Fyodorov Eye Microsurgery Federal State Research Articles

Послеоперационный эндофтальмит

Surgical treatment of postoperative endophthalmitis is an urgent problem of ophthalmic surgery. Purpose.The aim of the study was to analyze the results of treatment of patients with postoperative endophthalmitis using perfluorodecalin and antibiotic solutions for vitreal cavity tamponade. Materials and methods. For the period 2016-2020, 35 patients (35 eyes) were operated in the Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution. In 26 patients, this complication occurred after cataract extraction, in 7 after vitreoretinal operations, in 2 after intravitreal administration of an angiogenesis inhibitor. Visual acuity before treatment of endophthalmitis in 3 patients was to 0.02– 0.08, in 16 – counting of fingers in the face, in 13 – pr.l.certa, in 3-pr. l. incerta. All patients underwent vitrectomy with perfluorodecalin tamponade of the vitreal cavity for up to 14 days and intravitreal administration of vancomycin 1 mg and ceftazidime 2.25 mg at the end of the operation. On day 2-3, all patients underwent additional intravitreal administration of antibiotics, depending on the detected pathogen. Further, in 22 patients, the removal of perfluorodecalin and the remaining preretinal and peripherally located exudate was performed, in 13 patients - tamponade of the vitreal cavity with silicone oil. Results. As a result of the treatment according to the developed method, it was possible to preserve visual functions in 32 patients (91%) out of 35. At discharge, the corrected visual acuity was from 0.1 to 0.7 (0.28±0.2). After 6 months, the corrected visual acuity in 32 patients was from 0.1 to 0.9 (0.36±0.2). Visual acuity (above 0.3) was achieved in 26 cases (74.3%). Conclusion. Clinical results demonstrate the effectiveness of the developed method of surgical treatment of endophthalmitis. Key words: postoperative endophthalmitis, perfluorodecalin, intravitreal administration of vancomycin and ceftazidime.

Псевдоретинобластомы: спектр патологии и частота в различных возрастных группах. Анализ 14-летнего опыта

Purpose. To evaluate the spectrum and the occurrence frequency of lesions simulating retinoblastoma in different age groups. Material and methods. A retrospective study of 608 patients (871 eyes) with suspected retinoblastoma was performed in the Ocular Oncology and Radiology Department of the Fyodorov Eye Microsurgery Federal State Institution in the period from 2007 to 2020. The mean patient age at presentation was 21 months (from 1 to 209 months). In 475 patients (78.1%) (715 eyes), the diagnosis of retinoblastoma was confirmed after a comprehensive assessment of the eye. 133 patients (156 eyes) (21.9%) had symptoms mimicking retinoblastoma-pseudoretinoblastomas. All patients with pseudoretinoblastomas were divided into different groups based on the simulating condition and age: from 0 to 1 year, from 1 to 2 years, from 2 to 5 years, older than 5 years. Results. There were 25 conditions simulating retinoblastoma. The most common conditions were Coats' disease (n=17; 12.8%), combined hamartoma of retina and retinal pigment epithelium (n=12. 9%), retinal detachment (n=11; 8.3%), vitreous opacities caused by intrauterine uveitis (n=11; 8.3%), choroidal hemangioma (n=11; 8.3%), vasoproliferative tumor (n=10; 7.5%), retinopathy of prematurity (n=7; 5.3%), morning glory syndrome (n=7; 5.3%). Most patients had unilateral lesions (n=116; 87.2%). Pseudoretinoblastomas differed based on age at presentation, because children 1 year of age or younger were most likely to have vitreous opacities caused by intrauterine uveitis (n=9; 21.4%) and retinopathy of prematurity (n=7; 16.7%); children aged from 1 to 2 years – Coats' disease (n=4; 20%) and choroidal hemangioma (n=3; 15%), from 2 to 5 years – Coats' disease (n=8; 21.6%), older than 5 years – Coats' disease (n=5; 14.7%) and vasoproliferative tumors (n=7; 20.6%). Conclusion. Timely referral of children with suspected retinoblastoma in specialized ocular oncology centers helps to avoid unnecessary treatment for retinoblastoma, enucleation and improve the vital prognosis.

Отдаленные результаты комбинированного хирургического лечения пациентов с первичной открытоугольной глаукомой в сочетании с осложненной катарактой

Purpose. To improve the effectiveness of surgical treatment of patients with primary open-angle glaucoma in combination with complicated cataract in the long-term period. Material and methods. A retrospective analysis of the cards of 64 patients (64 eyes) with 1-3 stage primary open-angle glaucoma (POAG) in combination with complicated cataract, who applied to the Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution and underwent combined surgical treatment in the form of microinvasive non-penetrating deep sclerectomy with simultaneous implementation of cataract phacoemulsification. We analyzed the results of combined surgical treatment of this group of patients 1, 6 and 12 months after surgery. Results. The obtained results indicate the stabilization of intraocular pressure in 60.9% of cases. However, in 26.5% of cases in patients with POAG of stage 3, it was necessary to prescribe a combination of antiglaucoma drugs. The total field of view in these patients remained unchanged, however, according to OCT-angio and computed perimetry, they had a negative trend. Conclusion. Combined surgical treatment of microinvasive non-penetrating deep sclerectomy with simultaneous implementation of cataract phacoemulsification followed by implantation of a posterior chamber IOL is an effective method of treating patients with glaucoma and cataract, while both the hypotensive and optical effect persists one year after the operation. Key words: open-angle glaucoma, cataract, dry eye syndrome, unstabilized glaucoma.

Опыт хирургического лечения идиопатических макулярных разрывов в Оренбургском филиале ФГАУ НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Фёдорова»

Purpose. To study the anatomical and functional results of various methods of surgical treatment of idiopathic macular rupture. Material and methods. In the course of this study, 50 medical records of patients with a diagnosis of macular rupture were randomly selected from the total number of those, who underwent the surgery at the Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution for 2020 year. Patients were divided into 3 groups. In the first group (38 eyes), the macular rupture was closed using ACP and PRP, in the second group (7 eyes) – using an inverted flap of the internal border membrane, in the third group (5 eyes) – by mechanical convergence of the edges of the rupture followed by tamponade of the vitreous cavity with silicone oil. Results. To assess the medical efficiency of the studied methods of surgical treatment of idiopathic macular rupture, the rate of increase in the maximum corrected visual acuity (MCVA) was calculated for each patient. Conclusion. The calculated indicator of the dynamics of vision improvement «the rate of BCVA growth» as a whole reflects the positive dynamics of the treatment of idiopathic macular rupture by surgical methods and can be used to assess the medical effectiveness of methods of treating patients with eye diseases initially with different values of the BCVA parameter. In the course of the analysis, no significant differences were found between the influence of various methods of surgical treatment of macular rupture on the rate of BCVA growth or rupture closure. Correlation analysis did not establish a statistically significant dependence of the growth rate of BCVA on the initial size of the rupture. Key words: macular rupture, inverted flap, platelet-rich plasma (PRP), autologous conditioned plasma (ACP).

Опыт применения ИОЛ c отрицательными значениями рефракции при катаракте, осложненной экстремально высокой миопией

Purpose. To analyze the postoperative result of visual and refractive functions in patients with extremely high myopia, taking into account the initial changes in the macular zone and rather complex calculations of the optical power of negative aphakic IOLs. Materials and methods. On the basis of S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, 57 negative aphakic IOLs were implanted over the past 3 years, which amounted to an average of 0.14% of the total number of implanted IOLs. All patients who were supposed to have a negative IOL implanted in the list of preoperative diagnostics included OCT of the posterior segment of the eye and ultrasound scanning to assess the existing degenerative changes in the posterior segment of the eye. Results. The average visual acuity before surgery in the group of emmetropes was ±0.32, and in patients with extremely high myopia, visual acuity did not exceed 0.1 in 2018, 0.23 in 2019, and 0.22 in 2020. In the operated extreme myopes, the mean BCVA increased to ±0.43, which is slightly lower than the average BCVA of the operated emmetropes during the same period (±0.58). None of the patients had intraoperative complications. Posterior capsule opacification was noted in 20 cases (35%) within 12-14 months after cataract surgery, which is several times higher in comparison with emmetropes, where posterior capsule opacification is observed in 8-15%, depending on the IOL model. Conclusion. This group of patients requires a particularly careful preoperative diagnosis, as well as surgery with increased caution due to the presence of concomitant pathology of the posterior segment of the eye. The experience of using negative IOLs for cataract in patients with extremely high myopia has shown good results in relation to postoperative visual and refractive functions, despite the fact that BCVA in extreme myopes after surgery is limited by the initial changes in the macular zone. Key words: negative aphakic IOLs, extremely high myopia, complicated cataract.

Итоги лечебной работы Хабаровского филиала ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова» Минздрава России в 2020 г

Purpose. Analysis of organization and results of medical work in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (Khabarovsk Branch) in the context of a pandemic of the novel coronavirus disease (COVID-19) in 2020. Material and methods. The analysis of regulatory documents adopted in the Russian Federation, Khabarovsk Krai, and orders of the Director of the Khabarovsk Branch to ensure epidemiological wellbeing in organization of treatment process was carried out. Results. The developed complex of anti-epidemic measures to ensure epidemiological wellbeing at provision of emergency and planned ophthalmological care to residents of the Far Eastern Federal District of Russia made it possible in 100% of cases to fulfill the state task for the provision of high-tech medical care. The total volume of medical care for ophthalmological diseases in the Khabarovsk Branch as a whole decreased by 18,9%. It should be noted that the same trend was observed in all branches of the S. Fyodorov Eye Microsurgery Federal State Institution. Conclusion. Despite the problems that COVID-19 brought to work of the Khabarovsk Branch, it still fulfilled its mission, as defined by S. Fyodorov - to bring light and goodness to people living in the Far East of Russia. Key words: ophthalmology, medical work, hightech medical care, COVID 19, SARS-CoV-2, pandemic, organization of medical care, ocular emergency.

Взаимосвязь длительности применения гипотензивного режима и частоты случаев развития синдрома «сухого глаза» у пациентов с первичной открытоугольной глаукомой

Purpose. To study the incidence of dry eye syndrome (DES) in patients with primary open-angle glaucoma (POAG), depending on the duration of the use of local antihypertensive therapy. Material and methods. The material for the study was patients who were examined in the treatment and diagnostic department of the Khabarovsk branch the S. Fyodorov Eye Microsurgery Federal State Institution with a confirmed clinical diagnosis of POAG. The main group included 45 patients with a duration of antihypertensive therapy of 1 month or more. The comparison group consisted of 15 patients with newly diagnosed POAG. The period of use of antihypertensive therapy in them did not exceed one month. Depending on the experience of using antihypertensive therapy, the patients of the main group were divided into 3 subgroups. All were questioned using the DEQ-5 dry eye questionnaire, Schirmer I, II and Norn's tests, objective examination of the anterior segment of the eyes. The analysis of the detection and severity of DES among patients with POAG was carried out, taking into account the experience of using the antihypertensive regimen. Results. According to the questionnaire, 26 patients (58%) of the main group presented complaints typical of DES, while in the comparison group only 3 patients (20%) presented them (p<0.05). There was also a tendency towards a decrease in the total and main type of tear production in the main group according to the results of Schirmer's tests I and II – 10.9±1.04 mm and 7.7±0.48 mm versus 13.9±2.5 mm and 10, 2±2.1 mm in the comparison group (p>0.05). The stability of the tear film, according to Norn's test, also differed: 8.2±0.35 sec. and 9.5±1.8 sec. in the main and comparison group, respectively (p> 0.05). Conclusion. The initial symptoms of xerosis of the ocular surface are recorded in the period from 1 to 3 years from the beginning of the use of antihypertensive drugs and increase in proportion to the increase in the length of the disease. Key words: dry eye syndrome, glaucoma, antihypertensive therapy.

Анализ структуры офтальмологической патологии амбулаторных пациентов лечебно-диагностического отделения

Purpose. Clinical analysis of the nosological structure of ophthalmologic pathology in patients who applied to the treatment and diagnostic department (TDD) in 2020. Material and methods. The article provides an analysis of the number of patients who applied to the TDD of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution for the period from the beginning of January to the end of December 2020 (continuous sampling method). An assessment of their age and gender composition is given, an analysis of the nosological structure of ophthalmopathology in the patients who have applied, its stage, is carried out, a comparison is made with similar data from five years ago. Results. In the structure of ophthalmic pathology, there was a high turnover rate of patients with the presence of various types of ametropia, as well as for the purpose of its surgical correction. A large number of patients with socially significant types of pathologies: cataracts, glaucoma, acquired diseases of the macular region, vascular diseases of the retina, requiring highly specialized surgical and conservative treatment. The analysis of the results of the work of the TDD showed a high percentage of detection of eye diseases, as well as for the first time detected serious pathology, achieved with the help of complex modern diagnostic methods. Conclusion. In 2020 8 851 patients with various ophthalmic pathologies were examined. In comparison with the five-year data, the volume of applications to LDOs increased significantly by 42%. Key words: ophthalmopathology, refractive error, cataract, glaucoma, medical and diagnostic department.

Частота пациентов с гиперметропической рефракцией в отделении рефракционной хирургии офтальмохирургической клиники

Purpose. Determination of proportion patients with hyperopia in refractive surgery department of ophthalmic surgery clinic, analysis of degree of their hyperopia, morphometric parameters of anterior segment of the eye. Material and methods. The proportion of patients with hyperopia who were operated in the refractive surgery department of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution in 2019 were assess. On limited sample of these patients, a quantitative assessment of degree of hyperopia was carried out, and morphometric parameters of the anterior segment of the eyes were studied. Results. In 2019, 141 patients with hyperopia were operated (282 operations), which amounted to 11.3% of the total number of patients in the department. The majority of patients had a moderate degree of hyperopia (55.3%). In 47.5% of eyes, hyperopia was combined with astigmatism up to 4 diopters. Conclusion. Femto LASIK technology made it possible to achieve maximum uncorrected visual acuity in 52% of patients with hyperopia in the study group. Modern capabilities of refractive surgery are capable of providing high functional results in patients with varying degrees of hyperopia. Key words:refractive errors, hyperopia, refractive surgery, Femto LASIK, age groups.

Работа клинико-экспертного отдела офтальмохирургической клиники в условиях пандемии новой коронавирусной инфекции

Changes in work of the clinical expert department of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (the Khabarovsk branch) in the context of a pandemic of the novel coronavirus disease were analyzed in the article. The difficulties that have appeared in all sections of the work performed are described, both medical and expert: the time for checking the quality of filling out medical documentation has increased due to the identification of a larger number of defects; the time for medical control and discharge of patients from the hospital has increased due to the impossibility of accumulating patients in one place and the need to maintain social distance; difficulties arose in working with experts from insurance companies due to the lack of direct communication (medical records are checked outside the Khabarovsk branch). The concern of people about the possibility of carrying out surgical treatment in conditions of coronavirus infection was expressed in an increase in the information load of the «Question - Answer» section on the website of the Khabarovsk branch and, accordingly, on the doctors in the clinical expert department working with it. Key words: pandemic, COVID-19, SARSCoV-2, anti-epidemic measures, personal protective equipment, social distance, treatment control, medical documentation, medical and economic expertise.

Структура клинической разновидности макулярной патологии среди пациентов диагностического отделения

Purpose. To study the frequency and nosological structure of concomitant macular pathology in patients admitted for ophthalmic surgery. Material and methods. A study of the state of the macula was carried out in 337 eyes of 170 patients who underwent a diagnostic examination in the Khabarovsk Branch the S. Fyodorov Eye Microsurgery Federal State Institution in 2020. The patients' age was 58±15.2 years. The selection criterion was sufficient transparency of the optical media for viewing the macular zone. An in-depth examination of the macular zone was carried out using a forehead binocular reflex-free ophthalmoscope (Heine OMEGA500, Germany) and a non-contact lens (VOLK Double Aspheric 20D, USA), as well as optical coherence tomography (Cirrus HD-OCT 5000, «Carl Zeiss», Germany). The proportion of macular pathology among the patients who applied, the frequency and severity of its individual nosological forms were evaluated. Results. Various macular pathologies occurred in 28.2% of cases. Age-related macular degeneration (AMD) (47.9%) and epiretinal fibrosis (27.1%) accounted for a significant share in the structure of macular pathology. The frequency and structure of macular pathology in patients with age-related cataracts was analyzed. The incidence of macular pathology in them was 45.1%, of which AMD was detected in 65.2% of cases, epiretinal fibrosis – 7.8%. Conclusion. Among the group of patients selected by the method of continuous sampling with various ophthalmic surgical pathologies, 28.2% had various pathologies of the macular zone. The most common macular pathology occurred in the age group from 45 to 59 years old, accounting for 56.2% of cases. In the nosological structure of macular pathology, the share of AMD and epiretinal fibrosis prevailed. Key words: macular pathology, age-related macular degeneration, epiretinal fibrosis.

Работа современного офтальмохирургического стационара в условиях пандемии новой коронавирусной инфекции COVID-19

The article evaluates the effectiveness of changes in the organizational work of the diagnostics department of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (Branch) in the context of a pandemic of the new coronavirus infection COVID-19. The data on the organizational restructuring of the activities of the diagnostic department of the Branch are presented. It was due to strict requirements for compliance with anti-epidemic measures in the context of the pandemic of the new coronavirus infection COVID-19. Thanks to this, it was possible to maintain the annual volume of providing ophthalmic surgical care to residents of the Far Eastern region of the Russian Federation. Its decline was only 17.4%. Key words: pandemic of the new coronavirus infection COVID-19, ophthalmosurgical clinic, reorganization of work, volumes of planned surgery.

Организация и выполнение экстренной офтальмохирургической помощи в условиях специализированной офтальмологической клиники в период пандемии COVID-19

Purpose. Evaluation of the frequency, structure and severity of the eye injuries, the effectiveness of the implementation of primary surgical treatment (PST) and the outcomes of their surgical treatment. Material and methods. In just a period from the end of March to December 2020, in the Khabarovsk branch the S. Fyodorov Eye Microsurgery Federal State Institution received 51 patients with various as penetrating (48 eyes) and imperriburing injuries of the eyeball (3 eyes). Their age varied widespread from 5 to 56 years (on average 35.5 years). Men were dominated among them – 44 people, women – 7 people. Adults were 49 people, children – 2 people. Results. Under the conditions of obtaining penetrating injuries, household injuries were isolated – 33 eyes (65%), production – 15 eyes (29%). The contusion injury of the eye was criminal, which was 6% (3 eyes). According to the localization of penetrating injuries or the impact of mechanical damage, they were presented: corneal wounds – 12 eyes, rootless – 17 eyes, scleral – 18 eyes. In 13 eyes, there was an intraocular foreign bodies (IFB). Conclusion. Thus, for the period from April to December 2020, in our branch, PST eyes were performed about 47 heavy penetrating injuries, including the introduction of IFB in 13 eyes, 4 eyes with extensive damage to conjunctiva. Among the victims were 49 adults and 2 children. Key words: penetrating eye wound, intraocular foreign body, microgery surgery, traumatic retinal detachment.

Структура сопутствующей соматической патологии пациентов различных возрастных групп перед офтальмохирургическими вмешательствами

Purpose. Analysis of structure somatic pathology in patients different age groups before planned ophthalmic surgery. Material and methods. Analyzed 1200 medical records patients previously operated in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 3 age groups were formed. The 1st group included 11 patients under age of 40 years (0.9%), the 2nd group – 234 patients from 41 to 60 years (19.5%), the 3rd group – 955 patients over 60 years (79.6%). In each of the groups, the frequency and structure of concomitant somatic pathology, the degree of its compensation were studied. Results. In the 1st group, 54.5% of patients were somatically healthy, 45.5% had a pathology, represented mainly by stage 1 hypertension and type 1 diabetes. All of them were compensated, there were no difficulties in preparing for the operation in this group. In the 2nd group, 90.2% of patients had somatic pathology. The leading positions were occupied by hypertension and type 2 diabetes, the respiratory system pathologies, rheumatic diseases and the carriage of chronic hepatitis B and C viruses were added. Treatment correction at the preoperative stage was required for 2 patients (0.9%), after which the patients were operated. In 3rd group, 100% of patients had somatic pathology. Its structure did not differ much from the 2nd group, but there were also complications such as heart attacks, acute cerebrovascular accidents, complicated diabetes. Correction of therapy was carried out in 61 people (6.4%), 60 of them were successfully operated, one did not appear for hospitalization. Conclusion. Somatic burden increased and degree of compensation for diseases decreased with increasing age of patients. Successful operations are facilitated by individual approach to patient, taking into account the existing pathology and preoperative preparation. Key words: patient's age, somatic burden, hypertension, diabetes mellitus, compensation.

К вопросу о выборе оптимального способа анестезиологического пособия при лазеркоагуляции сетчатки у младенцев с ретинопатией недоношенных

Purpose. To evaluate the method of anesthesia used in the Kaluga branch of the Fyodorov Eye Microsurgery Federal State Institution for retinal laser photocoagulation in premature infants with retinopathy of prematurity. Materials and methods. The data of children diagnosed with retinopathy of prematurity was analyzed for the period 2017– 2019. These children underwent retinal laser photocoagulation under general anesthesia at the Kaluga branch of the Fyodorov Eye Microsurgery Federal State Institution. As an anesthetic aid, inhalation monoanesthesia with sevoflurane by the method of «bolus» induction was carried out starting from 6–8 vol% with a Mapleson circuit filled with a gas-narcotic mixture of oxygen and air. Induction with using a face mask with reaching the surface level of the surgical stage of anesthesia was fixed by 4–5 minutes. Then, for better airway patency, the laryngeal mask was fixed. Results. With «bolus» induction, the surgical stage of anesthesia occurred within 3–4 minutes. The patient was in the optimal anesthetic condition for laser surgery during the entire surgical process. The eyeballs had a fixed central position, muscle tone was reduced, breathing was even, and there was no reaction to pain stimulus. No significant changes in the heart rate were revealed when monitoring the parameters of the state of the cardiovascular system during induction was being performed. In children with profound prematurity, a slight increase in heart rate was determined (10–15%) in the intraoperative period. The heart rate returned to its original values at the end of anesthesia. The exit from the narcotic state was characterized by smoothness and was carried out immediately after the elimination of the anesthetic within 4–8 minutes. Severe complications from vital systems and pronounced changes in behavioral reactions were not observed, in the immediate postoperative period. Conclusion. The use of this technology makes it possible to provide high-quality anesthetic treatment for premature infants during laser treatment of ROP, minimize the negative impact of anesthesia on the patient's body and optimize the work of an anesthesiologist. Key words: retinopathy of prematurity, retinal laser photocoagulation, anesthetic aid, sevoflurane, Mapleson's contour, laryngeal mask.

Исследование клинико-статистических, анатомо-оптических и функциональных характеристик первичных кератэктазий у пациентов, проживающих в Дальневосточном федеральном округе России

Purpose. To study clinical, statistical, anatomical, optical and functional properties of primary keratoectasia (PKE) in patients living in Far Eastern Federal District of Russia. Material and methods. A retrospective analysis of medical outpatient cards of 481 patients with PKE who observed in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution. We studied the detectability of PKE over the years, their quantitative structure and staging, visual acuity, refraction, maximum keratometry-readings and minimum corneal thickness. Results. Keratoconus (KC) occurred in 445 (92.5%) patients, pellucid marginal degeneration (PMD) occurred in 36 (7.5%). Among patients with KC, it was observed in 309 (69.4%) men and 136 (30.6%) in women. PMD was diagnosed in 19 (53%) men and 17 (47%) women. In 386 (86.7%) people with KC, the lesion was bilateral. Among the remaining 59 patients with KC, 6 people (1.3%) had a one-sided process, and 53 (12%) patients had signs of subclinical KC in the second eye. Bilateral PMD was detected in 35 (97%) people, in one (3%) patient the disease was detected in one eye. At comparable average values of refraction and corneal thickness in eyes with PMD and KC 1st stage, astigmatism-at PMD were 2–2.5 times greater. Conclusion. Among patients with KC, 34.9% eyes have the 2nd stage of the disease, in which visual acuity are already sufficiently reduced, and 28.5% eyes have KC the 3rd and the 4th stage and can be classified as visually impaired. The revealed differences in ratio of functional and refractive indexes of eyes with KC and PMD necessitate wider study of their diagnostic features and results of treatment latter. Keywords: keratoectasia, keratoconus, pellucid marginal degeneration.

Оценка эффективности эндоскопической биканаликулярной интубации слезоотводящих путей силиконовым дренажем при врожденном дакриоцистите

Purpose. To evaluate effectiveness of nasolacrimal duct intubation with silicone tube in congenital dacryocystitis (CD) and substantiate optimal timing of its removal. Material and Methods. 25 patients with CD were operated in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution in order to restoring conductivity of nasolacrimal duct of using the intubation set FCI (France). In addition to ophthalmic examination methods, all children underwent scleral examination which includes determination of acid base state (pH) of the wound exudate (secretion) from the nasal cavity. Inflammatory index was also scored which characterized the severity of standard signs of inflammation in the nasal mucosa after surgery. Results. There were no complications during the surgery. Normalization of nasal exudate pH values in children with uncomplicated СD was registered by the 4th week after the surgery. Normalization of nasal exudate pH values in children with recurrent СD was registered by the 6th week, coinciding with full disappearance clinical signs of inflammation. At the indicated periods, the silastic tubes were removed. One child had relapse of disease after suffering acute rhinitis 6 months after the surgery. This patient underwent dacryocystorhinostomy with positive effect. Conclusion. Bicanalicular temporary intubation of nasolacrimal duct using silicone tube in children with CD is considered as an effective treatment. In accordance with obtained results, in children with uncomplicated CD the removal of silicone implant is advisable 4 weeks after its installation, in children with recurrent CD the removal of silicone implant is advisable no earlier than 6 weeks. Key words: congenital dacryostenosis, intubation set, endoscopic rhinoscopy.

Особенности анестезии у пациентов при проведении кросслинкинга с болящей булезной кератопатией

Особенности анестезии у пациентов при проведении кросслинкинга с болящей булезной кератопатией

Применение контактных методов исследования у пациента после радиальной кератотомии (клинический случай)

«Российская офтальмология онлайн» - электронное информационное издание, создается с 1 марта 2010 года под эгидой Российского общества офтальмологов. Основная задача проекта - научно-информационная поддержка специалистов в области офтальмологии.

Современные возможности хирургии возрастной катаракты в практике Хабаровского филиала ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова» Минздрава России

Современные возможности хирургии возрастной катаракты в практике Хабаровского филиала ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова» Минздрава России