Цель — разработать комбинированную методику предварительной ИАГ-лазерной фрагментации и фемтолазерного воздействия на приборе CATALYS и оценить её роль в уменьшении временных и энергетических параметров хирургии катаракты высокой степени плотности. Материал и методы. В исследование были включены 118 пациентов (118 глаз) с возрастной катарактой 3-й и 4-й степени плотности ядра хрусталика. В основной группе перед факоэмульсификацией катаракты (ФЭК) с фемтолазерным сопровождением и имплантацией интраокулярной линзы (ИОЛ) проводили предварительную ИАГ-лазерную факофрагментацию ядра хрусталика. В первой контрольной группе выполняли ФЭК с фемтолазерным сопровождением и имплантацией ИОЛ. Во второй контрольной группе — ФЭК с имплантацией ИОЛ. Результаты. Достигнуто снижение энергии фемтолазерного воздействия на 35 % при 3-й степени плотности ядра хрусталика и на 40 % — при 4-й степени по сравнению с проведением ФЭК с фемтолазерным сопровождением без предварительной ИАГ-лазерной факофрагментации; снижение кумулятивной энергии ультразвука на 38 % при 3-й степени плотности ядра хрусталика и на 42 % — при 4-й степени по сравнению с изолированной ультразвуковой ФЭК. Заключение. Предложенная модификация методики комбинированного ИАГ-лазерного и фемтолазерного воздействия позволяет достичь полноценной фрагментации ядра хрусталика высокой степени плотности в ходе хирургии катаракты, способствует минимизации риска осложнений и быстрой послеоперационной реабилитации пациентов.

Introduction. Strabismus is the  deviation  of one  eye from  a  common  fixation point, associated  with impaired  of binocular  vision. The eye’s position in horizontal and vertical directions looking straight determines the t ype of strabismus. Despite  numerous reports of surgical  interventions on the  vertical action  muscles, there is no a differentiated approach to the  treatment of patients with this pathology. The search for the optimal methods and principles of surgical  treatment of vertical strabismus caused by hyperfunction  of the inferior oblique muscle, testifies to the relevance of developing new approaches to eliminate hypertropia  depending  on its severit y. The purpose — to  develop  a  method  of dosing  the  degree of anterior transposition of the  inferior  oblique muscle  in the  surgical treatment of vertical  strabismus caused by hyperfunction  of the  inferior oblique muscle  depending  on severit y,  and  to  evaluate  its clinical efficacy. Patients And Methods. In the  period  from January 2013 to October  2015 60 children  (96  eyes) aged  from 3 to 17 years  with a vertical strabismus caused by hyperfunction  of the inferior oblique muscle  were  followed-up. All patients underwent a complete pre  — and postoperative examinations. All patients received  surgical  treatment — weakening  of the inferior oblique muscle through  its anterior dosed  transposition. Results. There  were  no intraoperative complications and  specific complications t ypical for weakening  surgeries on the  inferior oblique muscle. Overcorrection  wasn’t  registered neither  in the  case of surgical  treatment of large vertical angles  of strabismus, no small vertical deviations.  Restriction of mobilit y of the eyeballs wasn’t recorded throughout the observation period  in any patient. Residual  hyperfunction  of the  inferior oblique muscle  was  in 3 patients (5%). It did not exceed  the value of the  vertical,  with the  fusion and  did not  require  additional surgical  treatment. Conclusion. The technology  will significantly improve  the  efficiency and  safet y  of treatment, reduce the  risk  of complications and  the  duration  of surgery and  anesthesia, the number of surgical treatment stages, to create optimal conditions  for the rehabilitation  of visual functions  in children.

The aim of the work was to determine the possibilities of the method fluorescent angiography (FAG) in the diagnosis and prediction of the flow of retinopathy of prematurity (ROP). FAG was performed 48 prematurely born children with different stages of active ROP. The survey was conducted on pediatric retinal digital video system RetCam-3, equipped with a built-in power for FAG. As a result, found that the most characteristic feature of the retinal circulation at different stages of ROP are expressed unlike vascularized from avascular retina and clearly visualized boundary between them.

To determine the morphometric parameters of retinal vessels in the central zone of the fundus and on the periphery of each type during the active phase of retinopathy of prematurity (ROP) were examined 155 premature infants (310 eyes) with I, II and III stages of ROP, with the division into types 1 and 2 course of the disease. The result was determined by a clear increase in the diameter of the retinal vessels, arterial tortuosity factor in the central zone of the fundus on the periphery when compared to the type 2 with type 1 ROP in each stage. The data obtained can serve as clear criteria for determining high and low risk of progression of ROP within each stage.

The article is aimed to develop a differentiated approach to laser treatment for active stages of retinopathy of prematurity using pattern retinal photocoagulation and evaluate its effectiveness. The study was conducted at 1158 eyes 613 premature infants. In the main group pattern retinal photocoagulation (Pascal) was performed, in the control in single pulse regime. Pattern photocoagulation advantages as compared with standard are the significant reduction in the duration of the intervention (not less than 2 times) and high dosage of impact.

Dynamic assessment of diameters of renal vessels in fundus central zone, 2 nd order vessels, and peripheral vessels, and central zone arteries tortuosity index during II and III ROP stages regressing after laser treatment is performed. The given data may be used for determination of optimal follow-up to define early a probability of ROP progressing after the lasercoagulation and to decrease a quantity of diagnostic examinations if ROP regressing.

The basic regulations of the complex retinopathy of prematurity treatment are early, within first 6 weeks of chronologic age, photocoagulation to delay progression of the retinal detachment and to stabilize vascularity, and early vitrectomy if ROP progressing after the laser treatment.