Actuality. One of the significant ophthalmic diseases is a dry form age-related macular degeneration (dAMD). The issues of etiology and pathogenesis are not completely cleared nowadays and they signify the subject of discussion. There are risk factors of dAMD (age, heredity, lifestyle etc.) which can cause metabolic disorders, changes hemorheological parameters which promote activation of druseogenesis and as a result an angiogenesis. Mostly an outcome of dAMD is geographical atrophy and decrease of central visual acuity. At the same time, it is known that similar metabolic and rheological disorders detected in other diseases are effectively corrected by extracorporeal rheoaferesis, in particular, using double filtration plasmapheresis. Thus, using of extracorporeal rheoaferesis with dAMD patients is pathogenetically well-reasoned, but in the available literature, a correct analysis of the effectiveness and safety of double filtration plasmapheresis in patients with intermediate stage of dAMD is presented poorly.Objective. To study along with data of OCT, OCT angiography, visometry, microperimetry and electroretinography structural and functional changes in the macular zone in patients with a dry form of age-related macular degeneration after the using of double filtration plasmapheresis.Patients and methods. The study included 63 patients (94 eyes) with an intermediate stage of dAMD. The patients were separated into two groups randomly. The first (main) group included 34 patients (52 eyes) who were performed double filtration plasmapheresis (DFPP) on an OctoNova device using a Plasmaflo plasma filter and a Cascadeflo EC40 fractionator in the amount of 4 procedures with a frequency of 1 time per week for 1 month. The second group (control) included 29 patients (42 eyes) who did not receive any specific treatment. In the main group of patients, OCT, OCT angiography, microperimetry and electroretinography were additionally performed in addition to standard ophthalmological examination before the DFPP course, after the DFPP course (1 month after the start of follow-up), 6 and 12 months later. Patients in the control group also underwent a similar examination at the specified time — 1, 6, 12 months after the start of follow-up.Results. In this study we found according to optical coherence tomography, optical coherence tomography-angiography, visometry, microperimetry and electroretinography, positive dynamics of structural and functional parameters of the macular retina is observed in patients with a dry form of age-related macular degeneration with using double filtration plasmapheresis. At the same time, a statistically significant difference between the two groups begins at 1 month and persists for 12 months of follow-up, which points to stabilization of the pathological process during the specified period.Conclusions. This study showed that after applying the double filtration plasmapheresis in patients with dry form of age-related macular degeneration, there is an improvement in structural and functional parameters of the macular zone, consisting in a decrease volume DOPES and stabilization of retinal light sensitivity.

Background. Controlled arterial hypertension (HTN) does not mean complete regression of preclinical target organ damage. Objective. To study the relationship between indicators characterizing the structural and functional state of the kidneys and retina in middle-aged patients with uncomplicated HTN, receiving combination antihypertensive therapy (AHT) and having office systolic (SBP) and diastolic (DBP) blood pressure levels < 140 and < 90 mmHg. Design and methods. We examined 87 patients (65 males and 22 females, average age 50,5 ± 4,87 years) with stage I and II HTN without clinically significant concomitant pathology taking double combined AHT (group average office level of SBP and DBP 134 ± 12,3 and 84 ± 14,5 mmHg, respectively). For at least the previous 12 months, patients had regularly received voluntary dual combination AHT based on pharmacological blockade of the renin-angiotensin-aldosterone system. HTN patients underwent a comprehensive assessment of the structural and functional state of the kidneys and fundus of the eye. To assess the relationships between biomarkers of kidney and retinal damage in the examined individuals within the entire set of studied parameters, correlation analysis and comparative analysis of the same quantitative (renal or retinal) indicators were used in subgroups of individuals divided according to a conditionally selected qualitative characteristic corresponding to the norm or deviation from the norm (value central retinal arterial equivalent (CRAE ≥ or < 145 μm), central retinal venous equivalent (CRVE ≥ or < 227 μm), albumin-creatinine ratio (ACR ≥ or < 10 mg/g), foveal avascular zone area (FAZ ≥ or < 0,36 mm²). Statistical processing of data was carried out using the Basic Statistics / Tables modules of the application package Statistica for Windows (version 12). The relationship between quantitative renal and retinal indicators was studied using the Pearson r correlation coefficient. Comparative analysis of quantitative parameters within the examined group, conditionally subdivided according to a certain qualitative criterion, was performed using the nonparametric Mann-Whitney U-test. Results. CRVE values directly correlated with ACR (r = 0,30; p = 0,037), FAZ area — with ACR (r = 0,40; p = 0,005), subfoveal choroidal thickness (SCT) — with estimated glomerular filtration rate (eGFR) (r = 0,45; p = 0,001); CRAE values inversely correlated with serum urea (r = –0,34; p = 0,019), SCT — with serum creatinine (r = –0,36; p = 0,011). Patients with ACR ≥ 10 mg/g compared with patients with ACR < 10 mg/g were characterized by significantly lower values of the retinal arteriovenous ratio (0,646 ± 0,09 and 0,689 ± 0,08, respectively, p = 0,016). Patients with FAZ area ≥ 0,36 mm² compared with those with FAZ area < 0,36 mm² had higher proteinuria values (0,101 ± 0,13 and 0,075 ± 0,14 mg/g, respectively, p = 0,01). Conclusions. Middle-aged patients with uncomplicated HTN without clinically significant concomitant pathology, receiving double combined AHT, demonstrate significant associations of indicators characterizing the structural and functional state of the kidneys and retinal microcirculation in terms of their preclinical damage.

In view of the current trend — growth of antibiotic resistance, the search for possible alternative methods of preoperative prophylaxis is relevant.The purpose: to assess the impact of different methods of preoperative eradication of Staphylococcus epidermidis (the use of specific bacteriophage and picloxidine in combination with eyelid massage) on conjunctival and aqueous moisture contamination in the course of planned phacoemulsification.Patients and Methods. 44 patients (48 eyes) were examined. Patients in group I underwent eradication with staphylococcal bacteriophage in combination with eyelid massage, in group II — with picloxidine according to the similar technique, group III was control group. Microbiological material was sampled from the conjunctival cavity before the application of the said methods and after blepharostat placement. Anterior chamber fluid (ACF) was examined at the end of the operation. Microorganisms were identified by MALDI-TOF method, sensitivity was determined by drip method.Results. The percentage of S. epidermidis contamination of conjunctiva after blepharostat placement was 25.0 %, 68.8 % and 87.5 % in groups I, II, III, respectively, in the ACF it was found in 0.0 %, 12.5 % and 37.5 % in groups I, II, III, respectively.Conclusion. Preoperative measures for S. epidermidis eradication with staphylococcal bacteriophage in combination with eyelid massage are significantly more effective than the similar technique with picloxidine and provide a significant reduction of conjunctival sac contamination by 75 %, and also absence of S. epidermidis in the ACF by the time of phacoemulsification completion.

Purpose: to determine the risk factors of the inflammatory reaction in the anterior chamber aqueous humor in routine cataract surgery of patients with concomitant ophthalmological and systemic pathology based on a quantitative assessment of the eye anterior segment optical coherent tomography (OCT) data.Material and methods. The study enrolled 60 patients aged 38 to 85 years, 45 % of them were men. Before planned phacoemulsification, a standard ophthalmological examination, the eyelids status assessment, parameters of the lacrimal meniscus, calculation of cell in the anterior chamber using OCT were performed, also general clinical data were analyzed. 2 groups were analyzed: group 1 — risk group — 30 patients with symptoms of inflammatory reaction according to a blood test, paraocular foci of chronic infection and diabetes mellitus, as well as those who had chronic blepharitis, group 2 control — 30 patients without these signs. Biomicroscopy and anterior segment OCT were performed before and 4 hours after the surgery, as well as on days 1, 7, and 14.Results. Group 1 patients had cytosis of 2.5 cells (0-20) in the anterior chamber humor at the preoperative stage. Cells were detected in 57.58 % of cases (p = 0.000), but in no case in group 2. In the first hours after surgery, the same frequency of humor opalescence fibrinoid reaction and ophthalmohypertension was observed in the groups, but the frequency of corneal tunnel edema in group 1 was significantly higher (p = 0.048). In the first hours after the intervention, the cell suspension in the aqueous humor was more intense in patients of the risk group; in all cases the number of cells progressively decreased and leveled out between the groups. Correlation analysis showed the relationship between the severity of cell suspension and opalescence of the anterior chamber humor with the presence of cytosis at the preoperative stage (R = 0.88, p = 0.002), the type of IOL chosen (R = 0.74, p = 0.021) and the presence of diabetes mellitus in history (R = 0.82, p = 0.007).Conclusions. Usage of precise imaging techniques to assess anterior chamber humor cytosis is a convenient, objective, and reliable method. The presence of cell suspension in the anterior chamber aqueous before surgery, especially in elderly patients with diabetes mellitus, is a prognostic factor for a more expressed inflammatory reaction of the anterior segment in uncomplicated phacoemulsification.

Purpose. To study the indicators of regional hemodynamics, as well as the dynamics of structural and functional parameters of the macular zone in patients with a dry form of agerelated macular degeneration (dAMD ) before and after the use of double filtration plasmapheresis (DFPP). Material and methods. The study included 34 patients (52 eyes) with intermediate stage dAMD. The patients underwent DFPP on an OctoNova device using a Plasmaflo plasma filter and a Cascadeflo EC40 fractionator. The course included 4 procedures with a frequency of 1 time per week. In the period before the DFPP course, after the DFPP course (1 month after the start of follow-up), after 6 and 12 months, a comprehensive ophthalmological examination and ultrasound examination were performed to assess the blood flow rate in the posterior short ciliary arteries. For a reliable interpretation of the results of the study, the age norm was set: 20 patients (20 eyes), comparable in gender and age. Results. The study revealed positive dynamics of structural and functional parameters of the macular retina and improvement of microcirculation parameters against the background of the use of DFPP of patients with dAMD. At the same time, a statistically significant difference begins at 1 month and persists for 12 months of follow-up, which indicates stabilization of the pathological process. Conclusion.DFPP has a positive effect on the course of dAMD, but the effect may weaken over time. However, there is a possibility of regular repetition of the course. Keywords: treatment of the dry age-related macular degeneration, regional hemodynamics, druses, double filtration plasmapheresis

The objective of the study: to analyze characteristics of a standardized model of type B gunshot open global injury (open injury without intraocular foreign body).Methods: The experiment was carried out on 36 rabbits (71 eyes). Simulation of type B gunshot open global injury (GOEI) was accomplished using pump equipment. The complex of modern standard and high­technology diagnostic methods to study characteristics of type B GOEI in the control period was performed. Biomicroscopy, ophthalmoscopy, optical coherence tomography, electroretinography, ultrasound examination, MRI, enzyme multiplied immunoassay to determine vitreous fibronectin, and pathomorphological study of the eye globe were carried out. Non­parametric statistical methods of data analysis were used.Results: The above diagnostic methods being used, the GOEI experimental model characteristics were determined, including proliferative vitreoretinopathy (PVR) i.e.incidence rate and dynamics.Conclusion. High reproducibility (77–100 %) of microlevel signs of type B GOEI experimental model was demonstrated, that evidenced standardization of the developed model. The viability of the use of hyphema and hemophthalmia as the PVR and GOEI predictors was justified on the basis of correlation analysis in experiment. The analysis of proliferative signs being made when using different study methods (pathomorphological, indirect ophthalmoscopy, optical coherence tomography, ultrasound examination and MRI) proved their application as PVR markers possible. The interchangeability of the study methods used for PVR diagnosis was also justified.

PURPOSE:This study analyzes the effectiveness and safety of brolucizumab in the treatment of neovascular age-related macular degeneration (nAMD) in real clinical practice. MATERIAL AND METHODS:The study included patients with nAMD who received brolucizumab treatment and evaluated the changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), macular volume, as well as the number of injections and adverse events. RESULT:The group of previously treated patients included 28 subjects (28 eyes) that were switched to brolucizumab with a loading phase. By 12 months, BCVA changed from 0.43±0.29 to 0.33±0.27 LogMAR (p=0.11), CRT decreased from 281.5±58.2 to 239.9±45.6 µm (p=0.02). The group of previously untreated patients included 29 subjects (29 eyes). By 12 months, BCVA changed from 0.47±0.32 to 0.40±0.30 LogMAR (p=0.09), CRT decreased from 333.2±77.3 to 226.2±49.6 µm (p<0.001). Patients received 6.3±0.7 injections. In this group, baseline choroidal thickness showed a statistically significant correlation with final visual acuity (r=0.54; p<0.05) and CRT (r= -0.5; p<0.05). The group of previously treated patients switched without a loading phase included 18 patients (18 eyes). By 6 months, BCVA changed from 0.42±0.2 to 0.37±0.26 LogMAR (p=0.42). CRT remained stable at 285.6±56.9 µm (p=0.97). No adverse events related to intraocular inflammation were reported during the course of 385 injections. CONCLUSION:Brolucizumab therapy helps achieve significant anatomical and functional improvements in real clinical practice both in patients switched from previous treatments and in treatment-naïve patients. Greater baseline choroidal thickness may be associated with better anatomical and functional outcomes with brolucizumab treatment.

Purpose. To develop a method for predicting near visual acuity at 40 cm after TECNIS Symphony IOL implantation based on preoperative biometry data. Material and methods. 2 groups of patients were enrolled in the study – the test group (50 eyes), where IOL TECNIS ZCB00 was implanted, and the main group (30 eyes), who received the TECNIS Symphony lens. Preoperatively all patients underwent Lenstar LS900 measurement and OCT of the anterior segment Cassia 2. There were no differences in biometry and demographic parameters between the groups. In the postoperative period, the measurements were repeated, refraction, distance and near visual acuity were also determined in the main group. The follow-up period was 6,48±0,15 months. Results.The posterior surface of the TECNIS IOL was 0.06±0.17 mm (p=0.022) closer to the cornea than the center of the crystalline lens. Center of the crystalline lens depth had correlation with the distance between cornea and the anterior (R=0.76 and R=0.74 according to Cassia 2 and Lenstar, respectively, p=0.000 in both cases) and posterior IOL surface (R=0.74 and R=0.86, p=0.000 in both cases). The average near visual acuity in the main group was 0.50±0.20 and did not depend on the axial length of the eye, IOL power, length of the vitreous chamber, residual ametropia and gender. Based on the results of regression analysis, an equation was derived for predicting near visual acuity after implantation of the TECNIS Symphony IOL (sum of squares 0.83, p=0.000), which included center of the crystalline lens depth, flat cornea meridian power and its thickness.Conclusion. Near visual acuity at 40 cm after implantation of TECNIS Symphony IOL can be reliably predicted based on center of the crystalline lens depth, flat cornea meridian power and its thickness. It is also possible to use the simplified nomogram proposed by the authors.

Glaucoma is one of the main causes of irreversible vision loss worldwide, its prevalence is increasing with age, reaching 10 % in individuals over 90 years old. Combined surgical treatment of cataract and glaucoma has proven to be safe and effective, reducing overall treatment costs. Minimally invasive glaucoma surgery (MIGS) combined with cataract surgery has become a popular alternative to traditional methods. One such intervention is endoscopic laser cyclodestruction (ELCD), aimed at reducing the production of aqueous humor.Objective: To evaluate the conditions for achieving maximum efficacy and safety of endoscopic laser cyclodestruction (ELCD) in the combined surgical treatment of glaucoma and cataract.Methods. A clinical study was conducted involving 110 patients (56 males and 54 females) with a mean age of 73.7 years, who underwent combined surgery (phacoemulsification + ELCD). Inclusion criteria were stages I-IV glaucoma and initial complicated cataract, while exclusion criteria included lens subluxation and presence of uveal processes or their consequences. ELCD was performed using the Endo Optiks Inc (USA) video-endoscopic ophthalmic laser device. Patients were evaluated preoperatively and followed up at 1, 3, 6, 9, 12, 18, 24, 36, 48, and 60 months postoperatively. The primary safety outcomes included the frequency of intraand postoperative complications, and efficacy outcomes were based on intraocular pressure (IOP) reduction.Results. No hemorrhagic complications were noted. An inflammatory reaction was observed in 18.2% cases, which was managed with subconjunctival injections of prourokinase. The frequency of postoperative IOP elevation correlated negatively with preoperative IOP levels. ELCD demonstrated a statistically significant reduction in IOP and medication burden, with a complete success rate of 52.7 % and a partial success rate of 90.3 %. The extent of cyclodestruction (180–360°) did not significantly affect IOP reduction outcomes.Conclusion. ELCD, performed as part of combined surgery for glaucoma and cataract, proved to be effective and safe, achieving significant IOP reduction and decreasing the need for antiglaucoma medications. Recommendations include avoiding vaporization effects during surgery and preferring patients with preoperative IOP above 27 mm Hg for optimal outcomes.

Conditionally pathogenic conjunctival microflora is the most frequent cause of endophthalmitis after cataract phacoemulsification (“PEC”).The purpose. To evaluate the sterility of the surgical field and anterior chamber fluid (ACF) during elective (PEC).Materials and methods. 75 eyes were examined. Patients in the group I underwent standard treatment of the surgical field, in the group IA — the standard technique was supplemented with mechanical delimitation of the upper eyelid margin, in group II additional treatment of the surgical field with povidone iodine after blepharostat installation was performed. Microbiological material was collected preoperatively from three loci (conjunctival cavity, eyelid free margin, lacrimal ducts) and at different stages of surgery from the conjunctival cavity (after standard treatment, after blepharostat placement, after additional treatment). In addition, anterior chamber fluid (ACF) was examined — also during surgery. Microorganisms were identified by the MALDI­-TOF method, sensitivity was determined by the disc­diffusion method.Results. S. epidermidis prevails among all microorganisms. The percentage of the surgical field contamination by S.epidermidis after blepharostat setting was 33,33 %, 26 % and 40 % in the I, IA, II groups respectively; after additional treatment 6,6 % in the II group; in the ACF it was found in 23,33 %, 13 % and 0 % in the I, IA, II groups respectively.Conclusion. The additional treatment of the surgical field is the most effective technique to reduce the contamination of the conjunctival cavity by S.epidermidis after placing a blepharostat and the only one in the study to ensure its absence in the ACF. Standard treatments with and without mechanical delineation are less effective and do not prevent the contamination of the ACF.

Актуальность. ВМД является хроническим прогрессирующим полиэтиологичным заболеванием при отсутствии целостного представления об этиопатогенетических механизмах, что определяет отсутствие клинически эффективного лечения, способного привести к регрессу этого заболевания. Выделяют несколько факторов риска, совокупность которых определяет нарушения метаболизма комплекса хориокапилляры/мембрана Бруха/ПЭС/нейросенсорный слой сетчатки. Цель. Изучить динамику структурно-функциональных показателей макулярной сетчатки на фоне применения каскадной плазмофильтрации (КПФ) у пациентов с сухой формой ВМД. Материал и методы. В исследование включено 34 пациента (52 глаза) с промежуточной стадией сВМД. Выполнялось 4 сеанса КПФ с периодичностью 1 раз в неделю. Комплексное офтальмологическое обследование, исследование реологических и биохимических показателей крови до и после курса КПФ. На 6 и 12-й месяц наблюдения оценивались отдаленные результаты. Результаты. После применения КПФ у пациентов с сВМД наблюдалось улучшение регионарной гемодинамики (увеличение скорости кровотока в задних коротких цилиарных артериях) сопровождающееся улучшением биохимических показателей крови (в метаболическом, реологическом, антиоксидантном, противовоспалительном профиле). Данные изменения определили положительную динамику структурно-функциональных показателей макулярной сетчатки (снижение объема друзеноидной отслойки ПЭС, повышение световой чувствительности, ретинальной плотности биоэлектрической активности, остроты зрения) в течение года. Выводы. Каскадная плазмофильтрация оказывает положительное влияние на течение сВМД.

Brolucizumab, an angiogenesis inhibitor, is a single-chain fragment of a humanized antibody used to treat neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). Although registration studies are the primary source of information on the new drug, post-marketing studies allow for further exploration and expansion of previous knowledge about its effectiveness, safety, and dosing regimens. This study summarizes the experience with brolucizumab from real-world clinical practice studies. A systematic literature review was conducted to identify articles published up to April 2024 that investigated the use of brolucizumab in the treatment of retinal vasogenic diseases, revealing the high effectiveness of brolucizumab compared to other angiogenesis inhibitors in the treatment of patients with nAMD and DME, including those who were treatment-naïve and those resistant to ongoing therapy, as well as patients with changes in the vitreoretinal interface. A significant advantage of brolucizumab is its ability to reduce the number of injections and extend the intervals between them up to 16 weeks. Study results demonstrate substantial improvements in anatomical and functional outcomes compared to previously existing and newly emerging angiogenesis inhibitors. Its ability to stabilize disease progression, achieve better disease control, and reduce injection frequency makes brolucizumab an attractive option for both first-line therapy and as a switching drug, highlighting its potential for expanded indications.

Purpose: to evaluate the features and outcomes of penetrating keratoplasty in combined opto-reconstructive surgery for combat eye injury and its complications.Patients and methods. The study enrolled 17 eyes (16 men) aged 34.00 ± 12.51 years, divided into 2 groups: I — with inflammatory diseases of the anterior segment, complicated combat eye injury (4 eyes), II — with open eye injury (OGI, 13 eyes). Patients underwent examination to reveal and localize damaged intraocular structures and intraocular foreign bodies (IOFB), determine the prognosis of visual functions, as well as impression cytology. In all cases penetrating keratoplasty was performed, as well as complex of vitreoretinal surgery if it was needed. In the postoperative period, visual acuity, the timing of epithelialization, and graft transparency were assessed. Period of observation was 4,5 ± 2,1 months.Results. Group I had severe keratouveitis, when intraocular structures were intact also as electrophysiological parameters. The presence of mucosal cells was determined in 50 % of cases. The number of surgery was 2.00 ± 0.82. Graft epithelialization was completed in 38.99 ± 35.43 days. Postoperatively all grafts had transparent retention and complete epithelialization, also as had high visual acuity (0.25 ± 0.10) was noted. Group II had damaged several intraocular structures and varying electrophysiological parameters. The epithelial phenotype was corneal all over. The average number of surgical treatments was 3.00 ± 1.48. The time of graft epithelialization was significantly less — 17.66 ± 8.69 days (p = 0.014). Corrected visual acuity ranged from zero (30.77 %) to 0.3 (0.08 ± 0.11) and was significantly less than in group I (p = 0.018). The parameters that correlated low visual acuity were aphakia, the level of electrical sensitivity, the number of surgical interventions, and the age of patients.Conclusions. Penetrating keratoplasty functional results prognosis is better in group with infectious complications of combat eye injury with reduced cornea transparency than in patient with open globe injury. Besides light perception and conducting structures (retina, optical nerve) lesion, optico-reconstructive surgery in open globe injury often leads to single-chamber formation in silicone filled eye, which significantly worsens the functional prognosis of treatment.

PURPOSE. To study the diagnostic effectiveness of an improved software version of the well-known authors' modification of Frequency Doubling Technology (FDT) perimetry by comparing it with the previous software version and standard automated perimetry on the same contingent of healthy individuals and patients with primary open-angle glaucoma (POAG).METHODS. The study included 56 patients (105 eyes) (mean age 61±13.2 years) with POAG. Patients were divided into three groups depending on the stage of glaucoma: group 1 — early stage (39 eyes), group 2 — moderate (25 eyes), and group 3 — advanced (9 eyes) stage. The fourth (control) group included 32 eyes of 16 healthy people (average age 48.2±6.2 years). All study subjects underwent standard automated perimetry (SAP) on the Humphrey III visual field analyzer and non-standard perimetry in the form of our own modification of FDT perimetry and its improved software version — FDT VR version based on the new portable automatic perimeter "Stimulus" (OOO Total Vizhen, Russia). The optic nerve disc was evaluated on the Heidelberg Retina Tomograph 3.RESULTS. The software version of the authors' modification of FDT perimetry has been improved for liquid crystal monitors and adapted to the portable perimeter "Stimulus". When comparing diagnostic effectiveness, both variants of FDT perimetry are not inferior to SAP in sensitivity (87.6; 87.8 and 86.7%, respectively), and in terms of specificity (98.2; 98.1 and 84.4%, respectively) they are superior. A strong (r=0.99988) and reliable (p<0.05) correlation was found between the average values of light sensitivity for both variants of FDT perimetry.CONCLUSION. The introduction of FDT perimetry based on the new portable automatic perimeter "Stimulus" into widespread ophthalmological practice can contribute to improving the effectiveness of screening and early diagnosis of glaucoma.

In case of corneal ulcers of various origin that are difficult for medical treatment, urgent surgery is indicated, including the usage of plastic materials. In the absence of them, the surgery of choice is conjunctival autoplasty of the cornea. Recent modifications of such surgical procedure don’t rule out complications as early dislocation of the flap and the progress of infection under it. A comparative analysis of the technique and outcomes of the applied autoconjunctival plasty with a pedunculated flap and the proposed modification of the procedure, performed in 9 patients, was carried out. It is concluded that the operation is a simple and effective method of eliminating corneal ulcers and ulcers complicated by descemetocele and corneal microperforation. Keywords: cornea, ulcerative defect, deepithelialization, autoconjunctival plasty.

Age related macular degeneration is a leading cause of vision loss and an increasing problem of disability throughout the world among adults. That revue covers historical points, risk factors, pathogenesis, classification and current treatment ways of that pathology. The causes of age-related macular degeneration are not fully understood, in spite of keeping a great amount of knowledge at etiology, pathogenesis, diagnosis and modern types of treatment. The problem of age-related macular degeneration treatment has remained actual nowadays. Now, the medicine doesn’t have etiotropic treatment of AMD, because we still don’t know a definite etiologic factor of this developing disease. The main treatment for wet AMD is the injection of medications called anti-VEGF agents. Currently, treatment of dry age-related macular degeneration includes modification of risk factors (stop smoking, healthy life style and etc) and dietary supplements containing a combination of certain ingredients (vitamin C, vitamin E, zinc, copper, and lutein with zeaxanthin or beta-carotene) may be able to slow the progression of the disease. The disadvantage of current treatment methods is a narrow focus at one of the pathogenesis components or using as symptomatic therapy. The analysis of literature date has allowed noticing of using of an extracorporeal hemocorrection as perspective way at exploration of new methods of treatment of dry age-related macular degeneration.

Epidermolytic drug reactions (EDR) are severe acute drug-induced allergic disorders characterized by extensive lesions of the skin and mucous membranes. Drug-induced Stevens-Johnson and Lyell's syndromes manifested with acute skin and mucous membrane disorders and often leading to lethal outcome may affect eyelids and ocular surface with different levels of severity and thus can cause serious functional ocular complications. The authors present two clinical reports of patients with ocular EDR manifestations in acute and long-term time periods and review the currently available effective treatment options for patients with such ocular complications and their consequences. The article describes surgical treatments which enabled to achieve satisfactory anatomical and functional results in patients with the above disorders. Timely treatment of Stevens-Johnson and Lyell's syndromes comprising systemic and topical conservative therapy in combination with surgical procedures during the acute stage plays an important role for the prediction of severe long-term ocular complications. The elimination of ocular complications caused by these syndromes is associated with multistage reconstructive surgery. The authors emphasize that long-term follow-up by ophthalmologist will be required for patients who survived Stevens-Johnson and Lyell's syndromes. Keywords: epidermolytic drug reactions, Stevens–Johnson syndrome, Lyell's syndrome, amniotic membrane transplantation, dry eye syndrome, pseudomembranous blepharoconjunctivitis, multistage reconstructive surgery. For citation: Chernysh V.F., Haritonova N.N., Kulikov A.N. et al. Current surgical treatment options for ocular complications of Stevens- Johnson and Lyell's syndromes. Russian Journal of Clinical Ophthalmology. 2023;23(2):99–106 (in Russ.). DOI: 10.32364/2311-7729- 2023-23-2-99-106.

A 24-year-old female patient with photophobia, discoria, redness and dryness in her right eye after intense pulsed light (IPL) therapy applied for posttraumatic subcutaneous hemorrhage received a comprehensive ophthalmic examination including optical coherence tomography (OCT) and OCT angiography of the anterior eye segment. Her best corrected visual acuity was 20/20 in both eyes. Medically induced mydriasis revealed discoria with paresis of pupil dilatator in the left eye (pupil size 4.2 mm and 6.6 mm in the right and left eye, respectively). Anterior segment OCT showed anterior chamber cytosis and increased iris vascularity. The patient was prescribed topical 1.0% tropicamide 2 times per day and 1.0% dexamethasone 4 times per day for two weeks. Examination performed after 3 months showed no restoration of pupil dilatator function in the left eye. The case demonstrates potential ocular complications of IPL therapy, which may include iris burn with iritis and persistent pupil dilatator dysfunction.

The main source of intraocular lens (IOL) power calculation errors in phacoemulsification (PE) is axial length (AL) measurement inaccuracy in cases if optical biometry cannot be used. bto describe an original double-step method of IOL power calculation in lens opacities which exclude AL measurement with optical biometry. Material and methods. Patient S. (male, 71) with a bilateral immature cataract underwent right eye phacoemulsification (PE) with no IOL implantation. After that, AL was measured in the aphakic state with transparent optical media and used in combination with preoperative anterior segment biometry data to calculate the IOL power. In the second stage, a selected lens with an extended focus range was implanted. Results. The patient was examined and discharged on the second day after surgery with visual acuity OD 0.3 sph +0.25 cyl -0.75 ax150 = 0.5 and signs of moderate postoperative keratopathy. After 2 weeks, uncorrected visual acuity was as high as 0.9 and could not be further corrected by spectacle lenses. The patient was admitted for surgical treatment of the left eye cataract and also operated in two stages. The AL measured by the optical method in the aphakic state, was 0.31 mm less than that measured before the operation. Six months after PE with IOL implantation, distance visual acuity in both eyes was 1.2, the patient could use binocular vision for reading and PC work with no difficulty. Conclusion. The double-step approach to IOL power calculation is justified in cases of strong decrease of crystalline lens transparency, especially in complicated cases, for example, in high myopia or “premium” lens implantation, in which patients are especially sensitive to correct target refraction, even though this approach requires a delayed IOL implantation, which should take place after a precise calculation of AL taken in the aphakic state.

Purpose. To study the relationship between baseline optical coherence tomography (OCT) characteristics of preservation of the neurosensory retina and retinal pigment epithelium (RPE) and functional outcome after full thickness macular hole (FTHM) surgery. Materials and methods. Patients with complete postoperative anatomical closure of the FTMH were included in this prospective interventional study. All patients received a standard ophthalmological examination and OCT before surgical treatment. At baseline the area and reflectivity of the neurosensory retina at the edges of the hole was measured on cross-sectional OCT scans. The reflectivity of RPE was evaluated within the hole on structural en face projections of RPE slab. Six months postoperatively, correlation between baseline OCT characteristics and visual outcome was evaluated. Results. Twenty-nine patients (30 eyes, 23 females and 6 males, average age — 66.2 ± 5.2 years) were included in the study. The final best-corrected visual acuity showed a statistically significant correlation with baseline best-corrected visual acuity ( r = 0.75, p < 0.001), reflectivity of RPE ( r = 0.81, p < 0.001), reflectivity of neurosensory retina ( r = –0.88, p < 0.001), and its area ( r = 0.41, p = 0.02). Conclusion. OCT-characteristics of retinal tissue preservation, including the area and reflectivity of the neurosensory retina and reflectivity of the RPE within the hole, correlate with functional recovery after FTMH surgery.