the visual analyzer with optic disc drusen and the possibility of identifying concomitant pathologies, increases with the introduction of the latest diagnostic techniques.In the S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, a patient, 50 years old, complaining of episodic blurred vision. The diagnosis revealed the drusen of the optic nerve head and concomitant congenital neurological pathology. The patient was consulted by a neurosurgeon with the aim of delivering a diagnosis and determining treatment tactics. The diagnosis was made: Arteriovenous malformation of the deep arteries of the sections of the left parietal lobe. After assessing the size of the arteriovenous malformation, its location in the functionally important area of the brain, it was decided to follow up the patient in dynamics

Сравнительный анализ эффективности хирургического лечения сквозных макулярных разрывов с применением и без применения послеоперационной газовой тампонады витреальной полости

Fyodorov Eye Microsurgery Federal State Institution, Ekaterinburg Branch, Ekaterinburg, Russian Federation

Алгоритм инфекционного скрининга доноров роговиц в Глазном тканевом банке ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова»

Purpose. To analyze an algorithm for infectious screening of cadaver corneal donors during corneal processing at the Eye Tissue Bank (ETB) of The Fyodorov Eye Microsurgery Federal State Institution and compare it with the European Eye Bank Association (EEBA) data from 2011 through 2015. Material and methods. Data analysis were done using the ETB in-house donor data registry and EEBA annual directory forms. The extracted data included the number of received eye globes, rates of inconclusive and serological tests for human immunodeficiency virus (type 1 and 2), Hepatitis B and C viruses, and Syphilis. Results. During the analyzed period 3479 eye globes were delivered in the ETB for the processing. Hemolysis caused exclusion for 13.9% (n=486) of corneas in the ETB. In opposite, the EEBA data demonstrated far lower rates of inconclusive tests. The positive serology tests lead to canceling 19.4% (n=676) of the incoming corneas in the ETB. Overall, the rates of positive tests were far higher in comparison with EEBA data. At the ETB, positive serological tests for HIV (type 1 and 2) and Syphilis had low variability annually, while the rates of Hepatitis B increased in 2015. Predomination of Hepatitis C was also noted. Often enough, the blood samples were multiply-infected. Conclusion. Overall, the positive serology and hemolysis were the major contraindications and led to exclusion 33.4% (n=1162) of incoming corneas in the ETB. Serological tests rates for indicated infections were higher in the ETB with predomination of Hepatitis C. An algorithm for infectious screening at the Eye Tissue Bank (ETB) of The S. Fyodorov Eye Microsurgery Federal State Institution was effective in selection of postmortem donors for cornea processing in clinical use. Key words: cornea transplantation, eye bank, serological tests, human immunodeficiency virus, hepatitis B viruses, hepatitis C virus, syphilis

In memory of Sergei F. Shkolnik

Information about the sudden death of a Doctor of Medical Sciences, Head of the Department of dacryology and ophthalmoplasty of the Cheboksary branch of the S.N. Fyodorov Eye Microsurgery Federal State Institution, Doctor of the highest qualification category Sergey F. Shkolnik.

Телемедицина как инструмент межрегионального дистанционного взаимодействия с профильными медицинскими организациями субъектов Российской Федерации: опыт Чебок- сарского филиала ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С. Н. Федорова» Минздрава России

At present, the possibility of providing qualified medical care anywhere in the world has become a reality thanks to the development of telemedicine technologies. The development and improvement of telemedicine technologies is due to the regulatory and legal regulation and implementation of the national project «Health Care», which was developed on the basis of the Presidential Decree № 204 of 07.05.2018 «On the national goals and strategic objectives of the Russian Federation for the period until 2024». (hereinafter – the Decree of the President of the Russian Federation of 07.05.2018 № 204) [9]. The National Medical Research Centers (NMRCs) were tasked with organizing advisory and methodological expert support for specialized regional medical organizations of the 3rd level of RF subjects. Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» supervises ophthalmological service of 8 subjects of the Russian Federation: Nizhny Novgorod, Kirov, Ulyanovsk regions, Republics of Mordovia, Udmurtia, Mari-El, Tatarstan and Chuvashia. The article presents the experience of Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» of Health of Russia on the use of telemedicine technologies to improve the provision of specialized, including high-tech medical care in the profile «Ophthalmology». Over the 3-year period of operation, the number of requests for telemedicine consultations at the «doctor-physician» level has increased significantly. In addition, from January 2021, Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» provides consultative care at the «doctor-patient» level. Purpose of the study is to present the experience of Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» of Health of Russia on the use of telemedicine consultations (TMC) performed using the «Telemedicine consultations» component of the federal electronic registry subsystem of the unified state information system in healthcare (USGISZ FER TMC component) from 2019 to 2021 and the «MEDTERA Telemedicine» unified secure technological platform from 2021. Material and Methods. Telemedical consultations on the basis of the Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» are performed by highly qualified specialists – heads of the departments, research workers, leading specialists in different fields of ophthalmology. Telemedical consultations at the «doctor-physician» level are performed as follows: at the initial stage, a request for a consultation is received from specialized medical organizations of the subjects of the Russian Federation, which is processed by the employees of the Department of Telemedical Consultations. Information about the request is registered in the database, its profile is evaluated, as well as the quality, completeness and relevance of the data of the attached medical documentation. For real-time consultation «doctor-patient» through video or audio conferencing, the patient makes an independent appointment for a convenient date and time with a particular specialist. Results. During 3 years of the TMC functioning at the Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» the number of requests for telemedicine consultations at the “doctor-physician” level in the field of ophthalmology from 8 subjects of the Russian Federation of the Volga Federal District is progressively increasing. The bulk of telemedicine consultations are scheduled requests. During the 3-year period of telemedicine consultations at the Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» there were 94 TMK from the Republic of Tatarstan, 79 TMK from the Chuvash Republic, 61 TMK from the Republic of Mariy-El, 53 TMK from the Republic of Udmurtia, 46 TMK from the Kirov region, 37 TMK from the Nizhny Novgorod region, 36 TMK from the Ulyanovsk region, 23 TMK from the Republic of Mordovia. Findings. Summarizing the results of the analysis of the structure of telemedicine consultations performed using the IGISZ FER TMC component, it can be summarized that the IGISZ FER TMC component is a convenient, effective tool, which allows to comply with the Russian legislation in conducting telemedicine consultations, as well as to analyze the structure of telemedicine consultations conducted with its use.

Russian scientific and practical conference with international participation «Laser intraocular and refractive surgery». section «Pediatric ophthalmology»

The article is devoted to reviewing the problems that were discussed in the section Pediatric ophthalmology, organized for the first time within the Russian scientific and practical conference with international participation in Laser intraocular and refractive surgery. The conference was held on December 1011, 2021 in St. Petersburg and organized by the St. Petersburg branch of S. Fyodorov Eye Microsurgery Federal State Institution with the support of the Society of Ophthalmologists of Russia and North-Western State Medical University named after I.I. Mechnikov. In the pediatric section, 11 reports were made by leading Russian and foreign experts, and the topics were mainly related to the use of laser technologies in ophthalmopediatric practice. The discussion focused on the issues of diagnosis and laser treatment of premature retinopathy and other retinal diseases, modern approaches and results of surgical and contact correction of ametropias (keratoconus, hypermetropia, and progressive myopia) in childhood, and clinical cases of the effectiveness of complex treatment of bilateral retinoblastoma. In conclusion, an overview of new portable technologies for visualization of the state of anterior and posterior eye parts was presented, which is especially important for pediatric ophthalmologists.

Evaluation of the efficiency of refractive error correction using phakic intraocular lens implantation

Background. Myopia is the most common clinical refractive error of the eye. Only in Russia, there are about 15 million myopic people. Currently, in addition to traditional correction (glasses, soft contact lenses), keratorefractive surgery actively develops; however, due to the initial parameters of the cornea or the magnitude of the refractive error, it may be contraindicated to the patient. Nowadays an alternative to these correction methods for young patients with refractive errors of high and ultra-high degrees is the implantation of a phakic intraocular lens.The aim. To evaluate the efficiency of refractive errors correction using phakic IOL implantation.Materials and methods. We carried out a retrospective analysis of outpatient records of 56 patients who received surgical treatment for myopia and complex myopic astigmatism at the Orenburg branch of the S. Fyodorov Eye Microsurgery Federal State Institution in the period from 2019 to 2020 (110 eyes), all patients underwent implantation of a phakic intraocular lens IPCL V2.0, IPCL V2.0 TORIC. Patients were examined before surgery and on the first day after surgery. In addition to standard, special clinical and functional examination methods were used: optical biometry on the IOL-Master 700, determination of the density of endothelial cells using an endothelial microscope, examination of the fundus under cycloplegia; if necessary, peripheral laser coagulation of the retina was performed before calculating phakic IOLs.Results. All operations and the early postoperative period went without complications. The target BCVA (0.75–1.0) was achieved in 90 (81.8 %) eyes. All patients were satisfied with the treatment results.Conclusion. Implantation of IPCL V2.0 and IPCL V2.0 TORIC phakic IOLs is an effective method for correcting refractive errors, regardless of the degree of myopia and the presence of astigmatism.

Клинические варианты периферических увеитов у детей и их осложнения

Purpose. To study the frequency and structure of complications of peripheral uveitis (PU) in children who were hospitalized in the Khabarovsk branch of The S. Fyodorov Eye Microsurgery Federal State Institution in the period from 2015 to 2020. Material and methods. The object of the study were 20 children (40 eyes) with bilateral chronic recurrent PU. In addition to standard examination methods, optical coherence tomography (OCT) was performed. And to clarify the etiological diagnosis of PU, laboratory examinations and examinations by specialists of a narrow profile were carried out. Results. The results of enzyme immunoassay showed the presence of IgG to the herpes simplex virus in 14 patients (70 %), IgG to the Epstein-Barr virus - 12 patients (60 %), IgG to cytomegalovirus – 15 patients (75 %). Two children were found to be infected with Toxoplasma gondii (IgG) and Chlamydia trachomatis (IgG). The results obtained show a significant role of herpesvirus infections in the development of PU in children. In a prospective observation, the most common complication was unilateral or bilateral complicated cataract (8 eyes – 20 %). In 4 eyes – 10 %, according to OCT, cystic macular edema was detected. Traction retinal detachment was diagnosed in 2 eyes of one 15-year-old child. Conclusion. It was found that the main etiological cause of PU was herpesvirus infection. Complicated cataract was the most frequent complication of PU (20 %). The results of the conducted studies are of practical importance for the development of rational treatment tactics in children with PU. Keywords: peripheral uveitis, complications, childhood, etiology.

Анализ качества оказания медицинской помощи в специализированной офтальмологической клинике в условиях пандемии новой коронавирусной инфекции COVID-19

The purpose of article was to study quality of planned medical care in conditions of reprofiling around the clock inpatient care into outpatients care in the Khabarovsk branch of the Eye Microsurgery Federal State Institution (the Khabarovsk branch) during pandemic of the novel coronavirus disease COVID-19. Due to unfavorable epidemic situation in the world and high risk of transmission of infection to patients and medical staff, the Khabarovsk branch was re-profiled from around the clock inpatient care into outpatients care. This form of specialized ophthalmic care has proven to be in high demand. It contributes to increasing the availability of planned specialized care. The percentage of complications from treatment performed predominantly in a day hospital (0.3% in 2021) does not exceed the number of complications from treatment performed in around the clock inpatient care before the COVID-19 pandemic. Practice has shown that in order to minimize the risks of complications during treatment in outpatients care hospital, a more thorough approach to patient preparation is required. Keywords: number of hospital beds, around the clock inpatient care, outpatients care, complications, re-profiling of hospital.

Анкетирование как независимая оценка качества оказания услуг в специализированной офтальмологической клинике

The article presents an analysis of the survey data, which made it possible to study the dynamics of the evaluation of the opinions of 460 patients of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (Branch) in 2018, 2019 and 2021. The questions formulated in the questionnaire concerned the respondents’ satisfaction with the work of medical and auxiliary departments, as well as interpersonal relations “medical worker – patient”. As a result, it was revealed that patient satisfaction with the work of all structures of the Branch was higher in 2021 than in 2018 and 2019. Negative feedback about the work of coordination (the inability to get through) remained the same, but for a smaller number of people (satisfaction with the work of coordination was 94% in 2018, in 2021 – 99%). The measures taken by the Administration based on the results of previous questionnaire surveys have led to an improvement in the quality of medical care in the Branch. Questioning is an effective method of independent assessment of the quality of medical care. Keywords: questioning, respondent, quality of medical care.