Purpose: to investigate the biointegration characteristics of orbital implants manufactured from BT-6 titanium powder using Direct Metal Laser Sintering (DMLS) and Electron Beam Melting (EBM) technologies. Materials and Methods. An experimental study was performed on 20 male chinchilla rabbits. Titanium implants measuring 10´5´2 mm were fabricated from BT-6 titanium powder using DMLS and EBM technologies. The implants were placed into surgically created intermuscular pockets in the dorsal region of the animals. Tissues without implantation served as the control. The observation period was six months. At the end of the study, the implants together with the surrounding tissues were excised and subjected to histological examination. The structure of the connective tissue capsule, vascular component, cellular response, presence of inflammatory changes, and the approximate morphometric thickness of the capsule were evaluated. Results. No signs of acute or chronic inflammation, microcirculatory disturbances, or pronounced cellular response were observed in any of the examined specimens, indicating good biocompatibility of both implant types. In both groups, a connective tissue capsule formed around the implant bed; however, its morphological characteristics differed. Implants manufactured by the EBM technique were surrounded by a thinner fibrous capsule, whereas implants produced by DMLS demonstrated a thicker capsule with a more pronounced fibrocellular organization. In several specimens, the inner surface of the implant bed was lined by epithelial cells without evidence of atypia or inflammatory reaction. Conclusion. Orbital implants manufactured from BT-6 titanium powder using DMLS and EBM technologies demonstrated excellent biocompatibility. The observed differences in the morphological organization of the connective tissue capsule suggest that the additive manufacturing technique may influence the tissue integration of titanium implants. These findings warrant further investigation to better understand the relationship between manufacturing technology and the biological response of peri-implant tissues.
Purpose: tо evaluate the effectiveness of a stepwise approach to the management of patients with glaucoma based on the sequential use of methods aimed at preservation, restoration, and, if necessary, creation of new pathways for aqueous humor outflow. Materials and methods. A retrospective observational study included 14 738 patients with different types of glaucoma treated at the ophthalmic clinic “Rascheskov Eye Surgery” between 2015 and 2025. Treatment was performed according to a stepwise strategy including medical therapy, laser procedures, reconstructive interventions, and surgical techniques aimed at creating alternative aqueous humor outflow pathways. The distribution of patients across treatment stages and the rate of intraocular pressure stabilization without signs of glaucoma progression were analyzed. Results. Stable intraocular pressure was achieved at the compensatory stage in 5309 patients. Reconstructive procedures were performed in 8973 patients, including phacoemulsification with intraocular lens implantation in 6295 cases, laser procedures in 2124 cases, ab interno trabeculotomy in 103 cases, and other types of interventions in 451 cases. Formation of alternative aqueous humor outflow pathways was required in 456 patients, including non-penetrating deep sclerectomy (245), Ahmed glaucoma valve implantation (190), and PRESERFLO microshunt implantation (21). In the majority of cases, intraocular pressure stabilization was achieved without the need for formation of an alternative drainage system. Conclusion. A stepwise approach to glaucoma treatment based on the sequential use of methods aimed at restoration of physiological aqueous humor outflow and creation of alternative pathways when necessary allows a more structured selection of surgical strategy and provides stable intraocular pressure control in most patients. Reconstructive procedures, including phacoemulsification, play an important role not only in improving ocular hydrodynamics but also in preparing anatomical conditions for possible subsequent glaucoma surgery.
Purpose: comparative analysis of two extended depth of focus IOLs bilateral implantation. Patients and methods. A total of 60 patients (120 eyes) after bilateral implantation of AcrySof IQ Vivity® IOLs ( n = 30, group I) (Alcon, USA) and TECNIS PureSee® ( n = 30, group II) (Johnson & Johnson, USA) with an average follow-up period of 6.2 ± 1.1 (3–32) were included in the study months. In the total cohort of patients, 58.3 % ( n = 35) were women and 41.7 % ( n = 25) were men. The age of the patients ranged from 39 to 81 (59.4 ± 8.0) years. Results. In both study groups, the postoperative values of UCVA and BCVA at all distances were significantly higher than before surgery ( p < 0.05). For both implantable IOLs, the values at the maximum follow-up period of 3 months were comparable ( p > 0.1). The results of the analysis of the defocus curve indicate the comparable effectiveness of both studied IOLs for correcting vision near, at an intermediate distance and in the distance. Under photopic conditions, the PureSee group showed significantly higher contrast sensitivity than the Vivity group at 12 cycles/deg ( p < 0.05) and 18 cycles/deg ( p < 0.05). Under mesopic conditions, this trend continued, and statistically significant differences were again observed at higher spatial frequencies at 18 cycles/deg ( p < 0.05). 20.8 % of patients from group I had permanent or periodic optical phenomena, of which 14.2 % had glare and 6.6% had halo. In group II, 6.7 % of patients complained about halo, and 3.3 % complained about glare. None of the patients from the study groups complained of difficulty driving at dusk. The differences between the groups were not statistically significant ( p > 0.05). Conclusion. For the first time in Russia, a comparative analysis of two modern EDOF IOLs has been performed. The studied IOLs were comparable in most of the parameters studied, including uncorrected and maximally corrected visual acuity at all distances, the frequency of adverse optical phenomena, and the degree of patient satisfaction. The advantage of implanting EDOF PureSee IOLs to achieve better contrast sensitivity in photopic and mesopic conditions is shown.
One of the important criteria for visual quality and satisfaction after uncomplicated cataract surgery is achieving the “target refraction” without residual ametropia. Despite the availability of highly accurate preoperative assessment and advanced formulas for calculating the optical power of intraocular lenses (IOLs), failure to achieve a postoperative refraction within ±0,5 diopters of the target still occurs in approximately one quarter of cases. The problem is further complicated by the absence of a generally accepted consensus regarding the optimal IOL power calculation formulas for hyperopia or myopia. In addition to various options for postoperative refractive correction, promising approaches include the use of IOLs with adjustable optical power after implantation and new-generation artificial intelligence-based IOL power calculation formulas.
Relevance. Cataracts and age–related macular degeneration (AMD) are a common combined pathology in patients of the older age group. Selecting an intraocular lens (IOL) in such patients remains a difficult task. Traditionally used monofocal IOLs do not satisfy the growing demands of AMD patients for eyeglass independence. The new EDOF (extended depth of focus) technology occupies an intermediate position between monofocal and multifocal IOLs, providing an extended range of vision with a minimum number of dysphotopsias. Purpose. Based on the analysis of literature data, to evaluate the advantages of EDOF lens implantation in patients with AMD-complicated cataracts. Materials and methods. The analysis of publications in the databases PubMed, Scopus, Web of Science, Google Scholar is carried out. Results. EDOF lenses demonstrate high efficiency in assessing longand medium-range visual acuity, accompanied by a low incidence of dysphotopsia in patients with healthy retinas. In the early stages of AMD, the implantation of EDOF lenses allows achieving satisfactory functional results that exceed the performance of monofocal IOLs. While in the late stages of AMD, the effectiveness of EDOF lenses decreases in proportion to the degree of central vision impairment. The prognostic success factors are the initial visual acuity, the preservation of the foveolar structure according to OCT data, and the stable course of AMD. Conclusion. The implantation of IOLs with extended depth of focus (EDOF lenses) in patients with age-related macular degeneration is a promising area of research. The lack of large prospective studies and insufficient knowledge of long-term results do not allow us to introduce a clear algorithm for selecting the studied group of patients.
