Purpose. To evaluate the main reasons, clinical effectiveness, and safety of exclusively refractive intraocular lens (IOL) exchange in a series of clinical cases involving patients after uncomplicated phacoemulsification. Material and methods. Fourteen patients (4 men and 10 women) aged 41 to 61 years with previously correctly implanted IOLs following uncomplicated phacoemulsification for cataracts (12 eyes) or refractive lens replacement (2 eyes), with no postoperative complications or associated intraocular pathologies, underwent IOL exchange exclusively for refractive purposes 2 to 9 months after the initial procedure. Results. The most common reason for refractive IOL exchange was uncompensated or incompletely compensated corneal astigmatism with oblique or againstthe-rule axes. The second most common reason was the patient’s desire to eliminate spectacle correction for intermediate and near distances. The third and fourth reasons were prominent positive dysphotopsia with blurred vision and significant residual ametropia following primary IOL implantation. All treated patients were satisfied with the clinical outcomes, and the postoperative period was uneventful. By postoperative days 1–3, statistically significant improvements in uncorrected visual acuity from 0.28 (0.20) to 0.81 (0.34) and best-corrected visual acuity from 0.73 (0.10) to 0.90 (0.19) were recorded. Postoperative visometry on days 1–3 demonstrated statistically significant (p<0.05) corneal astigmatism correction from 1.5 (0.75) D to 0.25 (0.2) D. Analysis of spherical equivalent changes one month after IOL exchange revealed significant (p=0.05) reduction from –0.5 (1.25) to –0.2 (0.5) D in all patients. Conclusion. Refractive IOL exchange can be a procedure of choice for patients dissatisfied with the functional outcomes of primary uncomplicated IOL implantation and seeking improved visual quality, including through the use of modern IOL models. Advanced surgical equipment and high-level surgeon expertise enable refractive IOL exchange to be considered an alternative method for correcting ametropia after lens surgery. Keywords: pseudophakia, intraocular lens (IOL) exchange, refractive IOL exchange, IOL reimplantation, astigmatism
Relevance. Microvascular status can inform about the onset, progression and prognosis of visual organ damage. In a number of works, the study of microcirculation is presented as fundamental, auxiliary or with a lack of standardization of the procedure. Therefore, the diagnostic potential of microcirculatory changes is not fully disclosed, especially as predictors of eye diseases, and there are few data on the study of microcirculatory changes in blepharitis. Purpose. To determine the role of microcirculatory changes in the pathogenesis of chronic blepharitis. Material and methods. The study included 16 patients (32 eyes) with chronic anterior blepharitis (10 women and 6 men, mean age 61.1±6.3 years), which made up group 1; 17 patients (34 eyes) with chronic posterior blepharitis (12 women and 5 men, mean age 62.4±5.8 years) — group 2; 30 patients (60 eyes) with chronic mixed blepharitis (19 women and 11 men, mean age 65.3±4.1 years) — group 3. The 4th group included 18 healthy individuals (36 eyes), of appropriate age (61 to 70 years) and sex. All subjects underwent ophthalmologic examination and measurement of eyelid skin microcirculation perfusion according to the standard technique using the device «LAZMA MC-1» (SPE «LAZMA» Ltd, Russia). Results. Microcirculation disorders were revealed in chronic blepharitis in comparison with the indicators of healthy volunteers, but especially in its mixed form. In the 1st and 2nd groups (in comparison with the 4th group) the ischemic type of blood circulation disturbance of the eyelid skin with oppression of active mechanisms of regulatory systems of blood flow was established. Insufficiency of active neurogenic oscillations of lymph flow was registered in group 1, and in group 2 — their protective activation (in comparison with group 4). Significant suppression of active and passive mechanisms of MC control was registered in group 3 in comparison with groups 1 and 2; a moderate congestive-ischemic type of eyelid skin blood circulation disorder was established in comparison with group 4. Protective activation of lymph flow was noted in group 3 in comparison with group 1, and its insufficiency against the background of average perfusion increase — with group 2. This is caused by the weakening of microvascular tone due to the increase in volume and complication of lymph outflow process. The increase of the shunt index in the 1st, 2nd and 3rd groups indicated tissue ischemization. Conclusion. Different degree of microcirculation disturbance is revealed in patients with chronic blepharitis. The exact analysis of eyelid skin perfusion value should be carried out taking into account both basic parameters and data of amplitude-frequency spectrum. Keywords: microcirculation, blood flow, lymph flow, blepharitis, laser Doppler flowmetry
Purpose. To evaluate the feasibility of fluorescence imaging of the photosensitizer chlorin e6 in the uveal tract during photodynamic therapy in an experiment. Material and methods. The experiment was performed on 20 rabbits (40 eyes). After intravenous administration of chlorin e6 (2.5 mg/kg), dynamic fluorescence monitoring (excitation 405±5 nm, detection 660±10 nm) was performed at 5–10 min intervals. The main criterion for determining the start time of transscleral photodynamic therapy (TS-PDT) was the appearance of fluorescence in the iris stroma. The time to reach the criterion (Tcrit) was recorded. TS-PDT (660 nm laser) was then performed using 5 mm (0.17 W) and 10 mm (0.6 W) probes. Histological analysis on day 14 included a semi-quantitative assessment of choroidal vessel thrombosis (0–3 points). Statistical analysis: Pearson correlation, ROC analysis, Fisher’s exact test. Results. The criterion was achieved in all animals. Tcrit was 27.6±9.8 min (median 26.0 min; range 15–55 min). In 75% of animals, Tcrit was within 20–35 min. Severe thrombosis (≥2 points) was detected in 85% of cases. A moderate negative correlation was found between Tcrit and the thrombosis score (r= –0.49; p=0.029). ROC analysis showed that Tcrit ≤31.5 min predicts the development of severe thrombosis with a sensitivity of 88.2% and specificity of 66.7% (AUC=0.77; 95% CI 0.57–0.97; p=0.031). The method provided high-contrast visualization of the iris microvessels. Conclusion. In vivo fluorescence imaging of chlorin e6 accumulation in the iris allows the optimal timing of PDT initiation to be objectified, as confirmed by correlation with the severity of choroidal thrombosis. The findings justify further study of this approach to improve the efficacy and safety of PDT in ophthalmic oncology. Keywords: fluorescence diagnostics, photodynamic therapy, chlorin e6, uveal melanoma, transscleral photodynamic therapy, ocular oncology
Purpose. To evaluate the hypotensive effect of simultaneous combined laser treatment of ocular hypertension and primary openangle glaucoma (POAG) associated with pigment dispersion syndrome (PDS). Material and methods. A prospective analysis of the hypotensive effect was performed in 47 patients (47 eyes) with ocular hypertension against the background of SD, initial and developed stages of POAG. The patients were divided into two groups. Group 1 (the study group) included 22 patients (22 eyes) who underwent simultaneous combined laser treatment. Group 2 (the control group) included 25 patients (25 eyes) who underwent only SLT. The differences between the groups based on gender and age of the patients were statistically insignificant (p>0.05). The follow-up period was 12 months. The main criteria for evaluating the treatment outcomes were the success and failure rates based on the target IOP values. Results. The absolute success in IOP compensat after combined laser technology was 98% after 3 months, and the absolute success in IOP compensation remained high at 95% after 6 months. The absolute success in IOP compensation after SLT was not observed after 3 and 6 months, and only relative success was achieved after 3 months in 100% of cases and after 6 months in 91% of cases. 12 months after one-stage combined laser technology, the rate of absolute success in compensation of IOP was 89%, only in 11% of cases, SRT or topical hypotensive therapy was required. In patients of the control group, absolute success in compensation of IOP was not traced, only relative success was observed in 21% of cases, in 79% of this group additional treatment was required. Conclusion. The proposed technology of simultaneous combined laser treatment of ocular hypertension and PG associated with SPD showed a pronounced and stable hypotensive effect throughout the entire follow-up period. Keywords: pigment dispersion syndrome, primary open-angle glaucoma, selective laser trabeculoplasty, laser surgery
Purpose. To present the results of complaency analysis after IOL implantation in Custom Match technique including results from VF-14 questionnaire. Material and methods. Patients were treated in the «EyeDoctor» ophthalmology clinic, Almaty, Kazakhstan. Authors analyzed not only standard results, but also subjective results by VF-14 questionnaire. Results. Results of surgical treatment with Custom Match technique were high enough with criteria of visual acuity, contrast sensitivity and high level of subjective satisfaction. Conclusion. Custom Match not only provides consistent high visual acuity at various distances, but also high-quality indicators, including high subjective patient satisfaction, especially in the middle age group of 40–55 years. Keywords: Custom Match technique, EDOF technique, ENLIGHTEN optics, VF-14 Questionnaire, defocus curve, contrast sensitivity
Purpose. Creation of a new method of epicanthoplasty for blepharophimosis syndrome, which makes it possible to fill the skin deficit in the medial angle area, evaluation of its effectiveness, cosmetic results, as well as the development of indications for its use. Material and methods. A prospective study of a group of patients (n=12) with blepharophimosis syndrome. At the stage of selecting patients for the study group, the type and severity of the epicanthic fold were evaluated according to the author’s classification. According to the results of the selection, the study group included 8 patients with the third degree of severity of epicanthus inversus and 4 patients with a type of epicanthus close in shape to the direct one. All patients underwent epicantoplasty with autotransplantation of the skin flap. Examination of patients and evaluation of treatment results were carried out on the day of the patient’s discharge from the hospital (5th day after surgery), 1 and 6 months after surgery. The evaluation of the results of the operation included an objective examination for the complete elimination of epicanthus, measurement of the length of the eye slit before and after surgery, determination of the visibility of the postoperative scar by cosmetometry, as well as assessment of patient satisfaction with the results obtained by means of a questionnaire. Additionally, for comparison, 14 postoperative photographs of patients with blepharophimosis syndrome operated with flap epicantoplasty techniques were analyzed by cosmetometry. Results. Epicanthus was completely eliminated in all 12 (100%) patients. The length of the palpebral fissure before surgery was 18.50±1.93, after surgery — 24.17±1.80 (p<0.001). An objective assessment of the condition of postoperative scars by cosmetometry also showed a statistical difference between the indicators of the main and control groups (p<0.001). According to the results of the questionnaire after the operation, all respondents rated their satisfaction with their appearance by 4 and 5 points, which corresponds to the indicators «good result» and «excellent result», respectively. Conclusion. The presented method of epicanthoplasty with autotransplantation of the skin flap is an affordable and effective method of treating epicanthus in patients with blepharophimosis syndrome. The technique does not require precise calculations and positioning of skin flaps, which are necessary when performing existing flap techniques of epicanthoplasty. At the same time, it allows you to get a good cosmetic result, reduce scarring of the skin in the area of surgery and minimize the risk of repeated operations associated with insufficient or asymmetric correction. Keywords: blepharophimosis syndrome, palpebral syndrome, epicanthus, epicanthus inversus, epicanthoplasty
Purpose. This work analyzes current literature data on capsular contraction syndrome (published from 2009 to 2024). Capsular contraction syndrome is a postoperative complication that occurs after phacoemulsification cataract surgery, characterized by shrinkage of the lens capsular bag, decentration, deformation, and tilt of the intraocular lens (IOL), and dislocation of the IOL complex, which adversely affects long-term surgical outcomes. Material and methods. A search for studies on the topic was conducted for the period from 2009 to 2024. The search was performed using the electronic databases Google Scholar (https://scholar.google.ru/), PubMed (https://www.ncbi.nlm.nih.gov/pubmed/), eLIBRARY.RU (https://www.elibrary.ru/), and foreign and domestic journals of ophthalmology. Results. The prevalence of CCS varies from 10 to 58.5%, correlating with the diameter of the anterior capsulorhexis (less than 5 mm), the type of IOL (lenses made of hydrophilic acrylic carry a higher risk), comorbidities (high myopia, pseudoexfoliation syndrome (PEX), uveitis, diabetes), and the activity of TGF-β2, which stimulates fibrosis. Prevention includes polishing the anterior capsule, performing a wide capsulorhexis (over 6 mm), using hydrophobic IOLs with a stepped-haptic design, and intracapsular rings. Treatment is based on YAG-laser capsulotomy (effective in early stages) and surgical methods for advanced and severe forms (IOL repositioning/exchange). Conclusion. CCS remains a significant complication, requiring a personalized approach for patients with risk factors. Future prospects are associated with the development of new surgical techniques, IOL designs, optimization of laser technologies considering the anatomical features of the capsular bag. The implementation of dynamic monitoring protocols for patients with pseudophakia and concomitant high myopia and PEX will help reduce the risks of IOL dislocation in the long-term postoperative period. Keywords: capsular contraction syndrome, anterior capsular phimosis, IOL dislocation, fibrosis of the lens capsular bag, high myopia, pseudoexfoliation syndrome
Relevance. Retinal vein occlusions (RVO) account for about 60% of all acute vascular pathologies of the organ of vision and are in second place after diabetic retinopathy in terms of severity of retinal damage. The prevalence of RVO is 2.14 per 1000 people aged 40 years and older. Among people over 49 years of age, thrombosis was detected in 1.6% of those examined (60 years old — 0.7%; 60–69 years old — 2.1%; 70 years and over — 4.6%). The growing incidence of central retinal vein occlusion (CRVO) and its branches among people of working age turns this group of diseases into a serious medical and social problem. Currently, the priority treatment method for macular edema (ME) resulting from CRVO is considered to be intravitreal administration of anti-VEGF inhibitors and steroids. Laser coagulation of thrombotic veins is an important step in the system of their complex treatment. A common disadvantage of most of the applied treatment methods is the unidirectional impact on one of several pathogenesis factors, which determines their lack of effectiveness. Purpose. To compare the effectiveness of combined treatment methods for post-occlusion ME. Material and methods. This study included 24 patients with various stages of retinal vein thrombosis complicated by ME. The duration of the disease after diagnosis varied from 1 to 3 months. Among the patients there were 14 men and 10 women. The age of the patients ranged from 48 to 72 years and averaged 50.2±0.05 years. In 3 patients, thrombosis was observed and they also suffer from diabetes mellitus, in 18 — also suffer from hypertension. Results. The effectiveness of the treatment was evaluated before and after treatment based on standard ophthalmological examinations, as well as highresolution optical coherence tomography (OCT) (RTvueXR 100 AVANTI OPTOVUE), including in angio-mode, computer perimetry (CP) using the «Macula program» on the visual field analyzer Peritest (APZ PERITEST 30/50/100), as well as total aberrometry using the optical media analyzer OPD Scan III. Conclusion. Combined treatment of post-occlusive ME using intravitreal administration of anti-VEGF inhibitors, sub-tenon administration of a prolonged steroids, laser coagulation of the retina is effective and pathogenetically oriented in occlusive processes in the retinal vein system. Keywords: macular edema, retinal vein thrombosis, optical coherence tomography, anti-VEGF inhibitors, laser coagulation of the r etina
Purpose. To determine the frequency of cases of insufficient therapeutic effect of corneal collagen crosslinking (CXL). Material and methods. 50 eyes with progressive keratoconus (KC) of 1–3 stages (50 patients). The average age of patients is 27 years; there are 39 men and 11 women. Morphometric parameters of the cornea were assessed using a Pentacam scanning projection keratotopograph (Oculus, Germany). The Belin/Ambrosio Enhanced Ectasia Display (BAD) corneal ectasia monitoring program and Topometric/KC-Staging were used. The studies were performed at baseline and one year after the CXL. 3 groups of patients were formed: 1st group with KC of 1st stage (12 eyes); 2nd group with KC of 2nd stage (25 eyes); 3rd group with KC of 3rd stage (13 eyes). The study design consisted of a comparative analysis of indicators at baseline and after 12 months of observation. Criteria for insufficient effectiveness of CXL: an increase in Kmax by 1 diopter or more by the end of the observation period, no increase in uncorrected visual acuity and best-corrected visual acuity (BCVA), corneal thickness and a number of keratotopographic KC indices (ISV, IVA, KI, CKI, IHA, IHD, Rmin). Results. In 8 patients, a year later, the average keratometry values increased from 62.8 diopters to 65.5 diopters (16%), what indicated further progression of KC (2 patients with 2nd stage of KC, 6 people with 3rd stage of KC). In 6 of 8 of these patients, the initial, preoperative Kmax values exceeded 57 diopters; their BCVA did not change with an increase in Kmax. In 2 patients with 2nd stage of KC, a loss of 2 and 3 lines was noted (from 0.63 to 0.32 and from 0.6 to 0.4, respectively). The average age of the 8 patients with unsuccessful CXL was 27 years old, all of them were male. Conclusion. Further progression of KC after 1 year of observatuin was noted in 16% of patients with 2nd and 3rd stages of KC after performing CXL. Keywords: keratoconus, crosslinking, cornea
Relevance. Many methods of in vivo diagnosis of limbal deficiency syndrome (LSCD) have been described, but the analysis of corneal fibrovascular pannuses taken during surgery provides valuable data at the histological level regarding the understanding of the pathogenesis of LCSD, the identification of patterns of the disease course, and the outcome of surgical treatment. Purpose. To describe the histological changes in fibrovascular pannuses of the cornea in patients with LSCD. Material and methods. This study included 39 surgical biopsies of the corneas of patients with keratitis and corneal burn injuries during glueless simple limbal epithelial transplantation (G-SLET). The material was stained with hematoxylin-eosin (H-E) and the type of LSCD (partial/ complete), stage, etiology of the disease, and the duration of the damage were examined based on the condition of the epithelium, the degree of fibrosis, vascularization, the nature of the inflammation, and the presence/ absence of goblet cells (GCs) and the Bowman’s membrane (BM). Results. The presence of symblepharon and prior biological corneal coating were observed in 71.4% of cases. Moderate epithelial hyperplasia was present in 71.4% of cases, while significant hyperplasia was noted in 28.6%. Previous arch reconstruction was documented in 57.1% of cases. Signs of active fibrosis in LSCD of alkaline etiology were observed in 100% of cases (p<0.05). No instances of giant cell reaction or stromal calcification were detected. GCs presence on the cornea was observed in only 14.3% of cases and the absence of BM was found in more than half of the samples (56.3%). Conclusion. It was determined that the type of LSCD does not influence the nature of inflammatory infiltration. In cases where the burn duration is less than 24 months prior to surgical intervention, histological images of the corneal pannus predominantly exhibit moderate to abundant cellular inflammation. The etiological factor has a minimal impact to the corneal angiogenesis. The primary factors contributing to the adverse outcomes of G-SLET include alkaline and acid burns, previous keratoplasty, symblepharon of the eyelids, and a burn duration of less than 24 months. Keywords: limbal stem cell deficiency, fibrovascular pannus, goblet cells, cultivation of limbal epithelial stem cells, epithelial markers, immunocytochemical examination, histological examination
Relevance. This study is dedicated to assessing the safety and efficacy of cold plasma (coblation) endonasal endoscopic dacryocystorhinostomy (CP-EDCR) in patients receiving long-term anticoagulant or antiplatelet therapy. Purpose. To evaluate the clinical efficacy, as well as the frequency of hemorrhagic and thromboembolic complications during cold plasma endoscopic dacryocystorinostomy in patients receiving anticoagulant and/or antiplatelet therapy. Material and methods. A study included 43 patients (mean age 66.4±6.1 years) with chronic dacryocystitis who were continuously taking warfarin, direct oral anticoagulants (rivaroxaban, apixaban), or antiplatelet agents. The perioperative management strategy for antithrombotic therapy was determined individually by a multidisciplinary team (ophthalmologist/cardiologist) based on the level of thromboembolic risk. Results. The use of CP-EDCR resulted in intraoperative bleeding requiring additional hemostasis in 7.0% of cases (3 patients), and delayed postoperative epistaxis in 4.65% (2 patients). All hemorrhagic complications occurred in the subgroup with a high thromboembolic risk, where bridging therapy was applied. Thromboembolic complications during the 30-day follow-up period were absent (0%). Anatomical patency of the ostium was maintained after 3 months in 90.7% of patients. Conclusion. Cold plasma EDCR combined with personalized perioperative anticoagulant management is a highly effective and safe method for treating chronic dacryocystitis in patients taking antithrombotic drugs. The technique provides reliable hemostasis and minimizes both hemorrhagic and thromboembolic risks, making it the preferred choice for this patient category. Keywords: chronic dacryocystitis, cold-plasma coblation, endoscopic endonasal dacryocystorhinostomy, anticoagulant therapy, bleeding risk
Purpose. To study the cellular and tissue response to intrastromal fixation of a new keratoprosthesis support plate in the human cadaveric cornea in comparison with the Fedorov — Zuev keratoprosthesis support plate using the organotypic cultivation method. Material and methods. In this work, a series of experimental and morphological studies was conducted, including an in vitro experiment that involved immunohistochemical and histological examinations, as well as electron scanning microscopy, in which two experimental groups were compared: Group 1 (n=5) — corneas with an implanted intrastromal model of a supporting plate made of a biocompatible spatially cross-linked acrylic polymer based on oligomers and monomers of the methacrylic series with a uv-filter; Group 2 (n=5) — corneas with an implanted supporting plate of the Fedorov — Zuev keratoprosthesis. Results. In the course of a series of experimental studies, the bioinertness of the studied intrastromal supporting plate made of hydrophobic acrylic was confirmed, and the material’s biocompatibility and high integrative capabilities were proven, in contrast to the support plate of the Fedorov — Zuev keratoprosthesis. Conclusion. The development of a new synthetic support plate model with an optimal size and design is one of the current areas of keratoprosthetics. A pilot study demonstrated the effectiveness, biocompatibility and safety of the developed intrastromal keratoprosthesis support plate compared to the existing Fedorov — Zuev keratoprosthesis support plate. Keywords: keratoprosthesis, organotypic culture, scanning electron microscopy, immunohistochemistry, light microscopy
Purpose. Analysis of statistical indicators on the state of morbidity, mortality, diagnosis and treatment of eyelid skin cancer (ESC) and eyelid skin melanoma (ESM) in the Republic of Belarus. Material and methods. Information from the Belarusian Cancer Registry on all registered cases of ESC and ESM in the population of the Republic of Belarus in 1994– 2023. Results. The incidence rates of women with ESC and ESM are statistically significantly higher (p<0.05) than men, and the incidence of urban residents is lower than rural ones. ESC and ESM are extremely rarely registered at a young age: 81.2% of ESC and 78.3% of ESM are at the age of 60 years and older. The average age of patients with ESC is 68.9 years, with ESM — 71.0 years. In stages I-II: The ESC is 93.0%, the ESM is 75.7%. Most often, ESC is diagnosed with T1 — 76.7% and T2 — 14.5%. For ESM, the prevalence of T1 and T4 was 30.0% and 32.2%, respectively. The detection rate of ESM with T3 and T4 is higher than ESC (p<0.05). Over a 35-year period, the one-year mortality rate in patients with ESC ranged from 0 to 7.1% (in on average — 2.4%), with ESM — from 0 to 33.3% (on average — 7.6%). The average standardized mortality rate of patients from ESM in all population groups was 0.001 per 100,000 population, among patients with ESC — 0.03 among the whole and male population, 0.02 among women and urban, 0.04 per 100,000 population among rural residents. When comparing 5-year mortality rates from ESC (for 1994–1998 and 2019–2023), a decrease was noted in all population groups, and from ESM, the indicator stabilized at the level of 0.01–0.02 per 100,000 population. At the end of 2023, 364 patients with a diagnosis of ESC and ESM were registered. Conclusion. The analysis of statistical indicators revealed that the incidence of ESC and ESM in women is statistically significantly higher (p<0.05) than in men, and urban residents are slightly lower than rural ones. The most common malignant tumors of the eyelid skin are diagnosed with a prevalence of T1–2N0M0. The detection rate of ESM with a prevalence of T3–4N0M0 is statistically significantly higher than ESC (p<0.05). Over a 30-year period, one–year mortality with ESC averaged 2.4%, among patients with ESM — 7.6%. Keywords: eyelid skin cancer, eyelid skin melanoma, morbidity, mortality, standardized indicators
Relevance. This study presents the main anatomical and refractive characteristics of the turkey cornea as a potential xenograft for keratoplasty. Currently, more than 12 million people are on the waiting list for keratoplasty due to a shortage of cadaveric donor corneas. Recent scientific advances demonstrate the feasibility of developing a xenograft to address this significant deficit. Purpose. To evaluate in a series of ex vivo experiments, the main anatomical, topographic, morphological and refractive characteristics of the turkey cornea (Latin: Meleagris gallopavo) as a potential xenomaterial for keratoplasty. Material and methods. Enucleated turkey eyeballs (n=28) and corneoscleral discs (n=28) were used. The research protocol included: optical coherence tomography (OCT), ultrasound biomicroscopy (UBM), measurement of the axial length, corneal diameter, and anterior chamber depth, assessment of endothelial cell density (ECD), autorefractometry, histological examination, and scanning electron microscopy (SEM). Results. The studies established that the axial length of the turkey eye is 19.2±1.07 mm, corneal thickness is 510±26.5 μm, corneal diameter is 10.2±0.2 mm, and anterior chamber depth is 3.6±0.8 mm. The endothelial cell density was 3749±388 cells/mm², and the corneal refractive power was 55.4±2.63 D. The presence of Bowman’s membrane and densely packed collagen fibers was verified. Conclusion. The main anatomical, topographic, and refractive characteristics of turkey corneas — specifically thickness, diameter, refractive power, and histological structure — position the turkey cornea as a promising alternative to scarce human donor material. This warrants further investigation into its application as a xenograft in reconstructive corneal surgery. Keywords: cornea, keratoplasty, xenotransplantation, turkey, xenograft
Purpose. To evaluate a method for assessment postoperative displacement of the fovea using optical coherence tomography angiography (OCTA) and evaluate its application in clinical practice. Material and methods. Patients with epiretinal fibrosis who underwent vitrectomy with or without epiretinal membrane removal and patients with unilateral retinal vein occlusion (fellow healthy eyes) were included in this study. Position of the fovea was noted in relation to the static structures of the choroid on structural en face OCTA projections pre- and postoperatively. The distance and direction of displacement of the fovea were measured after surgical treatment. Results. In total, 59 patients were included in this study. Twenty-nine eyes (29 patients, mean age 68.0±8.0 years) have received vitrectomy including 15 eyes with peeling of the inner limiting membrane (ILM) and 14 eyes without ILM peeling. Control group included 30 eyes (30 patients, mean age 64.0±12.0 years). Among eyes, which received vitrectomy, foveal displacement achieved 263.7±154.0 µm versus 7.2±3.7 µm in controls (p<0.05). Fovea was moved nasally in 23 eyes (79%) and to the temporal side in six eyes (21%). Upward displacement of the fovea was observed in 14 eyes (48%) and downwards displacement in 15 eyes (52%). Conclusion. Structural OCTA en face imaging allows assessment of foveal displacement after vitreoretinal surgery. The proposed method for detecting postoperative foveal displacement can be implementation in clinical practice. Keywords: epiretinal fibrosis, epiretinal membrane, foveal displacement, optical coherence tomography angiography, vitrectomy
Purpose. To compare the effects of loteprednol etabonate 0.5% and dexamethasone 0.1% on intraocular pressure, pain intensity, and the severity of the postoperative inflammatory reaction in patients undergoing cataract phacoemulsification. Material and methods. This prospective comparative study included 51 patients who underwent elective phacoemulsification of cataracts with background of glaucoma or after a combined operation of non-penetrating deep sclerectomy (NPDS) with implantation of antiglaucoma drainage Xenoplast and phacoemulsification of cataracts. Patients were divided into two groups based on the prescribed anti-inflammatory drug: 29 patients (56.9%) received dexamethasone 0.1%, and 22 patients (43.1%) received loteprednol etabonate 0.5%. Both groups were prescribed topical antiinflammatory treatment from the first postoperative day, for a duration of 4 weeks. To minimize side effects, dexamethasone 0.1% and loteprednol acetate 0.5% were prescribed in a decreasing regime: with a gradual reduction in the frequency of instillations from 4 times daily in the first week to 1 time daily in the fourth week and complete discontinuation by the fifth week. Intraocular pressure (IOP) was measured by three methods — non-contact tonometry with corneal-compensated pressure (IOPcc), Goldmann tonometry (IOPg) using a non-contact pneumotonometer Reichert, USA and an Icare tonometer — before surgery, as well as on the first day, 1 week, 2 weeks, and 1 month after the intervention. Pain syndrome and the degree of postoperative inflammatory reaction were simultaneously assessed. Results. Both drugs provided comparable control of postoperative inflammation and pain syndrome at all followup points without statistically significant intergroup differences. At the same time, the use of dexamethasone was associated with a significant increase in IOP starting from the first postoperative week by all three tonometry methods. The difference in IOPcc between the groups was 3.4 mmHg after 1 week (p=0.024) and 3.6 mmHg after 1 month (p=0.005); IOPg was 3.0 and 3.8 mmHg, respectively (p=0.045 and p=0.005). In the loteprednol etabonate group, the average increase in IOP over 4 weeks of postoperative observation was 1.4 mmHg. Clinically significant increase in IOP (≥10 mmHg) in the dexamethasone group was recorded in 4 patients (13.7%), while no cases were noted in the loteprednol etabonate group. Conclusion. Loteprednol etabonate 0.5% provides antiinflammatory and analgesic efficacy comparable to dexamethasone 0.1%, with a significantly more favorable safety profile in terms of intraocular pressure. The steroid-induced increase in IOP with dexamethasone is evident by the end of the first postoperative week and increases by the first month, making loteprednol etabonate preferable for postoperative anti-inflammatory therapy, especially in patients with glaucoma or ocular hypertension. Keywords: cataract phacoemulsification, loteprednol etabonate, dexamethasone, intraocular pressure, postoperative inflammation, steroidinduced hypertension, topical corticosteroids
Purpose. To provide summarized literature data on the use of porous titanium nickelide in ophthalmic surgery. Material and methods. To perform the review, literature sources of CyberLeninka, eLIBRARY.RU, and PubMed databases were analyzed using the keywords «titanium nickelide», «shape memory effect», «tissue-engineered construction», «orbital implant», «collagen formation», «vascularization». Scientific papers for the last 20 years were considered. Results. This review presents literature data on the application of porous titanium nickelide with shape memory effect, in medicine and, in particular, in ophthalmic surgery. Titanium nickelide is used as an implant, for the manufacture of medical instruments, as well as in tissue-engineering structures, being a matrix for transplanted cells. The review shows the advantages of using this alloy compared to other materials. Titanium nickelide has special properties – shape memory effect and superelasticity, high biocompatibility, ability to stimulate reparative processes. Unique properties of titanium nickelide allow to create new technological implants for various pathologies, which significantly improves the quality of medical care for patients. Conclusion. The combination of the «shape memory» effect with biomechanical compatibility, high corrosion resistance, reversible deformation ability provide wide demand for titanium nickelide as an implant in ophthalmosurgery for treatment of various types of pathologies of the visual organ. The unique properties of porous titanium nickelide open prospects for the development and implementation of new effective medical technologies. Key words: titanium nickelide, shape memory effect, tissue-engineered construction, orbital implant, collagen formation, vascularisation.
Purpose. A systematic analysis of domestic and foreign literature on the surgical treatment of giant macular ruptures. Material and methods. To carry out the review, a systematic analysis of scientific publications by domestic and foreign authors on PubMed, Medline, and eLIBRARY.RU resources from 1990 to 2024 devoted to the surgical treatment of giant macular ruptures was carried out. Results. During long-term observations of surgical intervention in giant macular ruptures, the lack of a universal treatment method is confirmed. Research is ongoing aimed at optimizing gap closure techniques, considering the duration of the disease and the parameters obtained using optical coherence tomography. Conclusion. The key task remains the development of microinvasive technologies with minimal traumatic effects on the retina, which contributes to improving functional outcomes. The introduction of such techniques can significantly improve the effectiveness of therapy and the quality of life of patients. Key words: macular rupture, vitreoretinal surgery, introverted flap, retinal autotransplantation, Balanced Salt Solution (BSS).
Relevance. The increasing life expectancy has led to a rise in age-related vision disorders, such as presbyopia and cataracts, with WHO predicting 2.1 billion presbyopia cases and 35 million annual cataract surgeries globally by 2030. In Russia, ~2 million cataract cases are diagnosed yearly, with 760K – 1 million lens replacements performed, highlighting the demand for precise IOL calculations to achieve optimal refractive outcomes. While the IOLMaster 700 remains the gold standard, the newly introduced Argos SS-OCT biometer (with Enhanced Retina Visualization) shows promise for challenging cases (e.g., dense cataracts, corneal opacities), though clinical data, especially in Russian-language literature, remain scarce. Purpose. Comparative analysis of the accuracy of biometric measurements and intraocular lens calculations using optical biometers (Argos and IOLMaster 700) in patients with cataracts of varying density. Material and methods. This prospective study included 194 eyes with cataracts. A comparative evaluation was performed between two SS-OCT biometers: Argos (featuring Sum-of-segments technology and ERV mode) and IOLMaster 700. Special attention was given to cases of dense cataracts (PNS ≥4). Results. Argos demonstrated significantly higher measurement success rates (97.9% vs 92.2%; p<0.001). In the dense cataract group, Argos achieved 92% effectiveness in ERV mode versus 65% for IOLMaster 700. A clinical case confirmed the accuracy of ERV measurements (error <0.3D). Both devices showed comparable accuracy in transparent media. Conclusion. The Argos biometer with ERV mode is the preferred choice for complex cases, providing high measurement accuracy in dense cataracts. SS-OCT technology combined with the Sum-of-segments method meets modern requirements for refractive cataract surgery. Key words: optical biometry, SS-OCT, cataract, axial length, refractive outcomes.
Relevance. Corneal collagen cross-linking (CXL) is the most effective treatment for keratectasia, based on irradiation of the affected cornea with ultraviolet light (370 nm). Complications of corneal cross-linking include stromal haze and stromal degeneration, often associated with keratocyte apoptosis. The study of pro- and anti-apoptotic processes in the cornea following the CXL procedure is of significant scientific interest. Purpose. To study the effect of corneal cross-linking in rats on the expression of keratocyte apoptosis and proliferation markers — Bcl-2, Bax, the Bcl-2/ Bax index and Ki-67. Materials and methods. Male rats weighing 200– 250 g were used in the experiment. Rats in the experimental group (n=5) underwent the standard epithelium off CXL (3 mW/cm2 — 10 min) with instillations of DEXTRALINK, a photosensitizing agent consisting of 0.1% riboflavin and 20% dextran. The cogroup consisted of intact animals (n=5). After 14 and 30 days, the eyeballs were enucleated and morphological and immunohistochemical studies (Bcl-2, Bax, Ki-67) were performed. The number of positively stained keratocytes was counted as a percentage per field of view. The Mann – Whitney U-test was used for statistical analysis. Results. In the intact group (control), the expression of the antiapoptotic factor Bcl-2 prevailed over the pro-apoptotic protein Bax. In the experimental group, the number of Bcl-2-stained cells significantly reduced compared to the intact group (p=0.0059), while the number of Bax-positive cells increased (p=0.0001). The Bcl-2/Bax cell survival index was 1.113132 (p=0.0001). The Ki-67+ keratocyte level was restored to control values, which corresponded with the normalization of the corneal morphology. Conclusions. Corneal collagen crosslinking with riboflavin (on day 14) contributed to a statistically significant increase in the number of Bax-immunopositive keratocytes (pro-apoptotic factor) and decrease in the number of Bcl-2-positive cells (anti-apoptotic factor). At the same time, the proliferative potential of keratocytes, studied by the level of expression of the Ki-67 protein, remained within the normal range. Keywords: corneal collagen cross-linking, immunohistochemical analysis of the rat cornea, apoptosis, Bcl-2, Bax, Ki-67, Bcl-2/Bax index.
