Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-90-101
I.E. Panova, N.A. Vorobiov, E. V. Samkovich, A.A. Bykhovskii, N.I. Martynova, E.M. Svistunova
Purpose. To present preliminary results of treatment of uveal melanoma with proton therapy using the scanning pencil beam technique. Material and methods. In this study we included 7 patients (female) with uveal melanoma aged 23 to 51 years. The tumor was localized in the choroid (4), ciliochoroidal (2) and iridociliary (1) zones. All patients received proton therapy in the hypofractionation mode at a total dose of 49 Gy in 7 fractions (BED0,6=620 Gy; EQD2=143 Gy). The follow-up period for patients ranged from 6 to 33 months. Results. In the early post-radiation period, a radiation reaction was observed in the form of skin erythema (2 patients), exudative retinal detachment (3 patients). Late complications were observed as neovascular glaucoma, which developed 6–11 months after the start of treatment in 4 patients, maculopathy (1 patient), dry eye syndrome with madarosis (3 patients). All treated patients had a slow rate of tumor regression, as a rule, the tumor began to regress after 6–8 months from the start of treatment. Complete regression was observed in 2 patients with T3aN0M0 stages of the process for a period of 24 months, the rest showed partial regression of the tumor. Conclusion. The obtained preliminary results of proton therapy using the scanning pencil beam technique are very encouraging in the treatment of large uveal melanomas and open a new perspective in their successful treatment. The use of photodynamic therapy with chlorin drugs should probably be considered as an adjuvant therapy, the effect of which will accelerate the rate of regression and reduce the incidence of complications. Key words: choroidal melanoma, proton therapy, brachytherapy, uveal melanoma, ophthalmo-oncology, choroidal melanoma treatment
{"title":"Proton therapy for uveal melanoma (preliminary results)","authors":"I.E. Panova, N.A. Vorobiov, E. V. Samkovich, A.A. Bykhovskii, N.I. Martynova, E.M. Svistunova","doi":"10.25276/0235-4160-2023-3s-90-101","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-90-101","url":null,"abstract":"Purpose. To present preliminary results of treatment of uveal melanoma with proton therapy using the scanning pencil beam technique. Material and methods. In this study we included 7 patients (female) with uveal melanoma aged 23 to 51 years. The tumor was localized in the choroid (4), ciliochoroidal (2) and iridociliary (1) zones. All patients received proton therapy in the hypofractionation mode at a total dose of 49 Gy in 7 fractions (BED0,6=620 Gy; EQD2=143 Gy). The follow-up period for patients ranged from 6 to 33 months. Results. In the early post-radiation period, a radiation reaction was observed in the form of skin erythema (2 patients), exudative retinal detachment (3 patients). Late complications were observed as neovascular glaucoma, which developed 6–11 months after the start of treatment in 4 patients, maculopathy (1 patient), dry eye syndrome with madarosis (3 patients). All treated patients had a slow rate of tumor regression, as a rule, the tumor began to regress after 6–8 months from the start of treatment. Complete regression was observed in 2 patients with T3aN0M0 stages of the process for a period of 24 months, the rest showed partial regression of the tumor. Conclusion. The obtained preliminary results of proton therapy using the scanning pencil beam technique are very encouraging in the treatment of large uveal melanomas and open a new perspective in their successful treatment. The use of photodynamic therapy with chlorin drugs should probably be considered as an adjuvant therapy, the effect of which will accelerate the rate of regression and reduce the incidence of complications. Key words: choroidal melanoma, proton therapy, brachytherapy, uveal melanoma, ophthalmo-oncology, choroidal melanoma treatment","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"42 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139011670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-102-108
O.V. Ageeva, M. Gatsu
Purpose. To summarize the data on the etiology, pathogenesis, diagnostic methods, and treatment of macular telangiectasia type 2 (MacTel 2) currently known. Material and methods. For this review, a search was conducted on PubMed and eLIBRARY resources, covering scientific publications by domestic and foreign authors from 1980 to 2021. The primary focus of the search was on the topic of MacTel 2. Results. Based on the current understanding of the disease process, it is recognized that dysfunction or loss of Muller cells represents an early stage that contributes to the development of MacTel 2. The review addresses the issues of diagnosis and differential diagnosis, pathogenesis, classification, clinical presentation, and treatment of MacTel 2. Detailed discussion is provided on the changes detected by optical coherence tomography in patients with MacTel 2, which can be valuable for the differential diagnosis of this condition and selection of appropriate patient management strategies. Conclusion. The emergence of new technologies enables the identification of specific changes occurring in the retina in MacTel 2, which require detailed analysis and can be used for differential diagnosis and disease prognosis. Key words: macular telangiectasia type 2, retinal degenerative disease, Muller cells, optical coherence tomography, differential diagnosis
{"title":"Macular telangiectasia type 2","authors":"O.V. Ageeva, M. Gatsu","doi":"10.25276/0235-4160-2023-3s-102-108","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-102-108","url":null,"abstract":"Purpose. To summarize the data on the etiology, pathogenesis, diagnostic methods, and treatment of macular telangiectasia type 2 (MacTel 2) currently known. Material and methods. For this review, a search was conducted on PubMed and eLIBRARY resources, covering scientific publications by domestic and foreign authors from 1980 to 2021. The primary focus of the search was on the topic of MacTel 2. Results. Based on the current understanding of the disease process, it is recognized that dysfunction or loss of Muller cells represents an early stage that contributes to the development of MacTel 2. The review addresses the issues of diagnosis and differential diagnosis, pathogenesis, classification, clinical presentation, and treatment of MacTel 2. Detailed discussion is provided on the changes detected by optical coherence tomography in patients with MacTel 2, which can be valuable for the differential diagnosis of this condition and selection of appropriate patient management strategies. Conclusion. The emergence of new technologies enables the identification of specific changes occurring in the retina in MacTel 2, which require detailed analysis and can be used for differential diagnosis and disease prognosis. Key words: macular telangiectasia type 2, retinal degenerative disease, Muller cells, optical coherence tomography, differential diagnosis","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"44 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139011664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-5-15
B. Malyugin, A. A. Khaletskaya, O. Antonova, D. G. Uzunyan, D.S. Ostrovskii
Purpose. Evaluate state of the vitreolenticular interface before surgery, during phacoemulsification of cataract, and in the early postoperative period. To assess the effectiveness of «Viscoblock» method application during phacoemulsification to prevent intraoperative irrigation fluid misdirection syndrome by blocking the penetration of irrigation fluid through the zonular fibers through injecting dispersive ophthalmic viscosurgical device behind the iris. Material and methods. We operated 49 patients (50 eyes) diagnosed with age-related cataracts. All patients were divided into two groups. In the first group, we performed phacoemulsification with hydrophobic intraocular lens (IOL) implantation and application of the «Viscoblock» method. This group included 24 patients. In the second group, we performed phacoemulsification with hydrophobic IOL implantation using standard technique, it included 25 patients. All patients underwent standard ophthalmological examination and specific additional ones: ultrasound biomicroscopy – UBM Aviso (Quantel Medical, France); spectral optical coherence tomography OCT (Solix, Optovue, USA). Surgical treatment was performed under the control of an operating microscope equipped with intraoperative OCT (Lumera Rescan 700, Carl Zeiss, Germany). Results. According to preoperative diagnostics and it's UBM data, all patients in the first and second groups showed abnormalities in lens zonular fibers. According to OCT data before the surgery, no cases of anterior hyaloid membrane (AHM) detachment were detected. During the surgery, AHM detachment was observed in 24% of cases in first group and in 56% of cases in second group. Intraoperative iris prolapses occurred in 8% of cases only in the first group. Posterior capsule rupture was observed in only 1 patient in second group. Conclusion. Our technique, «Viscoblock», allows us to limit the penetration of irrigation fluid through the Zonula ciliaris in 76% of cases. However, it should be noted that the method does not provide complete prevention of AHM detachment, as it may already exist in some patients. Additionally, we cannot exclude partial washout of viscoelastic substance during the surgery, which can reduce the tamponade effect. Key words: vitreo-lenticular interface, Berger's space, intraoperative fluid misdirection syndrome, optical coherence tomography, ultrasound biomicroscopy, «Viscoblock», cataract, lens zonular fibers, vitreous body, posterior lens capsule, anterior hyaloid membrane, intraocular lens
{"title":"Method of preventing irrigation flow deviation and its evaluation during phacoemulsification using dispersive viscoelastic (Viscoblock) in the aspect of the state of the vitreolenticular interface","authors":"B. Malyugin, A. A. Khaletskaya, O. Antonova, D. G. Uzunyan, D.S. Ostrovskii","doi":"10.25276/0235-4160-2023-3s-5-15","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-5-15","url":null,"abstract":"Purpose. Evaluate state of the vitreolenticular interface before surgery, during phacoemulsification of cataract, and in the early postoperative period. To assess the effectiveness of «Viscoblock» method application during phacoemulsification to prevent intraoperative irrigation fluid misdirection syndrome by blocking the penetration of irrigation fluid through the zonular fibers through injecting dispersive ophthalmic viscosurgical device behind the iris. Material and methods. We operated 49 patients (50 eyes) diagnosed with age-related cataracts. All patients were divided into two groups. In the first group, we performed phacoemulsification with hydrophobic intraocular lens (IOL) implantation and application of the «Viscoblock» method. This group included 24 patients. In the second group, we performed phacoemulsification with hydrophobic IOL implantation using standard technique, it included 25 patients. All patients underwent standard ophthalmological examination and specific additional ones: ultrasound biomicroscopy – UBM Aviso (Quantel Medical, France); spectral optical coherence tomography OCT (Solix, Optovue, USA). Surgical treatment was performed under the control of an operating microscope equipped with intraoperative OCT (Lumera Rescan 700, Carl Zeiss, Germany). Results. According to preoperative diagnostics and it's UBM data, all patients in the first and second groups showed abnormalities in lens zonular fibers. According to OCT data before the surgery, no cases of anterior hyaloid membrane (AHM) detachment were detected. During the surgery, AHM detachment was observed in 24% of cases in first group and in 56% of cases in second group. Intraoperative iris prolapses occurred in 8% of cases only in the first group. Posterior capsule rupture was observed in only 1 patient in second group. Conclusion. Our technique, «Viscoblock», allows us to limit the penetration of irrigation fluid through the Zonula ciliaris in 76% of cases. However, it should be noted that the method does not provide complete prevention of AHM detachment, as it may already exist in some patients. Additionally, we cannot exclude partial washout of viscoelastic substance during the surgery, which can reduce the tamponade effect. Key words: vitreo-lenticular interface, Berger's space, intraoperative fluid misdirection syndrome, optical coherence tomography, ultrasound biomicroscopy, «Viscoblock», cataract, lens zonular fibers, vitreous body, posterior lens capsule, anterior hyaloid membrane, intraocular lens","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"40 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139011841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-27-36
S. Shukhaev
Purpose. To elaborate the customized principle of determining the actual zone of the corneal astigmatism based on keratotopographic data and compare the accuracy of calculating the toric IOL according to the actual zone and conventional keratometry. Material and methods. The study included 48 patients (48 eyes) who underwent toric IOL implantation. 3–6 months (5.1±0.6) after surgery, all patients were measured the residual refractive astigmatism. The toric IOL was retrospectively calculated according to the data of the actual keratotopographic zone determined by the proposed method (1st group) and according to conventional keratometry (2nd group). Vector and centroid analyses were used to estimate the error in calculating the IOL toricity. Results. The principles of determining the actual zone are based on the assumption that maximum visual acuity and visual quality can be achieved when the regularity of astigmatism in the central parts of the cornea corresponds to the regularity of toric IOL. The mean diameter of the selected actual zone was 2.93±0.61 (from 2.0 to 4.3 mm respectively). The average vector error of toricity calculation in 1st group was 0.30±0.31, in 2nd group – 0.42±0.30 (p=0.006). Centroid analysis showed similar values of centroid error in 1st group and 2nd group (0.09 and 0.08), while the dispersion was higher in 2nd group (0.42 and 0.51, respectively). Conclusion. The customized principle of selecting the actual zone according to topographic maps of the cornea showed a more accurate calculation of the IOL toricity compared with the use of conventional keratometry data. Key words: toric IOL, corneal astigmatism, IOL calculation accuracy, keratometry, keratotopography
{"title":"Selection of keratometric data for the IOL toricity calculation","authors":"S. Shukhaev","doi":"10.25276/0235-4160-2023-3s-27-36","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-27-36","url":null,"abstract":"Purpose. To elaborate the customized principle of determining the actual zone of the corneal astigmatism based on keratotopographic data and compare the accuracy of calculating the toric IOL according to the actual zone and conventional keratometry. Material and methods. The study included 48 patients (48 eyes) who underwent toric IOL implantation. 3–6 months (5.1±0.6) after surgery, all patients were measured the residual refractive astigmatism. The toric IOL was retrospectively calculated according to the data of the actual keratotopographic zone determined by the proposed method (1st group) and according to conventional keratometry (2nd group). Vector and centroid analyses were used to estimate the error in calculating the IOL toricity. Results. The principles of determining the actual zone are based on the assumption that maximum visual acuity and visual quality can be achieved when the regularity of astigmatism in the central parts of the cornea corresponds to the regularity of toric IOL. The mean diameter of the selected actual zone was 2.93±0.61 (from 2.0 to 4.3 mm respectively). The average vector error of toricity calculation in 1st group was 0.30±0.31, in 2nd group – 0.42±0.30 (p=0.006). Centroid analysis showed similar values of centroid error in 1st group and 2nd group (0.09 and 0.08), while the dispersion was higher in 2nd group (0.42 and 0.51, respectively). Conclusion. The customized principle of selecting the actual zone according to topographic maps of the cornea showed a more accurate calculation of the IOL toricity compared with the use of conventional keratometry data. Key words: toric IOL, corneal astigmatism, IOL calculation accuracy, keratometry, keratotopography","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"39 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139011893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-37-48
M. Gushchina, S. Butsan, V. Sergeeva, K. Salikhov, A. V. Tereshchenko, E. Erokhina, S.A. Malkov
Relevance. Trigeminal nerve defeat can lead to the development of neurotrophic keratopathy. The only pathogenetically justified method of treating this pathology is corneal neurotization. Purpose. To develop rehabilitation tactic for the patients with neurotrophic keratopathy based on the analysis of the results of operations performed according to the author's technique of direct corneal neurotization. Material and methods. 10 direct corneal neurotizations: with initial manifestations – in 2 cases and in the advanced stage of neurotrophic keratopathy – in 8 cases. Results and discussion. Postoperative period proceeded without complications. Corneal sensitivity was restored in 60%. In all cases, corneal transparency improved, the density of the eyesore and the depth of the invasion of opacities decreased, subbasal nerve fibers began to be visualized, positive dynamic in the state of tear production were observed. Perforation defects of the cornea was closed. In initial stage of the disease corneal opacity has almost completely regressed. Conclusion. Direct corneal neurotization provides restoration of its sensitivity, prevention of neurotrophic keratopathy, which provides medical and social rehabilitation. Key words: facial nerve, paralytic lagophthalmos, abductive nerve, convergent paralytic strabismus, trigeminal nerve, corneal innervation, corneal opacity, corneal sensitivity, esthesiometry, supraorbital nerve, supratrochlear nerve
{"title":"Results of neurotrophic keratopathy treatment by direct corneal neurotization","authors":"M. Gushchina, S. Butsan, V. Sergeeva, K. Salikhov, A. V. Tereshchenko, E. Erokhina, S.A. Malkov","doi":"10.25276/0235-4160-2023-3s-37-48","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-37-48","url":null,"abstract":"Relevance. Trigeminal nerve defeat can lead to the development of neurotrophic keratopathy. The only pathogenetically justified method of treating this pathology is corneal neurotization. Purpose. To develop rehabilitation tactic for the patients with neurotrophic keratopathy based on the analysis of the results of operations performed according to the author's technique of direct corneal neurotization. Material and methods. 10 direct corneal neurotizations: with initial manifestations – in 2 cases and in the advanced stage of neurotrophic keratopathy – in 8 cases. Results and discussion. Postoperative period proceeded without complications. Corneal sensitivity was restored in 60%. In all cases, corneal transparency improved, the density of the eyesore and the depth of the invasion of opacities decreased, subbasal nerve fibers began to be visualized, positive dynamic in the state of tear production were observed. Perforation defects of the cornea was closed. In initial stage of the disease corneal opacity has almost completely regressed. Conclusion. Direct corneal neurotization provides restoration of its sensitivity, prevention of neurotrophic keratopathy, which provides medical and social rehabilitation. Key words: facial nerve, paralytic lagophthalmos, abductive nerve, convergent paralytic strabismus, trigeminal nerve, corneal innervation, corneal opacity, corneal sensitivity, esthesiometry, supraorbital nerve, supratrochlear nerve","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"44 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139011661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-82-89
A. A. Suetov, T. Doktorova, N. A. Molodkina
Purpose. To study the hypotensive effect of selective laser trabeculoplasty (SLT) treatment in cases of insufficient effectiveness or reduced hypotensive effect of glaucoma surgery in patients with moderate and advanced primary open-angle glaucoma (POAG). Material and methods. A retrospective study was conducted of 32 patients (32 eyes) with POAG after previous glaucoma surgery and uncompensated intraocular pressure (IOP), who underwent SLT due to the impossibility of reoperation. Changes in IOP were studied 1 day, 1, 3, 6 and 12 months after SLT. Results. After SLT, the IOP level decreased from 24.5±4.4 to 19.3±3.8 mm Hg after 1 day (p<0.001), the hypotensive effect was 5.2±5.1 mm Hg (21.2% of the baseline IOP) and did not change significantly within 3 months after laser treatment. After 6 and 12 months, a decrease in the hypotensive effect was revealed compared with the primary response 1 day after SLT (3.0±2.9 and 1.9±5.4 mm Hg, p=0.02). 12 months after SLT, the IOP level remained below the baseline IOP only in 46.9% of cases. There were no significant differences in the results of SLT at different stages of POAG, different types of glaucoma surgery, different medication regimens (p>0.05), and there was no dependence on the timing after previous glaucoma surgery. Conclusion. SLT can be used after previous glaucoma surgery when IOP reduction is insufficient in patients with moderate and advanced POAG. However, the hypotensive effect of SLT in such cases is unstable, so this method of treatment should be considered only as an auxiliary one and if repeated surgery is not possible, as well as providing more frequent control of IOP in patients. Key words: glaucoma, selective laser trabeculoplasty, intraocular pressure, glaucoma surgery, ophthalmic surgery
{"title":"Selective laser trabeculoplasty (SLT) after glaucoma surgery in moderate and advanced primary open-angle glaucoma","authors":"A. A. Suetov, T. Doktorova, N. A. Molodkina","doi":"10.25276/0235-4160-2023-3s-82-89","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-82-89","url":null,"abstract":"Purpose. To study the hypotensive effect of selective laser trabeculoplasty (SLT) treatment in cases of insufficient effectiveness or reduced hypotensive effect of glaucoma surgery in patients with moderate and advanced primary open-angle glaucoma (POAG). Material and methods. A retrospective study was conducted of 32 patients (32 eyes) with POAG after previous glaucoma surgery and uncompensated intraocular pressure (IOP), who underwent SLT due to the impossibility of reoperation. Changes in IOP were studied 1 day, 1, 3, 6 and 12 months after SLT. Results. After SLT, the IOP level decreased from 24.5±4.4 to 19.3±3.8 mm Hg after 1 day (p<0.001), the hypotensive effect was 5.2±5.1 mm Hg (21.2% of the baseline IOP) and did not change significantly within 3 months after laser treatment. After 6 and 12 months, a decrease in the hypotensive effect was revealed compared with the primary response 1 day after SLT (3.0±2.9 and 1.9±5.4 mm Hg, p=0.02). 12 months after SLT, the IOP level remained below the baseline IOP only in 46.9% of cases. There were no significant differences in the results of SLT at different stages of POAG, different types of glaucoma surgery, different medication regimens (p>0.05), and there was no dependence on the timing after previous glaucoma surgery. Conclusion. SLT can be used after previous glaucoma surgery when IOP reduction is insufficient in patients with moderate and advanced POAG. However, the hypotensive effect of SLT in such cases is unstable, so this method of treatment should be considered only as an auxiliary one and if repeated surgery is not possible, as well as providing more frequent control of IOP in patients. Key words: glaucoma, selective laser trabeculoplasty, intraocular pressure, glaucoma surgery, ophthalmic surgery","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"42 39","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139011828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-49-53
M. Sinitsyn, N. Pozdeeva, S. Bodrova, O. V. Shlenskaya, O. Tikhonova, A.E. Terenteva
Purpose. Analysis of clinical and functional results of correction of postkeratoplastic ametropia with rigid gas-permeable scleral lenses. Material and methods. Clinical and functional results of the correction of postkeratoplastic ametropia (PA) with rigid gas-permeable scleral lenses (RGSL) were analyzed based on a comprehensive examination of 25 eyes (25 patients). Of these, there were 16 men and 9 women. The mean age of the patients was 40±9 years. Uncorrected visual acuity (UCVA) was 0.14±0.16, best corrected visual acuity (BCVA) with glasses was 0.44±0.25, the spherical refractive component was 1.37±2.58 D, the cylindrical refractive component was –4,75±1.68 D. The follow-up period was about 5 years. Results. After application of RGSL, all patients noted a significant improvement in visual acuity due to the correction of PA and an increase in the regularity of the corneal graft. There was a statistically significant increase in BCVA in RGSL up to 0.66±0.13 (p=0.0022), which remained stable throughout the entire observation period. BCVA in RGSL 0.5 and above was noted in 93% of the eyes. In all patients, after the selection of RGSL, a significant decrease in total corneal aberrations, including higher order ones, was noted. When calculating the cell density of the epithelium of the corneal graft on HRT III Cornea after 5 years of wearing RGSL, a decrease in the cell density of all layers of the epithelium was noted. The absence of endothelial cell density loss, clinically significant corneal graft edema, and reduction in the biomechanical properties of the corneal graft indicate the safety of long-term use of RGSL in patients after keratoplasty. Conclusion. Clinical and functional analysis of the correction of postkeratoplastic ametropia with rigid gas-permeable scleral lenses during 5 years of observation showed: higher rates of best corrected visual acuity compared to spectacle correction by an average of 0.22±0.05, a significant decrease in corneal aberrations, a decrease in the density of cells of all corneal graft epithelium layers, high optical efficiency, and safety of their use during the entire observation period. Key words: postkeratoplastic ametropia, rigid gas-permeable scleral lens, corneal graft
{"title":"Scleral lenses application for the correction of postkeratoplastic ametropia","authors":"M. Sinitsyn, N. Pozdeeva, S. Bodrova, O. V. Shlenskaya, O. Tikhonova, A.E. Terenteva","doi":"10.25276/0235-4160-2023-3s-49-53","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-49-53","url":null,"abstract":"Purpose. Analysis of clinical and functional results of correction of postkeratoplastic ametropia with rigid gas-permeable scleral lenses. Material and methods. Clinical and functional results of the correction of postkeratoplastic ametropia (PA) with rigid gas-permeable scleral lenses (RGSL) were analyzed based on a comprehensive examination of 25 eyes (25 patients). Of these, there were 16 men and 9 women. The mean age of the patients was 40±9 years. Uncorrected visual acuity (UCVA) was 0.14±0.16, best corrected visual acuity (BCVA) with glasses was 0.44±0.25, the spherical refractive component was 1.37±2.58 D, the cylindrical refractive component was –4,75±1.68 D. The follow-up period was about 5 years. Results. After application of RGSL, all patients noted a significant improvement in visual acuity due to the correction of PA and an increase in the regularity of the corneal graft. There was a statistically significant increase in BCVA in RGSL up to 0.66±0.13 (p=0.0022), which remained stable throughout the entire observation period. BCVA in RGSL 0.5 and above was noted in 93% of the eyes. In all patients, after the selection of RGSL, a significant decrease in total corneal aberrations, including higher order ones, was noted. When calculating the cell density of the epithelium of the corneal graft on HRT III Cornea after 5 years of wearing RGSL, a decrease in the cell density of all layers of the epithelium was noted. The absence of endothelial cell density loss, clinically significant corneal graft edema, and reduction in the biomechanical properties of the corneal graft indicate the safety of long-term use of RGSL in patients after keratoplasty. Conclusion. Clinical and functional analysis of the correction of postkeratoplastic ametropia with rigid gas-permeable scleral lenses during 5 years of observation showed: higher rates of best corrected visual acuity compared to spectacle correction by an average of 0.22±0.05, a significant decrease in corneal aberrations, a decrease in the density of cells of all corneal graft epithelium layers, high optical efficiency, and safety of their use during the entire observation period. Key words: postkeratoplastic ametropia, rigid gas-permeable scleral lens, corneal graft","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"81 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138983671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-72-81
A. V. Tereshchenko, I. G. Trifanenkova, Y. Sidorova, E. Erokhina, N. Shilov, N. Yudina, O.M. Zhukova
Purpose. To develop an algorithm for the treatment of patients with advanced proliferative diabetic retinopathy with the determination of the stages of laser and surgical methods and evaluate its effectiveness. Material and methods. The study group included 38 patients (38 eyes) with type 1 diabetes mellitus (21 patients) and type 2 diabetes mellitus (17 patients, 16 of them with the insulin-requiring form of the disease). Patients age ranged from 24 to 75 years (41±8.6 years) old. All patients underwent staged treatment. Primary subtotal three-port 27 G vitrectomy was performed. Transpupillary patterned panretinal laser coagulation was performed at 1,5–2 months after the first stage of treatment. Panretinal laser coagulation was performed with a hexagonal matrix pattern with a laser spot diameter of 300 µm, exposure time of 30 ms on an Integre Pro Scan laser device (Ellex, Australia) with a wavelength of 561 nm using a panfundus lens. In cases of gas-air tamponade, panretinal laser coagulation was performed according to the same parameters in two sessions with an interval of 1–2 months between them, the average number of coagulates per session was 1053±107 applications. As the third stage of treatment, 1,5–2 months after panretinal laser coagulation, those patients whose vitreal cavity was tamponed with silicone oil underwent vitrectomy with the removal of silicone oil and it's replacement with a balanced solution. Results. The total number of treatment steps in the observation group (n=34) ranged from 1 to 5 and averaged 3±0.97. The time from primary vitrectomy followed by patterned panretinal laser coagulation to silicone oil removal was at average 3.7±0.48 months. Performing primary subtotal vitrectomy as the first stage of combined treatment made it possible achieve retinal attachment and its visualization throughout, to perform surgical intervention without massive endolaser coagulation, which reduced the duration of surgery and accelerated postoperative rehabilitation. The subsequent transpupillary panretinal laser coagulation of the retina in the pattern mode provided a dosed precision effect on the retina and made it possible perform the laser stage of treatment in one session. Conclusion. A step-by-step algorithm, including primary subtotal vitrectomy followed by simultaneous transpupillary pattern laser coagulation of the retina, is effective and safe in the treatment of proliferative diabetic retinopathy complicated by hemophthalmos. Key words: proliferative diabetic retinopathy, treatment algorithm, surgical treatment, laser treatment, vitrectomy, pattern laser coagulation
{"title":"Algorithm for the treatment of advanced proliferative diabetic retinopathy","authors":"A. V. Tereshchenko, I. G. Trifanenkova, Y. Sidorova, E. Erokhina, N. Shilov, N. Yudina, O.M. Zhukova","doi":"10.25276/0235-4160-2023-3s-72-81","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-72-81","url":null,"abstract":"Purpose. To develop an algorithm for the treatment of patients with advanced proliferative diabetic retinopathy with the determination of the stages of laser and surgical methods and evaluate its effectiveness. Material and methods. The study group included 38 patients (38 eyes) with type 1 diabetes mellitus (21 patients) and type 2 diabetes mellitus (17 patients, 16 of them with the insulin-requiring form of the disease). Patients age ranged from 24 to 75 years (41±8.6 years) old. All patients underwent staged treatment. Primary subtotal three-port 27 G vitrectomy was performed. Transpupillary patterned panretinal laser coagulation was performed at 1,5–2 months after the first stage of treatment. Panretinal laser coagulation was performed with a hexagonal matrix pattern with a laser spot diameter of 300 µm, exposure time of 30 ms on an Integre Pro Scan laser device (Ellex, Australia) with a wavelength of 561 nm using a panfundus lens. In cases of gas-air tamponade, panretinal laser coagulation was performed according to the same parameters in two sessions with an interval of 1–2 months between them, the average number of coagulates per session was 1053±107 applications. As the third stage of treatment, 1,5–2 months after panretinal laser coagulation, those patients whose vitreal cavity was tamponed with silicone oil underwent vitrectomy with the removal of silicone oil and it's replacement with a balanced solution. Results. The total number of treatment steps in the observation group (n=34) ranged from 1 to 5 and averaged 3±0.97. The time from primary vitrectomy followed by patterned panretinal laser coagulation to silicone oil removal was at average 3.7±0.48 months. Performing primary subtotal vitrectomy as the first stage of combined treatment made it possible achieve retinal attachment and its visualization throughout, to perform surgical intervention without massive endolaser coagulation, which reduced the duration of surgery and accelerated postoperative rehabilitation. The subsequent transpupillary panretinal laser coagulation of the retina in the pattern mode provided a dosed precision effect on the retina and made it possible perform the laser stage of treatment in one session. Conclusion. A step-by-step algorithm, including primary subtotal vitrectomy followed by simultaneous transpupillary pattern laser coagulation of the retina, is effective and safe in the treatment of proliferative diabetic retinopathy complicated by hemophthalmos. Key words: proliferative diabetic retinopathy, treatment algorithm, surgical treatment, laser treatment, vitrectomy, pattern laser coagulation","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"251 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138983778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-16-26
E.V. Boiko, M. Nemsitsveridze, S. Shukhaev, E.A. Simak
Purpose. Based on a comparative analysis of the results of using various laser methods of cataract treatment in the process of developing energy surgery in the St. Petersburg branch The S. Fyodorov Eye Microsurgery Federal State Institution, to determine the advantages and disadvantages of the technologies used. Material and methods. Analysis of the results of laser cataract extraction, ultrasonic phacoemulsification and combined surgery is based on data from a study of 28 802 surgical interventions (Phacoemulsification (Phaco) – 15 520, laser cataract extraction (LCE) – 7945, FemtoPhaco – 5135, FemtoLCE – 202) performed over the period 1995–2022. Results.The operative complication rate was 0.6, 0.55, 0.5 and 0% for Phaco, LCE, FemtoPhaco and FemtoLCE respectively. Visual acuity after LCE and FemtoLCE >0.8 was observed in more than 70% of cases, and in other groups such a functional result was achieved in 57% of cases. Comparing the postoperative spherical equivalent, a significant difference was noted only between the FemtoPhaco and standard Phaco (p=0.03), and between FemtoLCE and LCE groups (p=0.01), it indicates the advantage of femtolaser support for cataract surgery getting in target refraction. Analysis of endothelial cells loss reflects a significant advantage in groups with femtolaser support (p=0.01; p=0.02), as well as in the group of LCE and FemtoLCE over standard Phaco (p=0.01; p=0.02, respectively). Conclusion. Laser cataract extraction is an effective and safe technology that can be compared to ultrasonic phacoemulsification. The use of femtosecond laser assistance provides significantly lower deviation from the planned postoperative refraction. Modern laser technologies are safe and can reduce the risk of endothelial loss more effectively than standard Phaco. Key words: laser cataract extraction, femtosecond laser, femto laser assisted cataract surgery, cataract phacoemulsification, endothelial cell density
{"title":"Energy cataract surgery in the St. Petersburg branch of the S. Fyodorov Eye Microsurgery State Institution: analysis of 27-year experience","authors":"E.V. Boiko, M. Nemsitsveridze, S. Shukhaev, E.A. Simak","doi":"10.25276/0235-4160-2023-3s-16-26","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-16-26","url":null,"abstract":"Purpose. Based on a comparative analysis of the results of using various laser methods of cataract treatment in the process of developing energy surgery in the St. Petersburg branch The S. Fyodorov Eye Microsurgery Federal State Institution, to determine the advantages and disadvantages of the technologies used. Material and methods. Analysis of the results of laser cataract extraction, ultrasonic phacoemulsification and combined surgery is based on data from a study of 28 802 surgical interventions (Phacoemulsification (Phaco) – 15 520, laser cataract extraction (LCE) – 7945, FemtoPhaco – 5135, FemtoLCE – 202) performed over the period 1995–2022. Results.The operative complication rate was 0.6, 0.55, 0.5 and 0% for Phaco, LCE, FemtoPhaco and FemtoLCE respectively. Visual acuity after LCE and FemtoLCE >0.8 was observed in more than 70% of cases, and in other groups such a functional result was achieved in 57% of cases. Comparing the postoperative spherical equivalent, a significant difference was noted only between the FemtoPhaco and standard Phaco (p=0.03), and between FemtoLCE and LCE groups (p=0.01), it indicates the advantage of femtolaser support for cataract surgery getting in target refraction. Analysis of endothelial cells loss reflects a significant advantage in groups with femtolaser support (p=0.01; p=0.02), as well as in the group of LCE and FemtoLCE over standard Phaco (p=0.01; p=0.02, respectively). Conclusion. Laser cataract extraction is an effective and safe technology that can be compared to ultrasonic phacoemulsification. The use of femtosecond laser assistance provides significantly lower deviation from the planned postoperative refraction. Modern laser technologies are safe and can reduce the risk of endothelial loss more effectively than standard Phaco. Key words: laser cataract extraction, femtosecond laser, femto laser assisted cataract surgery, cataract phacoemulsification, endothelial cell density","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"73 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138983864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.25276/0235-4160-2023-3s-116-120
S. S. Shamkin, S. N. Subbotina, A. Stepanyants
Relevance. Currently, there is no single algorithm for the management of patients with extensive penetrating wounds of the sclera, and the frequency of proliferative vitreoretinopathy, leading to adverse outcomes, is very high. Purpose. To present relevant data about prevention of proliferative vitreoretinopathy with extensive penetrating wounds of the sclera, as well as to identify the most effective methods. Material and methods. To complete this review, a literature search was carried out on the databases CyberLeninka, eLIBRARY, PubMed, using the keywords «proliferative vitreoretinopathy», «penetrating wounds of the sclera», «eye injury», «vitrectomy». Preference was given to scientific papers over the past 15 years. Results. There are various approaches in the treatment of severe penetrating wounds. Classical primary microsurgical treatment involves external treatment, suturing of the sclera wound, and delayed optical-reconstructive surgery (including vitrectomy) are performed 1–2 weeks after the acute inflammation reduces. As a rule, in the case of extensive wounds with a whole set of concomitant risk factors, this time is sufficient to trigger pathological proliferation, which aggravates the course of the wound process. This review presents publications proving that the treatment of severe complicated penetrating wounds of the sclera should go beyond the classical treatment and be aimed at early warning and prevention of proliferative vitreoretinopathy. Conclusion. Modern data prove the indisputable advantage of early vitrectomy performed with extensive penetrating scleral and corneoscleral wounds. Vitrectomy in combination with other methods of prevention of proliferative vitreoretinopathy is the most promising direction for the future research. Key words: proliferative vitreoretinopathy, penetrating wounds of the sclera, eye injury, vitrectomy
{"title":"Proliferative vitreoretinopathy and it's prevention in cases of extensive penetrating wounds of the sclera","authors":"S. S. Shamkin, S. N. Subbotina, A. Stepanyants","doi":"10.25276/0235-4160-2023-3s-116-120","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-3s-116-120","url":null,"abstract":"Relevance. Currently, there is no single algorithm for the management of patients with extensive penetrating wounds of the sclera, and the frequency of proliferative vitreoretinopathy, leading to adverse outcomes, is very high. Purpose. To present relevant data about prevention of proliferative vitreoretinopathy with extensive penetrating wounds of the sclera, as well as to identify the most effective methods. Material and methods. To complete this review, a literature search was carried out on the databases CyberLeninka, eLIBRARY, PubMed, using the keywords «proliferative vitreoretinopathy», «penetrating wounds of the sclera», «eye injury», «vitrectomy». Preference was given to scientific papers over the past 15 years. Results. There are various approaches in the treatment of severe penetrating wounds. Classical primary microsurgical treatment involves external treatment, suturing of the sclera wound, and delayed optical-reconstructive surgery (including vitrectomy) are performed 1–2 weeks after the acute inflammation reduces. As a rule, in the case of extensive wounds with a whole set of concomitant risk factors, this time is sufficient to trigger pathological proliferation, which aggravates the course of the wound process. This review presents publications proving that the treatment of severe complicated penetrating wounds of the sclera should go beyond the classical treatment and be aimed at early warning and prevention of proliferative vitreoretinopathy. Conclusion. Modern data prove the indisputable advantage of early vitrectomy performed with extensive penetrating scleral and corneoscleral wounds. Vitrectomy in combination with other methods of prevention of proliferative vitreoretinopathy is the most promising direction for the future research. Key words: proliferative vitreoretinopathy, penetrating wounds of the sclera, eye injury, vitrectomy","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"108 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138983790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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