Pub Date : 2023-06-21DOI: 10.25276/0235-4160-2023-2-62-69
B. Malyugin, S. Kalinnikova, R. Isabekov, O. Antonova, A. V. Fomin
Purpose. To describe three clinical cases of corneal vascularization of different etiologies, to evaluate the possibilities of the method of optical coherence tomography of anterior segment in the mode of angiography (AS-OCTA) in diagnostic and selection of treatment strategies of corneal diseases, as well as to provide diagnostic protocol. Material and methods. For the first time AS-OCTА was performed at the S. Fyodorov Eye Microsurgery (Moscow). The presented clinical cases included three patients with different pathologies of the anterior segment of the eye: postherpetic neovascularization, superficial epithelial fibroplasia and limbal stem cell deficiency syndrome (LSCD). The scan was performed on an Avanti xR optical coherence tomography device (Optovue Inc. Fremont, California, USA) in the «OCT» and «Angio OCT» modes using the AngioVue program and the SSADA algorithm. Results. In the presented clinical cases, the use of AS-OCTA makes possible to accurately assess the depth, area and architectonics of the vessels, and helps to determine the tactics of surgical treatment and type of keratoplasty. However, the disadvantages of this technique include the complexity and long time required for its implementation, as well as the appearance of a large number of artifacts even with minimal eye movement of patients. At the same time, in the presence of a qualified operator and with proper compliance with the patient, it is possible to obtain valuable diagnostic data. Conclusion. Our study is the first in the Russian Federation to demonstrate the use of anterior segment OCT angiography to visualize the corneal vasculature and provide a protocol for performing it on an Avanti xR optical coherence tomograph. In this preliminary study of patients with corneal neovascularization, we regard the results obtained using AS-OCTA as promising for non-invasive vascular imaging, in particular, before and after the treatment of various conditions with corneal neovascularization. Key words: cornea, neovascularization, limbal stem cell deficiency, anterior segment optical coherence tomography, angiography, corneal limbal vasculature
{"title":"The possibilities of optical coherence tomography of the anterior segment in the angio mode (AS-OCTA) in the diagnosis and tactics of surgical treatment of corneal diseases","authors":"B. Malyugin, S. Kalinnikova, R. Isabekov, O. Antonova, A. V. Fomin","doi":"10.25276/0235-4160-2023-2-62-69","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-2-62-69","url":null,"abstract":"Purpose. To describe three clinical cases of corneal vascularization of different etiologies, to evaluate the possibilities of the method of optical coherence tomography of anterior segment in the mode of angiography (AS-OCTA) in diagnostic and selection of treatment strategies of corneal diseases, as well as to provide diagnostic protocol. Material and methods. For the first time AS-OCTА was performed at the S. Fyodorov Eye Microsurgery (Moscow). The presented clinical cases included three patients with different pathologies of the anterior segment of the eye: postherpetic neovascularization, superficial epithelial fibroplasia and limbal stem cell deficiency syndrome (LSCD). The scan was performed on an Avanti xR optical coherence tomography device (Optovue Inc. Fremont, California, USA) in the «OCT» and «Angio OCT» modes using the AngioVue program and the SSADA algorithm. Results. In the presented clinical cases, the use of AS-OCTA makes possible to accurately assess the depth, area and architectonics of the vessels, and helps to determine the tactics of surgical treatment and type of keratoplasty. However, the disadvantages of this technique include the complexity and long time required for its implementation, as well as the appearance of a large number of artifacts even with minimal eye movement of patients. At the same time, in the presence of a qualified operator and with proper compliance with the patient, it is possible to obtain valuable diagnostic data. Conclusion. Our study is the first in the Russian Federation to demonstrate the use of anterior segment OCT angiography to visualize the corneal vasculature and provide a protocol for performing it on an Avanti xR optical coherence tomograph. In this preliminary study of patients with corneal neovascularization, we regard the results obtained using AS-OCTA as promising for non-invasive vascular imaging, in particular, before and after the treatment of various conditions with corneal neovascularization. Key words: cornea, neovascularization, limbal stem cell deficiency, anterior segment optical coherence tomography, angiography, corneal limbal vasculature","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126028102","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 : 2023-06-21DOI: 10.25276/0235-4160-2023-2-54-61
A.Y. Keymenov
Currently, the use of platelet-rich plasma (PRP) is one of the successful areas of tissue engineering and cell therapy. In medicine PRP is widely used in ophthalmosurgery, in particular for macular hole (MH) closure. Purpose. To evaluate cellular composition of PRP in order to optimize its use in macular hole surgery. Material and methods. This study included platelet-rich plasma analysis of 20 patients (6 male and 14 female) who underwent surgical treatment of macular hole in Eye Microsurgery Center in the period from April till July 2021. Patients' age ranged from 57 to 82 (69,0±1.2) years. Ycellbio-Kit was used to obtain PRP. As a result of centrifugation 2 main blood fractions were obtained: plasma and erythrocyte layer. The study of the contents of the test tube was performed on 4 levels. The main attention was paid to the quantitative composition of platelets and leukocytes, which are the most important and significant in MH surgery. Results. The following platelet and leukocyte count in the general blood test and PRP were obtained as a result of the study. General blood test – platelet concentration was 140 to 285•10³/µL (215.85±9.23), P-PRP (pure platelet-rich plasma) – 699 to 5681•10³/µL (2600.4±329.9), L-PRP (plasma containing platelets and leukocytes) – 1995 to 9989•10³/µL (6555.8±506.7) (p<0.001). General blood test – white blood cell concentration was 3.83 to 7.73•10³/µL (5.58±0.29), P-PRP was 0.02 to 7.08•10³/µL (1.49±0.58), L-PRP was 6.12–494.69•10³/µL (99.3±38.1) (p<0.01). Conclusion. Platelet-rich plasma has regenerative activity and contractile properties in both fractions – in P-PRP and L-PRP, which simplifies the process of PRP extraction from the test tube and expands the possibilities for its use in MH surgery and other retinal pathologies associated with retinal tears. Given the lowest leukocyte concentration, the P-PRP fraction may be optimal for MH surgery. Key words: macular rupture, platelet-enriched plasma, platelets, leukocytes
{"title":"Сellular composition of platelet-rich plasma evaluation in order to optimize its use in macular hole surgery. Part 1","authors":"A.Y. Keymenov","doi":"10.25276/0235-4160-2023-2-54-61","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-2-54-61","url":null,"abstract":"Currently, the use of platelet-rich plasma (PRP) is one of the successful areas of tissue engineering and cell therapy. In medicine PRP is widely used in ophthalmosurgery, in particular for macular hole (MH) closure. Purpose. To evaluate cellular composition of PRP in order to optimize its use in macular hole surgery. Material and methods. This study included platelet-rich plasma analysis of 20 patients (6 male and 14 female) who underwent surgical treatment of macular hole in Eye Microsurgery Center in the period from April till July 2021. Patients' age ranged from 57 to 82 (69,0±1.2) years. Ycellbio-Kit was used to obtain PRP. As a result of centrifugation 2 main blood fractions were obtained: plasma and erythrocyte layer. The study of the contents of the test tube was performed on 4 levels. The main attention was paid to the quantitative composition of platelets and leukocytes, which are the most important and significant in MH surgery. Results. The following platelet and leukocyte count in the general blood test and PRP were obtained as a result of the study. General blood test – platelet concentration was 140 to 285•10³/µL (215.85±9.23), P-PRP (pure platelet-rich plasma) – 699 to 5681•10³/µL (2600.4±329.9), L-PRP (plasma containing platelets and leukocytes) – 1995 to 9989•10³/µL (6555.8±506.7) (p<0.001). General blood test – white blood cell concentration was 3.83 to 7.73•10³/µL (5.58±0.29), P-PRP was 0.02 to 7.08•10³/µL (1.49±0.58), L-PRP was 6.12–494.69•10³/µL (99.3±38.1) (p<0.01). Conclusion. Platelet-rich plasma has regenerative activity and contractile properties in both fractions – in P-PRP and L-PRP, which simplifies the process of PRP extraction from the test tube and expands the possibilities for its use in MH surgery and other retinal pathologies associated with retinal tears. Given the lowest leukocyte concentration, the P-PRP fraction may be optimal for MH surgery. Key words: macular rupture, platelet-enriched plasma, platelets, leukocytes","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116496519","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 : 2023-06-21DOI: 10.25276/0235-4160-2023-2-28-35
A. V. Tereshchenko, M. Timofeev, I. G. Trifanenkova, S. K. Demyanchenko
Purpose. To analyze the clinical and functional results of modified femtolaser refractive autokeratoplasty and evaluate its effectiveness in patients with keratoconus during a follow-up period of 36 months. Material and methods. The study included 24 patients (13 men and 11 women) diagnosed with stage 2 keratoconus according to the Amsler, 1998 classification. The age of the patients ranged from 25 to 37 years (mean 31±6 years). Taking into account the initial parameters of the spherical and cylindrical components, as well as biometric parameters, which indicated the deliberate ineffectiveness of intrastromal keratoplasty (ISKP) in this group, all patients were performed femtolaser refractive autokeratoplasty (FRAK) according to a modified technique using a Femto LDV Z8 femtolaser unit (Ziemer, Switzerland). Results. An analysis of the clinical and functional results of the modified FRAK technique for topographically centrally located keratoconus showed that this technology provides a stable refractive effect in patients with stage 2 keratoconus during a follow-up period of 36 months. Performing personalized FRAK according to indications provides an increase in corrected visual acuity already in the early postoperative period with a tendency to further increase an average up to 0,46±0,08 by 36 months after surgery, as well as stable state of the ecstatic process throughout the entire follow-up. Conclusion. The modified FRAK technology is effective and can be successfully used in the early stages of keratoconus in cases with initial low visual acuity and axial myopia. Key words: keratoconus, femtolaser refractive autokeratoplasty
{"title":"Clinical and functional results of modified femtolaser refractive autokeratoplasty in patients with keratoconus","authors":"A. V. Tereshchenko, M. Timofeev, I. G. Trifanenkova, S. K. Demyanchenko","doi":"10.25276/0235-4160-2023-2-28-35","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-2-28-35","url":null,"abstract":"Purpose. To analyze the clinical and functional results of modified femtolaser refractive autokeratoplasty and evaluate its effectiveness in patients with keratoconus during a follow-up period of 36 months. Material and methods. The study included 24 patients (13 men and 11 women) diagnosed with stage 2 keratoconus according to the Amsler, 1998 classification. The age of the patients ranged from 25 to 37 years (mean 31±6 years). Taking into account the initial parameters of the spherical and cylindrical components, as well as biometric parameters, which indicated the deliberate ineffectiveness of intrastromal keratoplasty (ISKP) in this group, all patients were performed femtolaser refractive autokeratoplasty (FRAK) according to a modified technique using a Femto LDV Z8 femtolaser unit (Ziemer, Switzerland). Results. An analysis of the clinical and functional results of the modified FRAK technique for topographically centrally located keratoconus showed that this technology provides a stable refractive effect in patients with stage 2 keratoconus during a follow-up period of 36 months. Performing personalized FRAK according to indications provides an increase in corrected visual acuity already in the early postoperative period with a tendency to further increase an average up to 0,46±0,08 by 36 months after surgery, as well as stable state of the ecstatic process throughout the entire follow-up. Conclusion. The modified FRAK technology is effective and can be successfully used in the early stages of keratoconus in cases with initial low visual acuity and axial myopia. Key words: keratoconus, femtolaser refractive autokeratoplasty","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122790363","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 : 2023-06-21DOI: 10.25276/0235-4160-2023-2-92-97
M. Sinitsyn, A. E. Terent’eva, T.G. Tolmacheva, N. Pozdeyeva
Purpose. The analysis of the advantages and disadvantages of existing optical methods for correcting postkeratoplastic ametropia (PA). Material and methods. When studying the literature review on PA correction, a search was carried out for sources in the PubMed and Scopus abstract databases for the period up to 2021 inclusive. In total, 50 articles related to the topic of the review were selected, including long-term observations on the methods of optical correction of PA that are currently used worldwide. Results. Today, in addition to spectacle and contact correction, there is a large selection of various methods of surgical correction of PA: wedge resection, various options for keratotomy, implantation of toric intraocular lenses, phakic toric lenses, refractive laser surgery – photorefractive keratectomy, laser in situkeratomileusis, ReLEx SMILE technology, and also implantation of intrastromal corneal segments. The choice of the most optimal optical method for PA correction, depending on the initial individual clinical and functional parameters of the patient, remains quite relevant today. This is due both to a large number of different methods of PA correction, each of which has its own advantages and disadvantages, which necessitates their improvement, and to the need to develop new techniques. Conclusion. Currently, there are a large number of various methods for correcting postkeratoplastic ametropia, each of which has its own advantages and disadvantages. It is necessary to develop a systematic approach to the personalized choice of an optical method for correcting postkeratoplastic ametropia, taking into account its effectiveness and safety, depending on the individual clinical and functional data of the patient. There is a need for the development of new methods of correction that would effectively and safely correct high values of postkeratoplastic ametropia, especially with an asymmetric type of keratotopogram. Key words: postkeratoplastic ametropia, femtosecond laser, corneal segments, scleral contact lenses
{"title":"Optical methods for the correction of postkeratoplastic ametropia","authors":"M. Sinitsyn, A. E. Terent’eva, T.G. Tolmacheva, N. Pozdeyeva","doi":"10.25276/0235-4160-2023-2-92-97","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-2-92-97","url":null,"abstract":"Purpose. The analysis of the advantages and disadvantages of existing optical methods for correcting postkeratoplastic ametropia (PA). Material and methods. When studying the literature review on PA correction, a search was carried out for sources in the PubMed and Scopus abstract databases for the period up to 2021 inclusive. In total, 50 articles related to the topic of the review were selected, including long-term observations on the methods of optical correction of PA that are currently used worldwide. Results. Today, in addition to spectacle and contact correction, there is a large selection of various methods of surgical correction of PA: wedge resection, various options for keratotomy, implantation of toric intraocular lenses, phakic toric lenses, refractive laser surgery – photorefractive keratectomy, laser in situkeratomileusis, ReLEx SMILE technology, and also implantation of intrastromal corneal segments. The choice of the most optimal optical method for PA correction, depending on the initial individual clinical and functional parameters of the patient, remains quite relevant today. This is due both to a large number of different methods of PA correction, each of which has its own advantages and disadvantages, which necessitates their improvement, and to the need to develop new techniques. Conclusion. Currently, there are a large number of various methods for correcting postkeratoplastic ametropia, each of which has its own advantages and disadvantages. It is necessary to develop a systematic approach to the personalized choice of an optical method for correcting postkeratoplastic ametropia, taking into account its effectiveness and safety, depending on the individual clinical and functional data of the patient. There is a need for the development of new methods of correction that would effectively and safely correct high values of postkeratoplastic ametropia, especially with an asymmetric type of keratotopogram. Key words: postkeratoplastic ametropia, femtosecond laser, corneal segments, scleral contact lenses","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130047557","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 : 2023-06-21DOI: 10.25276/0235-4160-2023-2-44-52
D. Shkvorchenko, O. Vedernikova, A. Shpak
Purpose. To evaluate the results of surgical treatment of lamellar macular holes (LMH) using autologous platelet-rich plasma (PRP) in comparison with the standard surgical technique. Material and methods. The study included 71 patients (71 eyes) with LMH. Of these, 39 patients (39 eyes) of the control group were operated according to the standard technique. In 32 patients (32 eyes), surgery was supplemented by the application of the autologous PRP on the hole area before the completion of the operation (PRP group). The functional and anatomical results of surgical treatment were compared. Results. There was no statistically significant difference in visual acuity improvement between the groups. In all patients of the PRP group and in the majority of patients in the control group, LMH was closed with restoration of the thickness of the retina in the area of the hole. In the control group, 6 patients had only partial closure of the LMR. In 2 cases, splitting or a smaller retinal defect was preserved. In 4 cases, partial closure of the LMR was combined with the preservation or increase of local thinning of the retina in the center of the foveola. In one of these cases, the residual thickness of the retina was only 28µm, which resembled the picture of a fullthickness macular hole. Conclusion. Surgical treatment of LMH with the use of autologous PRP is an affordable, effective surgical intervention that allows to get more favorable treatment outcomes compared to the standard surgical technique. Key words: lamellar macular hole, platelet-rich plasma, surgical treatment, vitrectomy
{"title":"Surgical outcomes of lamellar macular holes treatment using autologous platelet-rich plasma","authors":"D. Shkvorchenko, O. Vedernikova, A. Shpak","doi":"10.25276/0235-4160-2023-2-44-52","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-2-44-52","url":null,"abstract":"Purpose. To evaluate the results of surgical treatment of lamellar macular holes (LMH) using autologous platelet-rich plasma (PRP) in comparison with the standard surgical technique. Material and methods. The study included 71 patients (71 eyes) with LMH. Of these, 39 patients (39 eyes) of the control group were operated according to the standard technique. In 32 patients (32 eyes), surgery was supplemented by the application of the autologous PRP on the hole area before the completion of the operation (PRP group). The functional and anatomical results of surgical treatment were compared. Results. There was no statistically significant difference in visual acuity improvement between the groups. In all patients of the PRP group and in the majority of patients in the control group, LMH was closed with restoration of the thickness of the retina in the area of the hole. In the control group, 6 patients had only partial closure of the LMR. In 2 cases, splitting or a smaller retinal defect was preserved. In 4 cases, partial closure of the LMR was combined with the preservation or increase of local thinning of the retina in the center of the foveola. In one of these cases, the residual thickness of the retina was only 28µm, which resembled the picture of a fullthickness macular hole. Conclusion. Surgical treatment of LMH with the use of autologous PRP is an affordable, effective surgical intervention that allows to get more favorable treatment outcomes compared to the standard surgical technique. Key words: lamellar macular hole, platelet-rich plasma, surgical treatment, vitrectomy","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"85 41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130933311","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 : 2023-03-29DOI: 10.25276/0235-4160-2023-1-6-17
B. Malyugin, E. N. Panteleev, L. L. Khapaeva, S.G. Savenkov
Purpose. To evaluate clinical results of mixed ciliary-capsular fixation of a three-piece IOL in combination with the intracapsular ring's implantation during phacoemulsification in patients' zonular weakness caused by pseudoexfoliative (PEX) syndrome. Material and methods. This study included 78 patients (86 eyes) with complicated cataract and PEX syndrome associated with zonular weakness and natural lens instability. The average age of the patients was 74.3±9.3 years. Phacoemulsification was performed in a standard technique and followed by ciliary-capsular fixation of a three- piece IOL in all cases. Preoperative and postoperative follow up period lasted from 1st day until 10 months postop. It included biomicroscopy, visual acuity measurement, keratometry, tonometry, ultrasonic biomicroscopy, optical coherence tomography of the posterior segment of the eye. Results. At the 2nd day postop (86 cases) UCVA and BCVA were 0.46±0.29 and 0.58±0.27 respectively, IOP was 16.48±2.81 mm Hg; at 10 months postop (38 cases) UCVA and BCVA – 0.54±0.31 and 0.79±0.28, IOP – 15.34±3.71 mm Hg. The average deviation of the predicted refraction at the 2 days after surgery was –0.29±0.77 D with no significant change after 10 months. Efficiency ratio at 10 months postop was 193, the safety factor was 285. This type of IOL fixation didn't lead to an increase in IOP, development of chronic inflammation such as iridocyclitis or any other comorbidity. All IOLs were stable position regardless of the status of the zonular fibers. Conclusion. As a result of a preliminary study, it was found that mixed ciliary-capsular fixation of a three-piece IOL provides its stable position, high clinical and functional results in the early and late postoperative period after phacoemulsification in patients with pseudoexfoliative syndrome and failure of the lenticular ligamentous-capsular system. Key words: pseudoexfoliative syndrome, zonular weakness, intraocular lens, ciliary-capsular fixation, lens subluxation, myopic shift
目的。目的探讨超声乳化术中睫状体带性剥脱(PEX)综合征患者睫状体带性虚弱时，睫状体-晶状体混合固定联合囊内环植入术的临床效果。材料和方法。本研究纳入了78例(86只眼)伴有睫状体虚弱和自然晶状体不稳定的复杂白内障和PEX综合征患者。患者平均年龄74.3±9.3岁。所有病例均采用标准的超声乳化术，并行三件套人工晶状体睫状囊内固定。术前、术后随访时间为术后第1天至术后10个月。它包括生物显微镜、视力测量、角膜测量、眼压测量、超声生物显微镜、眼后段光学相干断层扫描。结果。术后第2天(86例)UCVA和BCVA分别为0.46±0.29和0.58±0.27,IOP为16.48±2.81 mm Hg;术后10个月(38例)UCVA和BCVA分别为- 0.54±0.31和0.79±0.28,IOP为- 15.34±3.71 mm Hg，术后2天预测屈光平均偏差为- 0.29±0.77 D，术后10个月无明显变化。术后10个月效率比为193，安全系数为285。这种类型的人工晶状体固定不会导致IOP升高、虹膜睫状体炎等慢性炎症的发展或任何其他合并症。所有人工晶状体均处于稳定位置，与带状纤维状态无关。结论。初步研究发现，对于假剥脱综合征和晶状体韧带-晶状体系统失效的患者，采用睫状体-晶状体-晶状体混合固定三片式人工晶状体在超声乳化术术后早期和后期，其位置稳定，临床和功能效果高。关键词:假性剥脱综合征，睫状体无力，人工晶状体，睫状体-晶状体固定，晶状体半脱位，近视移位
{"title":"Mixed ciliary-capsular fixation of a three-piece IOL during phacoemulsification in patients with the lenticular ligamentous-capsular system's failure","authors":"B. Malyugin, E. N. Panteleev, L. L. Khapaeva, S.G. Savenkov","doi":"10.25276/0235-4160-2023-1-6-17","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-1-6-17","url":null,"abstract":"Purpose. To evaluate clinical results of mixed ciliary-capsular fixation of a three-piece IOL in combination with the intracapsular ring's implantation during phacoemulsification in patients' zonular weakness caused by pseudoexfoliative (PEX) syndrome. Material and methods. This study included 78 patients (86 eyes) with complicated cataract and PEX syndrome associated with zonular weakness and natural lens instability. The average age of the patients was 74.3±9.3 years. Phacoemulsification was performed in a standard technique and followed by ciliary-capsular fixation of a three- piece IOL in all cases. Preoperative and postoperative follow up period lasted from 1st day until 10 months postop. It included biomicroscopy, visual acuity measurement, keratometry, tonometry, ultrasonic biomicroscopy, optical coherence tomography of the posterior segment of the eye. Results. At the 2nd day postop (86 cases) UCVA and BCVA were 0.46±0.29 and 0.58±0.27 respectively, IOP was 16.48±2.81 mm Hg; at 10 months postop (38 cases) UCVA and BCVA – 0.54±0.31 and 0.79±0.28, IOP – 15.34±3.71 mm Hg. The average deviation of the predicted refraction at the 2 days after surgery was –0.29±0.77 D with no significant change after 10 months. Efficiency ratio at 10 months postop was 193, the safety factor was 285. This type of IOL fixation didn't lead to an increase in IOP, development of chronic inflammation such as iridocyclitis or any other comorbidity. All IOLs were stable position regardless of the status of the zonular fibers. Conclusion. As a result of a preliminary study, it was found that mixed ciliary-capsular fixation of a three-piece IOL provides its stable position, high clinical and functional results in the early and late postoperative period after phacoemulsification in patients with pseudoexfoliative syndrome and failure of the lenticular ligamentous-capsular system. Key words: pseudoexfoliative syndrome, zonular weakness, intraocular lens, ciliary-capsular fixation, lens subluxation, myopic shift","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114542148","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 : 2023-03-29DOI: 10.25276/0235-4160-2023-1-62-68
V. P. Fokin, S. V. Balalin, L. Ushakova
Purpose. To evaluate safety and efficacy of Floas-T ® (Tobramycin 0.3% + Fluormetholone 0.1%) as a preoperative preparation and postoperative management of patients with wet form of age-related macular degeneration (AMD) before and after intravitreal injection (IVI) of anti-VEGF drugs. Material and methods. 50 patients (50 eyes) with the wet form of AMD were examined and divided into two groups. The first group included 32 patients (32 eyes) with wet form of AMD. The second group consisted of 18 patients (18 eyes) with primary (11 eyes) and advanced (7 eyes) stages of primary open angle glaucoma with normalized IOP and wet form of AMD. Results. There were no significant changes in ВСVA and tonometric IOP values in the two groups before and within 7 days after IVI of ranibizumab and Floas-T ® instillations. Average value of individually tolerable true IOP in patients of the second group was 16,3±1,1 mm Hg, while average value of initial true IOP (14,7±2,56 mm Hg) pre-op was lower than tolerable pressure, indicating that individual norm of ophthalmotonus in glaucoma patients was reached. The difference between the mean values of ocular hydrodynamics in both groups before and 1 week after surgery was also statistically unsignificant (p>0.05). The difference between the mean values of the Schirmer I test was statistically unsignificant in patients in the two groups (p>0.05) before and after surgery, indicating the absence of Floas-T ® effect on tear production. There were no local and systemic side effects of Floas-T ® in 50 patients (50 eyes) during the observation period. Conclusion. Floas-T ® had an antiinflammatory effect without a decrease in the aqueous humor outflow, did not cause a significant increase in IOP in the early postoperative period, did not decrease tear production, and did not cause adverse local and systemic side effects. Floas-T ® can be used as a preoperative preparation and postoperative management drug in patients with wet type of AMD as well as in combination with primary open angle glaucoma when achieving an individual level of intraocular pressure. Key words: wet AMD, preoperative preparation, postoperative management, Floas-T® drug
目的。评价Floas-T®(妥布霉素0.3% +氟美洛酮0.1%)作为湿型年龄相关性黄斑变性(AMD)患者玻璃体内注射(IVI)抗vegf药物前后的术前准备和术后管理的安全性和有效性。材料和方法。对湿型黄斑变性患者50例(50只眼)进行检查，分为两组。第一组包括32例湿性黄斑变性患者(32只眼)。第二组包括18例(18眼)原发(11眼)和晚期(7眼)伴有正常IOP和湿型AMD的原发性开角型青光眼患者。结果。注射雷尼单抗和Floas-T®后7天内，两组患者的ВСVA和眼压值均无显著变化。第二组患者个体可耐受的真眼压平均值为16.3±1.1 mm Hg，而术前初始真眼压平均值(14.7±2.56 mm Hg)低于可耐受压，达到青光眼患者眼压的个体标准。两组患者术前与术后1周眼水动力学平均值比较，差异均无统计学意义(p>0.05)。两组患者术前、术后Schirmer I检验平均值差异无统计学意义(p>0.05)，说明Floas-T®对泪液生成无影响。在观察期间，50例患者(50只眼)未出现Floas-T®的局部和全身副作用。结论。Floas-T®具有抗炎作用，但不会减少房水流出量，不会导致术后早期IOP显著升高，不会减少泪液产生，不会引起局部和全身不良副作用。Floas-T®可用于湿型AMD患者的术前准备和术后管理药物，也可用于原发性开角型青光眼患者，当达到个人眼压水平时。关键词:湿性AMD，术前准备，术后管理，Floas-T®药物
{"title":"Safety and efficacy of Tobramycin 0.3% + Fluormetholone 0.1% (eye drops) fixed combination as a preoperative preparation and postoperative management of patients with wet AMD after intravitreal injection of ranibizumab. An observational, noncomparative single-center study","authors":"V. P. Fokin, S. V. Balalin, L. Ushakova","doi":"10.25276/0235-4160-2023-1-62-68","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-1-62-68","url":null,"abstract":"Purpose. To evaluate safety and efficacy of Floas-T ® (Tobramycin 0.3% + Fluormetholone 0.1%) as a preoperative preparation and postoperative management of patients with wet form of age-related macular degeneration (AMD) before and after intravitreal injection (IVI) of anti-VEGF drugs. Material and methods. 50 patients (50 eyes) with the wet form of AMD were examined and divided into two groups. The first group included 32 patients (32 eyes) with wet form of AMD. The second group consisted of 18 patients (18 eyes) with primary (11 eyes) and advanced (7 eyes) stages of primary open angle glaucoma with normalized IOP and wet form of AMD. Results. There were no significant changes in ВСVA and tonometric IOP values in the two groups before and within 7 days after IVI of ranibizumab and Floas-T ® instillations. Average value of individually tolerable true IOP in patients of the second group was 16,3±1,1 mm Hg, while average value of initial true IOP (14,7±2,56 mm Hg) pre-op was lower than tolerable pressure, indicating that individual norm of ophthalmotonus in glaucoma patients was reached. The difference between the mean values of ocular hydrodynamics in both groups before and 1 week after surgery was also statistically unsignificant (p>0.05). The difference between the mean values of the Schirmer I test was statistically unsignificant in patients in the two groups (p>0.05) before and after surgery, indicating the absence of Floas-T ® effect on tear production. There were no local and systemic side effects of Floas-T ® in 50 patients (50 eyes) during the observation period. Conclusion. Floas-T ® had an antiinflammatory effect without a decrease in the aqueous humor outflow, did not cause a significant increase in IOP in the early postoperative period, did not decrease tear production, and did not cause adverse local and systemic side effects. Floas-T ® can be used as a preoperative preparation and postoperative management drug in patients with wet type of AMD as well as in combination with primary open angle glaucoma when achieving an individual level of intraocular pressure. Key words: wet AMD, preoperative preparation, postoperative management, Floas-T® drug","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126230798","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 : 2023-03-29DOI: 10.25276/0235-4160-2023-1-76-83
I. Isakov, U. Karimov, A. V. Seleznev, A. Kuroyedov, A. Brezhnev
Relevance. Currently, there is a steady increase in the age-associated eye diseases worldwide. First of all, this applies to such ocular diseases as age-related maculodegeneration (AMD), glaucoma and cataracts. Despite the development and standardization of surgical techniques, the widespread introduction of cataract phacoemulsification, appearance of many modifications of anti-glaucomatous surgery, and the active use of angiogenesis inhibitors used to treat AMD, these diseases continue to occupy a leading position in the causes of low vision and blindness. Purpose. To reveal the problem of the development of pseudophakic glaucoma in patients who underwent surgical treatment for cataracts. Material and methods.To complete this review, we searched for literature sources on the PubMed and Scopus abstract databases for the period up to 2021 inclusive. In total, 53 articles related to the topic of the review were selected. The beginning of publications on this topic dates back to 1963. Results. At risk are patients with pseudoexfoliative syndrome, high-grade myopia, traumatic, diabetic and uveal cataracts. Pseudophakic glaucoma can also be caused by intraoperative (iris damage, vitreous prolapse, implantation of an intraocular lens outside the capsular bag, incomplete viscoelastic washout) and postoperative complications (inflammatory process, hyphema, dislocation of the artificial lens, pupillary block or Ellingson syndrome). Conclusion. Pseudophakic glaucoma, although rare, is quite formidable, which can reduce result of cataract surgery. Key words: pseudophakic glaucoma, glaucoma, cataract, ophthalmohypertension, complications of phacoemulsification
{"title":"Glaucoma of the pseudophakic eye","authors":"I. Isakov, U. Karimov, A. V. Seleznev, A. Kuroyedov, A. Brezhnev","doi":"10.25276/0235-4160-2023-1-76-83","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-1-76-83","url":null,"abstract":"Relevance. Currently, there is a steady increase in the age-associated eye diseases worldwide. First of all, this applies to such ocular diseases as age-related maculodegeneration (AMD), glaucoma and cataracts. Despite the development and standardization of surgical techniques, the widespread introduction of cataract phacoemulsification, appearance of many modifications of anti-glaucomatous surgery, and the active use of angiogenesis inhibitors used to treat AMD, these diseases continue to occupy a leading position in the causes of low vision and blindness. Purpose. To reveal the problem of the development of pseudophakic glaucoma in patients who underwent surgical treatment for cataracts. Material and methods.To complete this review, we searched for literature sources on the PubMed and Scopus abstract databases for the period up to 2021 inclusive. In total, 53 articles related to the topic of the review were selected. The beginning of publications on this topic dates back to 1963. Results. At risk are patients with pseudoexfoliative syndrome, high-grade myopia, traumatic, diabetic and uveal cataracts. Pseudophakic glaucoma can also be caused by intraoperative (iris damage, vitreous prolapse, implantation of an intraocular lens outside the capsular bag, incomplete viscoelastic washout) and postoperative complications (inflammatory process, hyphema, dislocation of the artificial lens, pupillary block or Ellingson syndrome). Conclusion. Pseudophakic glaucoma, although rare, is quite formidable, which can reduce result of cataract surgery. Key words: pseudophakic glaucoma, glaucoma, cataract, ophthalmohypertension, complications of phacoemulsification","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129116202","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 : 2023-03-29DOI: 10.25276/0235-4160-2023-1-84-88
I. A. Mushkova, N. Sobolev, I. T. Bichenova
Purpose. To evaluate the possible role of the eye surface in the occurrence of residual ametropia and other complications after cataract surgery analyzing scientific ophthalmological data on this topic for the last five years. Material and methods. Analysis of domestic and foreign scientific ophthalmological literature over the past ten years. Results. There is a paradigm shift in the understanding of DES from a simple deficit of tear film to a chronic disease of the eye surface, followed by a complex of changes in all its structures. Conclusion. DES is an optical impairment and measurement of refractive parameters in patients with DES who will undergo cataract surgery is impossible. This leads to refractive errors in IOL power calculations and requires further keratorefractive operations to obtain high visual functions Key words: refractive errors, ametropia, ocular surface, dry eye syndrome
{"title":"The role of the ocular surface diseases in the pathogenesis of cataract surgery complications","authors":"I. A. Mushkova, N. Sobolev, I. T. Bichenova","doi":"10.25276/0235-4160-2023-1-84-88","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-1-84-88","url":null,"abstract":"Purpose. To evaluate the possible role of the eye surface in the occurrence of residual ametropia and other complications after cataract surgery analyzing scientific ophthalmological data on this topic for the last five years. Material and methods. Analysis of domestic and foreign scientific ophthalmological literature over the past ten years. Results. There is a paradigm shift in the understanding of DES from a simple deficit of tear film to a chronic disease of the eye surface, followed by a complex of changes in all its structures. Conclusion. DES is an optical impairment and measurement of refractive parameters in patients with DES who will undergo cataract surgery is impossible. This leads to refractive errors in IOL power calculations and requires further keratorefractive operations to obtain high visual functions Key words: refractive errors, ametropia, ocular surface, dry eye syndrome","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128523503","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 : 2023-03-29DOI: 10.25276/0235-4160-2023-1-97-102
O. V. Shilovskikh, V. O. Ponomarev, V.N. Kazaikin, A. Kulikov, N.S. Demchenko, K. A. Tkachenko, Y. Beikin, S. M. Rozanova, M. Kyrf
Purpose. To highlight modern microbiological technologies for the identification of microorganisms as: mass spectrometry, polymerase chain reaction (PCR), sequencing, laser light scattering. Material and methods. To carry out the review, a search was carried out for scientific publications of domestic and foreign authors on the resources PubMed, Medline, eLIBRARY from 2008 to 2021, devoted to the currently existing methods of identifying microorganisms with an emphasis on ophthalmological microbiological diagnostics. Results. Modern microbiological technologies for the identification of microorganisms are able to assess not only the presence of the pathogen, but also to record its viability, the degree of virulence, currently implemented on the basis of modern technologies: mass spectrometry, polymerase chain reaction (PCR), sequencing and others. Conclusion. The microbiological technologies presented in the review make it possible to ensure high speed, productivity, sufficient sensitivity and economic availability of microbiological analysis, and are able to increase the probability of a positive outcome of the therapy. Key words: identification of microorganisms, polymerase chain reaction, sequencing, mass spectrometry
{"title":"Modern technologies of microbiological research in ophthalmology. part 1","authors":"O. V. Shilovskikh, V. O. Ponomarev, V.N. Kazaikin, A. Kulikov, N.S. Demchenko, K. A. Tkachenko, Y. Beikin, S. M. Rozanova, M. Kyrf","doi":"10.25276/0235-4160-2023-1-97-102","DOIUrl":"https://doi.org/10.25276/0235-4160-2023-1-97-102","url":null,"abstract":"Purpose. To highlight modern microbiological technologies for the identification of microorganisms as: mass spectrometry, polymerase chain reaction (PCR), sequencing, laser light scattering. Material and methods. To carry out the review, a search was carried out for scientific publications of domestic and foreign authors on the resources PubMed, Medline, eLIBRARY from 2008 to 2021, devoted to the currently existing methods of identifying microorganisms with an emphasis on ophthalmological microbiological diagnostics. Results. Modern microbiological technologies for the identification of microorganisms are able to assess not only the presence of the pathogen, but also to record its viability, the degree of virulence, currently implemented on the basis of modern technologies: mass spectrometry, polymerase chain reaction (PCR), sequencing and others. Conclusion. The microbiological technologies presented in the review make it possible to ensure high speed, productivity, sufficient sensitivity and economic availability of microbiological analysis, and are able to increase the probability of a positive outcome of the therapy. Key words: identification of microorganisms, polymerase chain reaction, sequencing, mass spectrometry","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124764467","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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