Visual Rehabilitation Of Patients Research Articles

Timed instrumental activities of daily living tasks in adults with irreversible vision impairment: validation to visual function and self-report

BackgroundInstrumental activities of daily living (IADL) are typically self-reported ability to perform complex tasks vital for independent living. There is a need for a complementary objective, performance-based approach especially in tracking outcomes in visual rehabilitation for patients with irreversible vision impairment (“low vision”). Our goals are: (1) To describe the validity of timed performance of instrumental activities of daily living (timed IADL or TIADL) tasks in individuals with irreversible vision impairment, by examining its association with visual function (visual acuity, contrast sensitivity, visual field), (2) To explore the correlation between TIADL and self-reported IADL.MethodsTwenty TIADL tasks were administered to 88 patients (median age 63.3 years, IQR 37.4–78.0) recruited from the UAB Department of Ophthalmology, Callahan Eye Hospital Clinics. An average Z-score incorporating time and accuracy of task completion was constructed. Minor accuracy errors were penalized 1 standard deviation from their calculated Z-score and major accuracy errors were assigned maximum allotted time. Linear regression was used to analyze the association between TIADL score and measured visual acuity (Early Treatment Diabetic Retinopathy Study, ETDRS chart), contrast sensitivity (Pelli-Robson), and binocular visual field (Esterman) with an unadjusted model and an adjusted model accounting for age, comorbidities, and depression scale (Center for Epidemiological Studies Depression, CES-D). Pearson correlation was used to estimate the correlation between TIADL and IADL.ResultsIncreased time to task completion was associated with decreased visual function. Each decreased line of ETDRS read was associated with an increase of 0.002 (95% CI 0.001, 0.002) Z-score (P < 0.01). A decreased ability to discern each Pelli-Robson letter was associated with an increase of 0.26 (95% CI 0.19, 0.33) Z-score (P < 0.01). For each less Esterman target identified, there was an increase of 0.01 (95% CI 0.003, 0.02) Z-score. Self-reported IADL and TIADL were correlated for reading tasks such as newspapers, nutrients on food can, and microwave timer (P < 0.05).ConclusionsLonger time to perform TIADL is associated with decreased visual acuity, contrast sensitivity, and binocular visual field. TIADL and self-reported IADL are significantly correlated for reading tasks providing an accurate, complementary outcome measure in clinical practice and research.

Comparative Analysis of Combined Topography-Guided Photorefractive Keratectomy and Corneal Crosslinking in Progressive Versus Stable Keratoconus.

To perform a comparative analysis of visual, refractive, and tomographic outcomes of combined topography-guided photorefractive keratectomy (TG-PRK) and corneal crosslinking (CXL) in patients with progressive versus stable keratoconus. Longitudinal retrospective case-control study. Patients with keratoconus submitted to simultaneous TG-PRK and CXL were included, with a minimum follow-up of 12 months up to 3 years. According to predefined disease progression criteria, patients were considered as progressive or stable. A total of 101 eyes from 93 patients were included, 62 considered progressive and 39 stable keratoconus. All baseline characteristics were similar between groups, except for age at surgery (progressive: 23.40 ± 4.22 years; stable: 35.97 ± 9.09; P < 0.001). Logarithm of the minimum angle of resolution CDVA improved significantly in progressive (baseline: 0.48 ± 0.24; 12 months: 0.33 ± 0.29; P < 0.001) and stable (baseline: 0.51 ± 0.24; 12 months: 0.28 ± 0.21; P < 0.001) patients, with no differences between groups. Maximum keratometry decreased significantly in progressive (baseline: 59.18 ± 5.63 diopters; 12 months: 54.73 ± 5.95; P < 0.001) and stable (baseline: 57.77 ± 5.02; 12 months: 53.59 ± 4.20; P < 0.001) patients, with no differences between groups. Index of surface variance significantly improved in progressive (baseline: 109.18 ± 31.74 diopters; 12 months: 94.11 ± 34.11; P < 0.001) and stable (baseline: 102.87 ± 29.52; 12 months: 86.95 ± 27.21; P < 0.001) patients, with no differences between groups. Other tomographic outcomes were also similar between groups. Pachymetry significantly decreased after surgery but remained stable throughout the follow-up. Combined TG-PRK and CXL is a safe and effective procedure for improving CDVA and regularizing the cornea, with comparable visual, refractive, and tomographic outcomes in both progressive and stable keratoconus. Combined TG-PRK and CXL may be added to the armamentarium of therapeutic tools for visual rehabilitation in patients with stable keratoconus.

Improving the quality of visualization in phacoemulsification in the “triple procedure”

The so-called “triple procedure,” including penetrating keratoplasty in combination with cataract removal and posterior chamber IOL implantation, is the preferred treatment method for patients with combined pathology of the cornea and lens. Methods to reduce intraoperative complications and ensure rapid visual rehabilitation in patients with concomitant conditions are of particular importance when planning such surgeries. In this article, we describe a clinical case of a triple procedure, which involves a lamellar dissection of the damaged cornea of the recipient followed by exposure of the residual corneal stroma to a 40% glucose solution in combination with a viscoelastic, which allowed for optical clearing of the stroma and improved visualization of the anterior chamber structures for phacoemulsification with posterior chamber IOL implantation. This approach represents a safer alternative to the “cataract stage” of surgery, performed under “open sky” conditions.

Applying individual rigid scleral contact lenses in visual rehabilitation of patients with an irregular corneal surface. Clinical cases

Scleral rigid contact lenses efficiently correct the vision of patients with irregular corneas. Purpose. To study the features of contact correction and visual rehabilitation of patients with irregular corneal surface using individual scleral rigid contact lenses. Results. Three clinical cases of successfully selected rigid individual scleral lenses for patients with an irregular corneal surface that appeared after a penetrating keratoplasty, implantation of intrastromal corneal segments, and eye injury. The expected refractive result was achieved; high tolerance and good adaptation to lenses was revealed. Conclusion. Scleral RCL can be successfully used in patients with irregular cornea to improve visual acuity, reduce the number of aberrations, restore binocular vision and social adaptation.

Quintuple Procedure for Ocular Surface Reconstruction and Visual Rehabilitation.

The aim of this study was to describe a combined surgical approach for ocular surface and visual rehabilitation in patients with limbal stem cell deficiency, corneal scarring, and cataract. We aimed to introduce this combined approach as an alternative to a staged approach and to describe the intraoperative use of a diamond ophthalmic burr (DOB) and optical coherence tomography (OCT) to achieve and confirm a smooth graft-host interface during the anterior lamellar keratoplasty (ALK) portion of the procedure. The quintuple procedure described herein consists of a modified ALK, cataract extraction, intraocular lens implantation, simple limbal epithelial transplantation, and temporal tarsorrhaphy. Intraoperative OCT and DOB were used to guide the creation of the stromal bed during the ALK. The procedure was performed in a patient with limbal stem cell deficiency and corneal scarring after a chemical ocular burn. The tarsorrhaphy was removed at 3 months postoperatively once complete corneal epithelialization was observed. The best-corrected visual acuity improved from light perception preoperatively to 20/30 at 16 months postoperatively with the use of scleral contact lenses. At this postoperative time point, the cornea was clear and compact, and the ocular surface was stable. The quintuple procedure allowed for visual and ocular surface rehabilitation in cases in which follow-up for a staged approach was not possible. Intraoperative OCT allowed for real-time visualization and dissection of the stromal bed, whereas the use of the DOB helped achieve a smooth stromal surface for an optimal graft-host interface.

Efficacy of low-vision devices in elderly population with age-related macular degeneration.

Age-related macular degeneration (AMD) is a common cause of blindness, residual damage to macular area in spite of treatment necessitates visual rehabilitation by means of low-vision aids (LVAs). Thirty patients suffering from different stages of AMD requiring LVAs were included in this prospective study. Patients with nonprogressive, adequately treated AMD were enrolled over a 12-month period, prescribed requisite LVAs and followed-up for a minimum 1-month period. Before and after provision of LVAs, near work efficiencies were evaluated by calculating reading speed as words per minute (wpm) under both photopic and mesopic light conditions, and impact of poor vision on activities of daily living (ADL) was quantified by modified standard questionnaire based on Nhung X et al. questionnaire. Of the 30 patients mean studied with mean age of 68 ± 10 years, 20 patients (66.7%) had dry AMD in better eye and 10 (33.3%) had wet AMD. Post-LVA, near visual acuity improved significantly and all cases were able to read some letters on near vision chart with an average improvement of 2.4 ± 0.96 lines. The different LVAs prescribed were high plus reading spectacles (up to 10 D) in 23.3%, hand-held magnifiers in 53.3%, base in prisms in 10%, stand held magnifiers in 6.7%, and bar and dome magnifiers in 3.3%. LVAs are effective in visual rehabilitation in patients with AMD. Self-reported reduction in visual dependency and improvement in vision-related quality of life post use of aids corroborated perceived benefit.

Problems and prospects of new methods of light stimulation in visual rehabilitation

Neurodegenerative retinal diseases such as age-related macular degeneration, glaucoma, and diabetic retinopathy remain the leading causes of low vision and blindness worldwide. Visual rehabilitation of patients who are visually impaired due to neurodegenerative diseases of the retina requires solving problems associated with a violation of the structure of neural networks and a deficiency of visual functions provided by these networks. Despite certain successes in the application of innovative methods of therapy, it is important to develop new approaches to visual rehabilitation to improve the quality of life of visually impaired patients. In visual rehabilitation, not only medical, but also various non-pharmacological therapy strategies are widely used to protect and restore the structure of the retina and its function. Among them, a separate niche is occupied by the technologies of vision stimulation therapy (phototherapy), the analysis of the main aspects of which is the task of this review. The vector of new research in the field of phototherapy is aimed at developing methods that can maximize the plasticity of the visual system to increase the effectiveness of its protection and recovery in neurodegenerative pathology. In this regard, new technologies of fractal phototherapy have great potential in visual rehabilitation.

Visual outcome of fitting Rose-K2 XL lens in a case with advanced keratoconus

Keratoconus is a progressive non inflammatory bilateral but usually asymmetric corneal disease characterised by paraxial stromal thinning and weakening that leads to corneal surface distortion. Rose K2 XL lens has an aspherical optical zone and employed in the fitting of irregular corneas for vision and comfort while maintaining corneal health. Rose K2 XL lens was fitted in a 35 year old male presented to contact lens clinic of BP Koirala Lions Centre for Ophthalmic Studies, Kathmandu having advanced keratoconus. His presenting best corrected visual acuity was 6/36 in right eye with plano and 2/60 in left eye with plano with no improvement with glasses.The corneal topography performed with Bon Sirius showed keratoconus compatible in both eyes. Rose K2 XL is a mini scleral lens which saw excellent fitting attending visual acuity of 6/12 in both eye. Rose K2 XL lenses are of viable alternative in the visual rehabilitation of patients with advanced keratoconus.

Эффективность зрительной реабилитации пациентов с использованием склеральных линз после кератопластики

Objective. To analyze the efficacy and safety of SCL in patients after keratoplasty, both penetrating and layer-by-layer, and other concomitant conditions. Methods. The study included 114 patients (144 eyes) after keratoplasty (78 men and 27 women) aged 39.18 years (range, 18 to 75 years). In 23 cases fitting of SCL was refused. For the remaining 127 eyes, SCLs from the SkyOptix laboratory were selected according to the standard method. Scleral lenses were adapted in 127 eyes (100 patients): 81 patient in one eye and 23 patients in both. The average age of the corneal graft is from 1.7 to 32 years (11.2±11.4 years). Results. After fitting of scleral lenses in all patients visual acuity in the lens averaged 0.9±0.03, that is, it has increased compared to the maximum corrected visual acuity before fitting. It follows from the study that in the vast majority of patients with corneal scarring, the type of optimal lens design was Oblate (89.6 %). Conclusions. Scleral lenses can be successfully used for visual rehabilitation in patients after various types of keratoplasty, both penetrating and layered, as well as in other surgical interventions on the graft. Key words: scleral contact lenses; visual rehabilitation; keratoplasty.

Возможности использования низкоэнергетических параметров лазера при фемто-SMILE

Purpose. To study the influence of various laser energy parameters on the refractive result and the terms of visual rehabilitation of patients in the correction of myopia using SMILE. Material and methods. 120 patients (120 eyes) with moderate myopia, in some cases with myopic astigmatism, operated on using SMILE. Divided into 4 groups depending on the energy level applied during the operation (130–160 nJ). Patients underwent complete ophthalmic examinations preoperatively and over 3 months postoperatively. Results. A statistically significant increase in UCVA was obtained in the group with an energy of 130 nJ from 0,09±0,05 to 1,02±0,06 on the first day after surgery and up to 1,17±0,06 after 1 week. The use of low laser energies didn’t lead to an increase in HOAs. The black spots &amp; areas: 1 – 3,33% (4), 2 – 3,33% (4), 3 – 4,17% (5), 4 – 8,33% (10 eyes). The largest number of cases of OBL formation was noted in group 1 (160 nJ) – 40% (12), 2 – 26% (8), 3 – 17% (5), 4 – 7% (2 eyes). The actual residual stromal thickness (OCT) after SMILE was 78,32%±0,02, 78,76%±0,02, 78,81%±0,02, and 79,23%±0,02 in each of groups in accordance with the applied energy (no significant differences). Conclusion. The use of low laser energies in SMILE contributes to a rapid recovery of vision in the early postoperative period with less energy impact on the corneal tissue, which allows to obtain a better surface without OBL, rapid healing and restoration of corneal thickness after correction. Keywords: SMILE, myopia, lower laser energy levels of femtosecond laser, OBL, Black spots &amp; Areas.

Имплантация факичной интраокулярной линзы пациенту с индуцированной гиперметропией после радиальной кератотомии (клинический случай)

The article describes a clinical case of the first experience of implantation of a phakic intraocular lens (PIOL) model IPCL V2.0 in a patient with induced hyperopia after radial keratotomy (RKT). The procedure for performing the operation and the course of the postoperative period are written. PIOL implantation in a patient with induced hyperopia that occurred in the long term after RKT allowed to achieve a high level of uncorrected visual acuity both for distance and near. This technique has a number of advantages: fast visual rehabilitation of patients, preservation of accommodation and reversibility of the intervention. Keywords: radial keratotomy, induced hypermetropia, phakic intraocular lens, VERION.

Modern approaches to visual rehabilitation of patients with neuromotor disorde

Background. Approximately 50 % of children with cerebral palsy have vision problems, manifested in strabismus, impaired eye mobility, refractive errors, nystagmus development and partial atrophy of the optic nerve.The aim: to present a clinical case of combined correction of myopia and divergent strabismus in a patient with cerebral palsy (CP).Materials and methods. A clinical case of combined correction of myopia and divergent strabismus in a patient with cerebral palsy is presented. General anesthesia was used to perform a two-stage treatment under one anesthesia: the first stage – laser myopia correction by femtosecond extraction of the lenticule through a small access (SMILE) to both eyes, the second stage was the strabismus correction by performing tenoscleroplasty of the external rectus muscle and resection of the internal rectus muscle of both eyes. The sequence of stages is due to the relative traumatism of strabismus surgery, in some cases, accompanied by a reaction from the bulbar conjunctiva and the cornea in the form of edema, which, during subsequent femtosecond vision correction, can affect the refractive result and worsen visual acuity in the postoperative period.Results. The performed treatment let significantly increase uncorrected visual acuity, achieve a correct and stable eye position, which became the basis for changing the vision nature from monocular to binocular.Conclusion. Thus, modern laser and surgical technologies in combination with an adequate anesthesia allow rehabilitating patients as much as possible in a short time, even with severe forms of cerebral palsy, and significantly improving the quality of life.

Microperimetry in Children’s Practice

Child health is a global health priority. The program “Elimination of Eliminable Blindness in the World of Vision-2020” gives the fourth place to the problems of pediatric ophthalmopathology and creates targeted programs for their elimination. The introduction of modern equipment in the clinical practice of pediatric ophthalmologists has expanded the boundaries of traditional diagnostics. Microperimetry is an innovative, quantitative, non-invasive diagnostic study aimed at assessing the functional ability of the retina in strict correlation with morphology. Along with the assessment of light sensitivity, the device allows you to measure fixation parameters, which serves as a reliable criterion for its stability and indirectly reflects the functional organization of central vision. In this regard, the literature review presents the results of domestic and foreign researchers who used microperimetric testing as the main or additional research method for diseases of various etiologies, such as hereditary retinal diseases, amblyopia, and nystagmus. Most authors have demonstrated the high diagnostic significance of this method, the ability to assess photosensitivity of the retina, the detection of fixation disorders, such as eccentricity and instability, even in pediatric patients. The use of microperimetry as a new method of treatment for these diseases has also been shown. Visual rehabilitation based on biofeedback provided by this device has shown high efficiency in diseases of the central region. More research remains to be done to determine future potential applications of this technology, in particular in pediatric practice, and to develop the potential of microperimetry as a tool for the visual rehabilitation of patients.

Study of intraoperative challenges and early surgical outcome of phacoemulsification through temporal incision in patients with senile cataract at rural tertiary care hospital.

Introduction: Temporal phacoemulsification (Phaco) gives a better surgical outcome in senile cataracts as it nullifies, “against the rule astigmatism” which is common in elderly patients. It is a well-established, effective and safe technique. We conducted this study to verify the surgical outcome of temporal phacoemulsification at a rural tertiary care hospital (RTCH). Aims and Objectives: To study the intra operative and early post-operative complications, post-operative UCVA (Uncorrected Visual Acuity) and BCVA (Best Corrected Visual Acuity) in patients with senile cataract who underwent temporal phacoemulsification.Materials and Methods: In this prospective, hospital-based observational study, we studied intraoperative and postoperative data of 42 patients, above 50 years of age, who underwent temporal phacoemulsification for senile cataracts from August 2019 to May 2020 after obtaining institutional ethical committee approval and written informed consent from all patients. All patients underwent minimum 6 weeks of postoperative follow-up. Results: Out of 42 patients, 57.14% were females and the most common age group was 61-70 years. Intraoperative bleeding was seen in 19.04% of patients and the post-operative mild corneal stromal haze and mild uveitis were seen in 4.76% and 7.14% of patients on a postoperative day 1(POD 1) respectively. Reduction in preoperative “against the rule astigmatism” was seen in 68% of patients. All patients had a UCVA of &gt;6/12 and a BCVA of 6/6 at the last follow-up. Conclusion: Temporal phacoemulsification gives a good UCVA and faster visual rehabilitation in patients with senile cataracts.

Интрастромальная кератопластика с имплантацией роговичных сегментов как самостоятельный метод зрительной реабилитации у пациентов с кератоконусом

Purpose. To assess the possibility of using intrastromal keratoplasty with intracorneal ring segments implantation as an independent technique to achieve visual rehabilitation in patients with keratoconus of the stages I and II. Material and methods. There were examined and operated 14 eyes (10 patients) with keratoconus of the stages I and II (classification by Izmailova SB, 2014). Patients were divided into two groups depending on the keratoconus stage. All patients underwent intrastromal keratoplasty with intracorneal ring segments implantation using the femtosecond technology. The on average follow-up was 5.7 months. Results. In the first group: the average UCVA value increased with from 0.31±0.21 to 0.81±0.31 (p&lt;0.05); the BCVA increased from 0.89±0.08 to 0.94±0.10 (p&gt;0.05); the spherical component of refraction decreased from 0.96±1.25 to 0.08±0.20 (p&lt;0.05); the cylindrical component of refraction decreased from 4.25±1.73 to 0.50±1.22 (p&lt;0.05). In the second group: UCVA increased from 0.51±0.40 to 0.61±0.28 (p&lt;0.05); the BCVA increased from 0.70±0.17 to 0.81±0.26 (p&gt;0.05); the spherical component of refraction decreased from 4.88±2,61±0.53±0.63 (p&lt;0.05); the cylindrical component of refraction decreased from 2.69±1.65 to 1.41±1.02 (p&lt;0.05). Conclusion. 1. After implantation of intracorneal ring segments, both in patients with I and in patients with the II stage of keratoconus, there was an increase in the UCVA and BCVA, as well as a significant reduction in maximal keratometry and coma, which provides the improving of the quality of vision. 2. In all cases the UCVA and BCVA that were obtained after the treatment reached a sufficiently high level to ensure the possibility of performing their professional functions, without resorting to additional surgical treatment techniques. That characterizes this method as an independent and sufficient to achieve high visual acuity in patients with I and II stages of keratoconus. Key words: keratoconus, corneal intrastromal segments, femtosecond laser, visual rehabilitation.

About the Possible Mechanisms of the Influence of Optical Intraocular Implants on the Characteristics of Neurosensory Rehabilitation and Adaptation in Patients with Pseudophakia. Literature Review

This literature review analyzed the possible mechanisms of the influence of the design features and optical characteristics of monofocal intraocular lenses (IOLs) on the characteristics of sensorineural adaptation and visual rehabilitation in patients after cataract phacoemulsification. Bibliographic research of scientific publications was carried out in the following databases: Medline, Pubmed, Cochrane, eLibrary. Languages of publications: Russian and English. The literature review reflects research data on the physicochemical properties, optical surface and color of the IOL filter, spatial contrast sensitivity and wavefront aberrations. Analysis of domestic and foreign literature has demonstrated the absence of a systematic approach to the study of sensorineural adaptation in patients after implantation of monofocal IOLs, which would make it possible to reasonably develop requirements for qualitative and constructive characteristics in the production of intraocular lenses to improve the quantitative and qualitative indicators of their visual functions in order to reduce the terms of rehabilitation and improvement of quality of life indicators in patients with pseudophakia. At the same time, there is an obvious need for research on the influence of the design and quality characteristics of optical intraocular implants on the subjective “quality of vision” of patients with pseudophakia, which is, ultimately, the target indicator of cataract surgery at the present stage. Also, the key mechanisms of neurosensory rehabilitation and adaptation of patients who underwent cataract surgery need to be studied and clarified in order to develop recommendations for the production of intraocular implants.

To improve the classification of eye burns

Currently, the system of the Ministry of Health of Russia has adopted the classification of eye burns, proposed in 1973 by N.A.Puchkovskaya and V.M.Nepomashy. The appearance in recent years of the concept of limbal stem cells of the corneal epithelium and its application in clinical practice has significantly expanded the possibilities of diagnostics, treatment, and visual rehabilitation of patients with eye burns. In 1997, M.D.Wagoner proposed a classification of eye burns, in which the gradation of burn severity is determined by the degree of damage to limbal stem cells. Taking into account this modern approach, a new classification of eye burns is proposed.

Decellularized porcine conjunctiva as an alternative substrate for tissue-engineered epithelialized conjunctiva

PurposeThe long-term success of visual rehabilitation in patients with severe conjunctival scarring is reliant on the reconstruction of the conjunctiva with a suitable substitute. The purpose of this study is the development and investigation of a re-epithelialized conjunctival substitute based on porcine decellularized conjunctiva (PDC). MethodsPDC was re-epithelialized either with pre-expanded human conjunctival epithelial cells (PDC + HCEC) or with a human conjunctival explant placed directly on PDC (PDC + HCEx). Histology and immunohistochemistry were performed to evaluate epithelial thickness, proliferation (Ki67), apoptosis (Caspase 3), goblet cells (MUC5AC), and progenitor cells (CK15, ΔNp63, ABCG2). The superior construct (PDC + HCEx) was transplanted into a conjunctival defect of a rabbit (n = 6). Lissamine green staining verified the epithelialization in vivo. Orbital tissue was exenterated on day 10 and processed for histological and immunohistochemical analysis to examine the engrafted PDC + HCEx. A human-specific antibody was used to detect the transplanted cells. ResultsFrom day-14 in vitro onward, a significantly thicker epithelium and greater number of cells expressing Ki67, CK15, ΔNp63, and ABCG2 were noted for PDC + HCEx versus PDC + HCEC. MUC5AC-positive cells were found only in PDC + HCEx. The PDC + HCEx-grafted rabbit conjunctivas were lissamine-negative during the evaluation period, indicating epithelial integrity. Engrafted PDC + HCEx showed preserved progenitor cell properties and an increased number of goblet cells comparable to those of native conjunctiva. ConclusionPlacing and culturing a human conjunctival explant directly on PDC (PDC + HCEx) enables the generation of a stable, stratified, goblet cell-rich construct that could provide a promising alternative conjunctival substitute for patients with extensive conjunctival stem and goblet cell loss.

О совершенствовании классификации ожогов глаз

Currently, the classification of eye burns, proposed in 1973 by N.A. Puchkovskaya and V.M. Nepomyashaya. Over the last years, knowledges about the pathophysiology of the burn process has been significantly expanded in the world of ophthalmology. The emergence, in particular, of the concept of limbal stem cells of the corneal epithelium and its application in clinical practice has significantly expanded the possibilities for the diagnosis, treatment, and visual rehabilitation of patients with eye burns. In 1997, M.D. Wagoner proposed a classification of eye burns, in which the grade of burn severity is determined by the degree of damage to the limbal stem cells. Given this approach, the authors conducted a comparative analysis of the classifications of eye burns (of different years) in our country and those that have appeared in the West in recent years. In this regard, the attention of ophthalmologists is offered a new classification of eye burns.

Combined Phacoemulsification and Pars Plana Vitrectomy for the Treatment of Cataract in Patients With Noninfectious Uveitis.

This work evaluates the role of combined phacoemulsification and vitrectomy surgery in the management of cataract associated with noninfectious uveitis. A retrospective chart review was conducted of all patients aged 7 years or older who underwent a combined surgical approach from 2005 to 2018. Eighty-five eyes of 67 patients were included in the study; 10.7% of eyes had a best-corrected visual acuity (BCVA) of 20/40 or better at time of surgery. At 1-year follow-up, 63.4% of eyes had a BCVA 20/40 or better and 7.6% had a BCVA of 20/200 or worse. There was an overall decrease in cystoid macular edema after surgery compared with preoperatively (47.6% vs 34.5% presurgery and postsurgery, respectively). Complete inflammatory disease remission off immunomodulatory therapy and systemic steroids was achieved in 21.1% of patients. A combined surgical approach is effective in visual rehabilitation in patients with uveitic cataracts and may promote inflammatory disease remission specifically in intermediate uveitis.