Pub Date : 2023-02-17DOI: 10.25276/0235-4160-2022-4s-21-28
A. A. Rascheskov, I. Frolychev, N. Pozdeyeva
Purpose. To evaluate the possibility of clinical application of the AITonometry neural network in determining IOP by Maklakov method and identifying patients with increased intraocular pressure. Material and methods. A prospective study, 697 impressions of IOP measurement by Maklakov were selected. Each impression was evaluated using the neural network (group I), and by 3 experts with using the measuring ruler of Prof. B.L. Polyak (groups II1 , II2 , II3 ), the experts' data were averaged in order to create a «comparison standard» (group IIM ) for analysis. Results. The data obtained are presented in the form of M±σ(Me [Q25%; Q75%]), where M is the mean value, ±σ is the standard deviation, Me is the median ([Q25%; Q75%]) are quartiles: group I – 22,32±4,18 (22 [20; 24]); II1 group – 19.95±3.58 (19 [18; 21]); II2 group – 20,35±3,65 (20 [18; 22]); II3 group – 20,41±3,58 (20 [18; 22]); IIM – 20,23±3,53 (19,66 [18,33; 21,66]). A statistically significant difference was found between all data groups. The accuracy of AI-Tonometry: the mean absolute error (MAE) is 2.5 mmHg, the mean squared error (MSE) is 8.76, the root mean squared error (RMSE) is 2.96. Performance: Sensitivity – 91.94%; Specificity – 93.7%; Accuracy – 58.76%; Accuracy – 93.54%; F1 Score – 0.7170, AUC-ROC – 0.987. Conclusion. The AI-Tonometry neural network has high characteristics of accuracy and performance in combination with the convenience of using the service, the speed of interpretation of impressions made by Maklakov method, a small discrepancy in the results of determining the presence or absence of increased IOP. This service can be considered as an alternative to the usual approach with using ruler of Prof. B.L. Polyak and can be used in clinical practice. Keywords: neural network, intraocular pressure, artificial intelligence, tonometry, Maklakov applanation tonometry
{"title":"The neural network for measuring IOP by Maklakov method: comparison between neuronal net and experts","authors":"A. A. Rascheskov, I. Frolychev, N. Pozdeyeva","doi":"10.25276/0235-4160-2022-4s-21-28","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4s-21-28","url":null,"abstract":"Purpose. To evaluate the possibility of clinical application of the AITonometry neural network in determining IOP by Maklakov method and identifying patients with increased intraocular pressure. Material and methods. A prospective study, 697 impressions of IOP measurement by Maklakov were selected. Each impression was evaluated using the neural network (group I), and by 3 experts with using the measuring ruler of Prof. B.L. Polyak (groups II1 , II2 , II3 ), the experts' data were averaged in order to create a «comparison standard» (group IIM ) for analysis. Results. The data obtained are presented in the form of M±σ(Me [Q25%; Q75%]), where M is the mean value, ±σ is the standard deviation, Me is the median ([Q25%; Q75%]) are quartiles: group I – 22,32±4,18 (22 [20; 24]); II1 group – 19.95±3.58 (19 [18; 21]); II2 group – 20,35±3,65 (20 [18; 22]); II3 group – 20,41±3,58 (20 [18; 22]); IIM – 20,23±3,53 (19,66 [18,33; 21,66]). A statistically significant difference was found between all data groups. The accuracy of AI-Tonometry: the mean absolute error (MAE) is 2.5 mmHg, the mean squared error (MSE) is 8.76, the root mean squared error (RMSE) is 2.96. Performance: Sensitivity – 91.94%; Specificity – 93.7%; Accuracy – 58.76%; Accuracy – 93.54%; F1 Score – 0.7170, AUC-ROC – 0.987. Conclusion. The AI-Tonometry neural network has high characteristics of accuracy and performance in combination with the convenience of using the service, the speed of interpretation of impressions made by Maklakov method, a small discrepancy in the results of determining the presence or absence of increased IOP. This service can be considered as an alternative to the usual approach with using ruler of Prof. B.L. Polyak and can be used in clinical practice. Keywords: neural network, intraocular pressure, artificial intelligence, tonometry, Maklakov applanation tonometry","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126384982","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 : 2023-02-17DOI: 10.25276/0235-4160-2022-4s-115-122
R.V. Alekhin, A. I. Katasonov, M.V. Lesnevskii, D.N. Smirnov
Relevance. The functionality of malware has grown exponentially in recent years. There are more and more ways in which attackers can gain access to secret or personal data, as well as information stored in critical information infrastructure, including those related to the healthcare sector, but the consequences of attacks on such objects lead to serious consequences. A striking example is the leak of data to the public from the database of the unified dispatch service of the Lipetsk Region, which contained a lot of information about the patient, including their full name and address. Purpose. Investigation of the vulnerability BDU:2022-05212, which allows an attacker to gain full rights to the infrastructure. On the basis of the research done, to study the principles of operation of this vulnerability, as well as classify it and identify the consequences for CII objects. Make a list of measures necessary to ensure security against attacks of this kind. Material and methods. This article describes how to gain unauthorized access through the CAS administrative interface by calling the URL on the page that is used to install the default on the server and create the first administrator user. As well as an experimental study of this vulnerability, methods for its detection and consequences for CII subjects was carried out. Results. In accordance with the Federal Law of July 26, 2017 Nо. 187-FZ, definitions are considered that allow classifying information systems in the field of health care as CII and consider an actual example of data leakage in this area due to the vulnerability of the CAS server at the network level. The article also discusses the basics of the CAS server, compiled a vulnerability classification table BDU:2022-05212, and indicated the basic vulnerability vector metric according to the FSTEC standards. The conclusion in this article is based on how to protect against this vulnerability, as well as recommendations for resolving the problem if the attack has already been committed before. The results of the study will improve the level of authentication security in web applications and sites using CAS server technologies, organizations operating in the banking sector, as well as in the healthcare sector related to CII. Conclusion. The article puts the key – the security of the infrastructure of subjects of critical information infrastructure in the field of healthcare. This article will be useful for employees of the information security department working with CII objects, especially those operating in healthcare, banking, and other areas of the financial market. Keywords:critical information infrastructure protection, information security, healthcare industry, vulnerabilities, infotelecommunications
{"title":"Study of the critical vulnerability of the authentication service and the consequences for medical institutions related to CIIP objects","authors":"R.V. Alekhin, A. I. Katasonov, M.V. Lesnevskii, D.N. Smirnov","doi":"10.25276/0235-4160-2022-4s-115-122","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4s-115-122","url":null,"abstract":"Relevance. The functionality of malware has grown exponentially in recent years. There are more and more ways in which attackers can gain access to secret or personal data, as well as information stored in critical information infrastructure, including those related to the healthcare sector, but the consequences of attacks on such objects lead to serious consequences. A striking example is the leak of data to the public from the database of the unified dispatch service of the Lipetsk Region, which contained a lot of information about the patient, including their full name and address. Purpose. Investigation of the vulnerability BDU:2022-05212, which allows an attacker to gain full rights to the infrastructure. On the basis of the research done, to study the principles of operation of this vulnerability, as well as classify it and identify the consequences for CII objects. Make a list of measures necessary to ensure security against attacks of this kind. Material and methods. This article describes how to gain unauthorized access through the CAS administrative interface by calling the URL on the page that is used to install the default on the server and create the first administrator user. As well as an experimental study of this vulnerability, methods for its detection and consequences for CII subjects was carried out. Results. In accordance with the Federal Law of July 26, 2017 Nо. 187-FZ, definitions are considered that allow classifying information systems in the field of health care as CII and consider an actual example of data leakage in this area due to the vulnerability of the CAS server at the network level. The article also discusses the basics of the CAS server, compiled a vulnerability classification table BDU:2022-05212, and indicated the basic vulnerability vector metric according to the FSTEC standards. The conclusion in this article is based on how to protect against this vulnerability, as well as recommendations for resolving the problem if the attack has already been committed before. The results of the study will improve the level of authentication security in web applications and sites using CAS server technologies, organizations operating in the banking sector, as well as in the healthcare sector related to CII. Conclusion. The article puts the key – the security of the infrastructure of subjects of critical information infrastructure in the field of healthcare. This article will be useful for employees of the information security department working with CII objects, especially those operating in healthcare, banking, and other areas of the financial market. Keywords:critical information infrastructure protection, information security, healthcare industry, vulnerabilities, infotelecommunications","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122269413","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 : 2023-02-17DOI: 10.25276/0235-4160-2022-4s-70-76
S. Shukhaev, E.A. Mordovtseva, E. Pustozerov, S. S. Kudlakhmedov
Purpose. To evaluate the application of convolutional neural networks for the automatic detection of Fuchs' dystrophy. Material and methods. The study included 700 biomicroscopic images of the corneal endothelium (Tomey EM-3000) randomly selected from the database of the Saint-Petersburg brunch of the S. Fyodorov Eye Microsurgery Federal State Institution. At the first stage, the images were divided into 2 groups. The first group included images with the presence of Fuchs' dystrophy, the second – another pathology or a healthy cornea. The corneal endothelial cell density images were divided into three categories: training, validation, and test datasets. In our study we tested various architectures of convolutional neural networks: ResNet18, ResNet50, VGG16, VGG19 and GoogleNet. Results. The approbation of the neural network on the test sample has given the following values of the F-measure: ResNet18: 0.985; ResNet50: 1,000; VGG16: 0.940; VGG19: 0.990; GoogleNet: 0.987. Pre-trained network ResNet50 performed best with frozen layers, Adam optimizer, cross-entropy as a loss function, and a training step of 0.000005. Conclusion. The use of convolutional neural networks for the automatic detection of Fuchs' dystrophy can be successfully implemented as part of a doctor's decision support system. ResNet50 showed the best results among all types of models and did not give a single error on the test sample, which indicates the high efficiency of using this network in the classification algorithm for corneal endothelial images. Keywords: artificial intelligence, Fuchs corneal dystrophy, convolutional neural networks
{"title":"Application of convolutional neural networks to define Fuchs endothelial dystrophy","authors":"S. Shukhaev, E.A. Mordovtseva, E. Pustozerov, S. S. Kudlakhmedov","doi":"10.25276/0235-4160-2022-4s-70-76","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4s-70-76","url":null,"abstract":"Purpose. To evaluate the application of convolutional neural networks for the automatic detection of Fuchs' dystrophy. Material and methods. The study included 700 biomicroscopic images of the corneal endothelium (Tomey EM-3000) randomly selected from the database of the Saint-Petersburg brunch of the S. Fyodorov Eye Microsurgery Federal State Institution. At the first stage, the images were divided into 2 groups. The first group included images with the presence of Fuchs' dystrophy, the second – another pathology or a healthy cornea. The corneal endothelial cell density images were divided into three categories: training, validation, and test datasets. In our study we tested various architectures of convolutional neural networks: ResNet18, ResNet50, VGG16, VGG19 and GoogleNet. Results. The approbation of the neural network on the test sample has given the following values of the F-measure: ResNet18: 0.985; ResNet50: 1,000; VGG16: 0.940; VGG19: 0.990; GoogleNet: 0.987. Pre-trained network ResNet50 performed best with frozen layers, Adam optimizer, cross-entropy as a loss function, and a training step of 0.000005. Conclusion. The use of convolutional neural networks for the automatic detection of Fuchs' dystrophy can be successfully implemented as part of a doctor's decision support system. ResNet50 showed the best results among all types of models and did not give a single error on the test sample, which indicates the high efficiency of using this network in the classification algorithm for corneal endothelial images. Keywords: artificial intelligence, Fuchs corneal dystrophy, convolutional neural networks","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124120449","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 : 2023-02-17DOI: 10.25276/0235-4160-2022-4s-138-145
A. R. Vinogradov, B. G. Dzhashi, O. V. Yuferov, S. V. Balalin, E.S. Tarapatina
Purpose. To develop optimized machine learning technology to improve the accuracy of intraocular lens (IOL) optical power calculation. Material and methods. Publications in Russian and foreign media fort he last 5 years which report about using artificial intelligence to improve the accuracy of IOL optical power calculation were analyzed. Results. Two different approaches using artificial intelligence in optimization of IOL calculation are known: firstly, modification of existing theoretical formulas and secondly, based only on analysis of patients' database before and after IOL implantation. Each approach has its advantages and disadvantages. The absence of an «ideal» formula forces surgeons to analyze incoming patient data and make corrections to the results obtained based on their own experience when calculating IOLs. In the clinic of the Volgograd branch of the S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery» developed a design project for the LensCalc software application and algorithms of its step-by-step operation. Conclusion. The development of a software application based on artificial intelligence is a rather labor-intensive process that requires processing a large amount of data, using formulas and algorithms with obtaining the final result, as well as subsequent training, optimization, and improving the quality of its work. The LensCalc software application is based on the use of artificial intelligence algorithms to select the formula for calculating the optical power of the IOL that is most suitable in a particular clinical situation. Keywords: IOL calculation, artificial intelligence
{"title":"Modern possibilities for optimizing the calculation of intraocular lens optical power using deep machine learning capabilities","authors":"A. R. Vinogradov, B. G. Dzhashi, O. V. Yuferov, S. V. Balalin, E.S. Tarapatina","doi":"10.25276/0235-4160-2022-4s-138-145","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4s-138-145","url":null,"abstract":"Purpose. To develop optimized machine learning technology to improve the accuracy of intraocular lens (IOL) optical power calculation. Material and methods. Publications in Russian and foreign media fort he last 5 years which report about using artificial intelligence to improve the accuracy of IOL optical power calculation were analyzed. Results. Two different approaches using artificial intelligence in optimization of IOL calculation are known: firstly, modification of existing theoretical formulas and secondly, based only on analysis of patients' database before and after IOL implantation. Each approach has its advantages and disadvantages. The absence of an «ideal» formula forces surgeons to analyze incoming patient data and make corrections to the results obtained based on their own experience when calculating IOLs. In the clinic of the Volgograd branch of the S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery» developed a design project for the LensCalc software application and algorithms of its step-by-step operation. Conclusion. The development of a software application based on artificial intelligence is a rather labor-intensive process that requires processing a large amount of data, using formulas and algorithms with obtaining the final result, as well as subsequent training, optimization, and improving the quality of its work. The LensCalc software application is based on the use of artificial intelligence algorithms to select the formula for calculating the optical power of the IOL that is most suitable in a particular clinical situation. Keywords: IOL calculation, artificial intelligence","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"165 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131924004","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 : 2023-02-17DOI: 10.25276/0235-4160-2022-4s-40-50
A. Chuprov, E. Borshchuk, D. Begun, I. Bolodurina, L. Grishina, A. O. Lositskiy
Relevance. The problem of evaluating the choice of treatment method for patients with glaucoma is widely covered in the medical literature, but currently there are no publications on indications and decision making about reoperation in case of complete or partial ineffectiveness of the treatment. Purpose. To describe a method for assessing the need and type of reoperation in the surgical treatment of glaucoma using an artificial neural network. Material and methods. 7801 cases of observation and treatment of patients diagnosed with glaucoma were selected for 2018 –2020. The development and statistical analysis of the factors associated with repeated surgical operations was carried out, a model for predicting the probability of repeated operations was created, mathematical modeling of the onset of complications depending on the identified factors was carried out using the method of constructing classification trees. The resulting model was used to assess the need for surgical treatment in patient registered in clinic in 2019. Cases of specialized medical care have been identified, in which, with a high degree of probability, long-term compensation of the pathological course of glaucoma will not occur and repeated surgical treatment will be required. These cases were copied into a separate database for further work. The preferred reoperation method for patient management was selected using an artificial neural network. Results. A number of factors that are statistically significantly associated with reoperation have been identified, and an artificial neural network model has been created to predict the type of reoperation in glaucoma. Application of the obtained method on patients who received treatment at the clinic in 2019 –2021 years made it possible to predict the probability of reoperation within a three-year follow-up period in 5%, while among the patients the need for treatment was distributed as follows: microfistulizing deep sclerectomy with allodrainage – 88.37%, selective laser trabeculoplasty – 6.98%, transscleral cyclophotocoagulation – 4.65%. Conclusion. The obtained method allows predicting the probability of re-treatment of glaucoma and the type of surgery required. Considering the specificity and sensitivity of the obtained models, it is necessary to increase the number of observations, further clinical and organizational study of aspects of the provision of medical services in previously operated glaucoma, and an assessment of the clinical and economic effect of the introduction of this method. Keywords: glaucoma, artificial neural network, assessment method
{"title":"Method for assessing the need and type of surgical re-treatment in glaucoma using an artificial neural network","authors":"A. Chuprov, E. Borshchuk, D. Begun, I. Bolodurina, L. Grishina, A. O. Lositskiy","doi":"10.25276/0235-4160-2022-4s-40-50","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4s-40-50","url":null,"abstract":"Relevance. The problem of evaluating the choice of treatment method for patients with glaucoma is widely covered in the medical literature, but currently there are no publications on indications and decision making about reoperation in case of complete or partial ineffectiveness of the treatment. Purpose. To describe a method for assessing the need and type of reoperation in the surgical treatment of glaucoma using an artificial neural network. Material and methods. 7801 cases of observation and treatment of patients diagnosed with glaucoma were selected for 2018 –2020. The development and statistical analysis of the factors associated with repeated surgical operations was carried out, a model for predicting the probability of repeated operations was created, mathematical modeling of the onset of complications depending on the identified factors was carried out using the method of constructing classification trees. The resulting model was used to assess the need for surgical treatment in patient registered in clinic in 2019. Cases of specialized medical care have been identified, in which, with a high degree of probability, long-term compensation of the pathological course of glaucoma will not occur and repeated surgical treatment will be required. These cases were copied into a separate database for further work. The preferred reoperation method for patient management was selected using an artificial neural network. Results. A number of factors that are statistically significantly associated with reoperation have been identified, and an artificial neural network model has been created to predict the type of reoperation in glaucoma. Application of the obtained method on patients who received treatment at the clinic in 2019 –2021 years made it possible to predict the probability of reoperation within a three-year follow-up period in 5%, while among the patients the need for treatment was distributed as follows: microfistulizing deep sclerectomy with allodrainage – 88.37%, selective laser trabeculoplasty – 6.98%, transscleral cyclophotocoagulation – 4.65%. Conclusion. The obtained method allows predicting the probability of re-treatment of glaucoma and the type of surgery required. Considering the specificity and sensitivity of the obtained models, it is necessary to increase the number of observations, further clinical and organizational study of aspects of the provision of medical services in previously operated glaucoma, and an assessment of the clinical and economic effect of the introduction of this method. Keywords: glaucoma, artificial neural network, assessment method","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126518504","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 : 2022-12-19DOI: 10.25276/0235-4160-2022-4-6-12
Y. V. Belonozhenko, E. L. Sorokin, S. V. Krivko
Purpose. To evaluate method for spontaneous dislocation of «intraocular lens – capsular bag» complex (CICB) surgical treatment, that developed after phacoemulsification (PE), in relation to its severity. Material and methods. Clinical material included 36 patients (36 eyes) aged 61 to 89 years. Spontaneous dislocation of CICB after PE performed varied from 3 months to 11 years after surgery, average 5±2 years. According to our proposed classification degrees of severity spontaneous dislocation of CICB, its 1st degree took place in 8 eyes; 2nd – in 9 eyes; 3rd – in 16 eyes; 4th – in 3 eyes. Surgical treatment was not performed in patients with the 1st degree of CICB dislocation. At the 2nd degree of CICB dislocation and more severe, patients underwent its surgical correction, according to severity of the eye condition. Results. All surgical intervensions were carried out as planned, without complications. The postoperative response of the eyes was evaluated on the 1st and next days of the postoperative period (SN Fedorov, EV Egorova, 1992). In all cases, it corresponded to the amount of performed surgical intervention. So, in 19 eyes, it corresponded to the 1st degree; in 6 eyes – 2nd degree; 3 eyes developed 3rd degree postoperative response of the eyes (postoperative uveitis). Indexes of uncorrected visual acuity on days 3–5 in 14 eyes (50%) ranged from 0.05 to 0.4; in 6 eyes (21%) – did not change significantly; in 8 eyes (29%) we reached the indexes that took place immediately after PE. Conclusion. Thus, in our experience, the surgical correction of spontaneous dislocations of CICB of the 2–4 degrees have shown itself to be effective in all of these cases. Key words: phacoemulsification, spontaneous dislocation of the «intraocular lens – capsule bag» complex, surgical treatment.
{"title":"Effectiveness of surgical treatment for spontaneous «intraocular lens – capsular bag» complex dislocation, developed after phacoemulsification","authors":"Y. V. Belonozhenko, E. L. Sorokin, S. V. Krivko","doi":"10.25276/0235-4160-2022-4-6-12","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4-6-12","url":null,"abstract":"Purpose. To evaluate method for spontaneous dislocation of «intraocular lens – capsular bag» complex (CICB) surgical treatment, that developed after phacoemulsification (PE), in relation to its severity. Material and methods. Clinical material included 36 patients (36 eyes) aged 61 to 89 years. Spontaneous dislocation of CICB after PE performed varied from 3 months to 11 years after surgery, average 5±2 years. According to our proposed classification degrees of severity spontaneous dislocation of CICB, its 1st degree took place in 8 eyes; 2nd – in 9 eyes; 3rd – in 16 eyes; 4th – in 3 eyes. Surgical treatment was not performed in patients with the 1st degree of CICB dislocation. At the 2nd degree of CICB dislocation and more severe, patients underwent its surgical correction, according to severity of the eye condition. Results. All surgical intervensions were carried out as planned, without complications. The postoperative response of the eyes was evaluated on the 1st and next days of the postoperative period (SN Fedorov, EV Egorova, 1992). In all cases, it corresponded to the amount of performed surgical intervention. So, in 19 eyes, it corresponded to the 1st degree; in 6 eyes – 2nd degree; 3 eyes developed 3rd degree postoperative response of the eyes (postoperative uveitis). Indexes of uncorrected visual acuity on days 3–5 in 14 eyes (50%) ranged from 0.05 to 0.4; in 6 eyes (21%) – did not change significantly; in 8 eyes (29%) we reached the indexes that took place immediately after PE. Conclusion. Thus, in our experience, the surgical correction of spontaneous dislocations of CICB of the 2–4 degrees have shown itself to be effective in all of these cases. Key words: phacoemulsification, spontaneous dislocation of the «intraocular lens – capsule bag» complex, surgical treatment.","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"162 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116910735","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 : 2022-12-19DOI: 10.25276/0235-4160-2022-4-92-99
A. Sidorova, A. V. Starostina, K. S. Norman, D. M. Sultanova, S. M. Dibirova, I.A. Makarova
Purpose. To analyze the literature on the etiology, pathogenesis, and methods of treatment of secondary glaucoma caused by emulsification of silicone oil after pars plana vitrectomy. Material and methods. The search for literature sources was carried out using the reference databases PubMed, Scopus and eLibrary for the period up to 2022 using the keywords: «silicone oil induced glaucoma», «secondary glaucoma after vitrectomy», «silicone oil», «silicone oil emulsification», and the same words in Russian. Results. The use of silicone oil ensures stabilization of the retina and has a number of advantages. However, prolonged presence of it in the vitreal cavity can lead to such a complication as secondary glaucoma. The review presents an analysis of the methods of treatment of secondary glaucoma induced by emulsification of silicone oil, their effectiveness and safety. Conclusion. The main mechanism for the development of secondary glaucoma due to silicone oil emulsification is the mechanical closure of the outflow pathways by silicone oil bubbles. According to the literature, traditional methods of surgical treatment of glaucoma in this pathology are ineffective. The use of drainage devices gives a more persistent hypotensive effect. Key words: secondary glaucoma, emulsification, silicone oil, ExPRESS, Ahmed.
目的。目的:分析玻璃体切割术后硅油乳化致继发性青光眼的病因、发病机制及治疗方法。材料和方法。使用参考数据库PubMed, Scopus和eLibrary检索截至2022年的文献来源，关键词:“硅油诱发青光眼”，“玻璃体切除术后继发性青光眼”，“硅油”，“硅油乳化”和俄语相同的单词。结果。硅油的使用确保了视网膜的稳定，并具有许多优点。然而，长时间存在于玻璃体腔内可导致继发性青光眼等并发症。综述了硅油乳化致继发性青光眼的治疗方法及其疗效和安全性。结论。硅油乳化致继发性青光眼发生的主要机制是硅油气泡机械封闭流出通道。根据文献，传统的手术治疗方法在这种病理青光眼是无效的。引流装置的使用使降压效果更加持久。关键词:继发性青光眼，乳化，硅油，ExPRESS, Ahmed
{"title":"Etiopathogenesis and treatment for secondary glaucoma after pars plana vitrectomy with silicone oil","authors":"A. Sidorova, A. V. Starostina, K. S. Norman, D. M. Sultanova, S. M. Dibirova, I.A. Makarova","doi":"10.25276/0235-4160-2022-4-92-99","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4-92-99","url":null,"abstract":"Purpose. To analyze the literature on the etiology, pathogenesis, and methods of treatment of secondary glaucoma caused by emulsification of silicone oil after pars plana vitrectomy. Material and methods. The search for literature sources was carried out using the reference databases PubMed, Scopus and eLibrary for the period up to 2022 using the keywords: «silicone oil induced glaucoma», «secondary glaucoma after vitrectomy», «silicone oil», «silicone oil emulsification», and the same words in Russian. Results. The use of silicone oil ensures stabilization of the retina and has a number of advantages. However, prolonged presence of it in the vitreal cavity can lead to such a complication as secondary glaucoma. The review presents an analysis of the methods of treatment of secondary glaucoma induced by emulsification of silicone oil, their effectiveness and safety. Conclusion. The main mechanism for the development of secondary glaucoma due to silicone oil emulsification is the mechanical closure of the outflow pathways by silicone oil bubbles. According to the literature, traditional methods of surgical treatment of glaucoma in this pathology are ineffective. The use of drainage devices gives a more persistent hypotensive effect. Key words: secondary glaucoma, emulsification, silicone oil, ExPRESS, Ahmed.","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116592587","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 : 2022-12-19DOI: 10.25276/0235-4160-2022-4-66-73
V. Ponomarev, V.N. Kazaikin, S. Dezhurov, S. M. Rozanova, M. Kyrf, V. Timofeev
Relevance. Resistant fungal keratitis (keratomycosis) is a big current problem in ophthalmology. The limited arsenal of drugs and the low efficiency of surgical treatment often leads to extremely low anatomical and functional results. One of the alternative approaches to the management of fungal keratitis can be the use of nanoparticles, in monotherapy, or as a catalyst for a more effective effect of a native drug. Quantum dots (QDs) act as nanoparticles. Under the action of light in the visible region of the spectrum, QDs are capable of participating in redox reactions and the simulated formation of reactive oxygen species (ROS) by changing the electronic interactions with the surrounding atoms. Purpose. Synthesis of QDs potentially active against fungal microflora, study of the ability of this type of QDs and analogues to produce ROS and analysis of their fungicidal activity against yeast microflora in vitro. Material and methods. The study determined the effectiveness of the QDs solution in suppressing the growth of colonies of resistant species of fungi of the genus Candida spp (C. albicans, C. glabrata, C. tropicalis, C. Parapsilosis) in vitro. QDs Ag(10%):InP/ZnS MPA were used in the form of a native solution (10%) and at a dilution of 1:100 (0.1%). Results. It was possible to reveal the complete suppression of the visible growth of Candida spp. in the area treated with QDs, regardless of concentration. The diameter of the growth inhibition zone (GIZ) in all cases exceeded 24 mm, which corresponded to a high degree of sensitivity. Conclusion. The synthesized Ag(10%):InP/ZnS MPA QDs showed high antiinfective activity against the resistant yeast microbiota Candida spp. in laboratory conditions, playing one of the primary roles in the course of keratomycosis. It is necessary to consider QDs Ag(10%):InP/ZnS MPA as one of the alternative/additional agents for the treatment of resistant ophthalmomycosis, in particular keratomycosis, after limited clinical trials in various variations. Key words: fungal keratitis, yeast fungi, quantum dots, nanoparticles.
{"title":"Perspectives of Ag(10%):InP/ZnS MPA nanoparticles application in the treatment of yeast keratomycosis","authors":"V. Ponomarev, V.N. Kazaikin, S. Dezhurov, S. M. Rozanova, M. Kyrf, V. Timofeev","doi":"10.25276/0235-4160-2022-4-66-73","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4-66-73","url":null,"abstract":"Relevance. Resistant fungal keratitis (keratomycosis) is a big current problem in ophthalmology. The limited arsenal of drugs and the low efficiency of surgical treatment often leads to extremely low anatomical and functional results. One of the alternative approaches to the management of fungal keratitis can be the use of nanoparticles, in monotherapy, or as a catalyst for a more effective effect of a native drug. Quantum dots (QDs) act as nanoparticles. Under the action of light in the visible region of the spectrum, QDs are capable of participating in redox reactions and the simulated formation of reactive oxygen species (ROS) by changing the electronic interactions with the surrounding atoms. Purpose. Synthesis of QDs potentially active against fungal microflora, study of the ability of this type of QDs and analogues to produce ROS and analysis of their fungicidal activity against yeast microflora in vitro. Material and methods. The study determined the effectiveness of the QDs solution in suppressing the growth of colonies of resistant species of fungi of the genus Candida spp (C. albicans, C. glabrata, C. tropicalis, C. Parapsilosis) in vitro. QDs Ag(10%):InP/ZnS MPA were used in the form of a native solution (10%) and at a dilution of 1:100 (0.1%). Results. It was possible to reveal the complete suppression of the visible growth of Candida spp. in the area treated with QDs, regardless of concentration. The diameter of the growth inhibition zone (GIZ) in all cases exceeded 24 mm, which corresponded to a high degree of sensitivity. Conclusion. The synthesized Ag(10%):InP/ZnS MPA QDs showed high antiinfective activity against the resistant yeast microbiota Candida spp. in laboratory conditions, playing one of the primary roles in the course of keratomycosis. It is necessary to consider QDs Ag(10%):InP/ZnS MPA as one of the alternative/additional agents for the treatment of resistant ophthalmomycosis, in particular keratomycosis, after limited clinical trials in various variations. Key words: fungal keratitis, yeast fungi, quantum dots, nanoparticles.","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131848942","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 : 2022-12-19DOI: 10.25276/0235-4160-2022-4-36-44
E. Boiko, S. Shukhaev, S. S. Kudlakhmedov, I. Litvin
Purpose. Compare the effectiveness of regular corneal astigmatism correction with toric monofocal IOL using various keratometric data and calculation methods. Material and methods. The study included 28 patients (31 eyes) with age-related cataracts and regular corneal astigmatism who underwent phacoemulsification (n=31) with implantation of a monofocal toric IOL (EnVista Toric). Two groups were formed according to the type of calculation and possible options of keratometric data: 1) keratometric data of IOL-master 500 + online manufacturer's calculator; 2) keratometric data of the anterior and posterior corneal surfaces (Pentacam HR) + Barrett's toric calculator. Results. The mean absolute deviation of the predicted residual astigmatism from the actual one was distributed as follows: 1st group – 0.62±0.62 D, 2nd group – 0.41 ± 0.71 D. The values of the mean absolute vector and mean centroid error in diopters were: 0.80±0.59 D and 0.06 D in 1st group, 0.48±0.65 D and 0.02 D in 2nd group, respectively. Conclusion. When using the measured astigmatism of the anterior and posterior surface of the cornea, Barrett's toric calculator showed the best result. The most accurate forecast of residual astigmatism was obtained using the Barrett calculator in combination with Pentacam keratometry data (AxialSagittal (Front), AxialSagittal (Back)). Key words: corneal astigmatism, posterior corneal astigmatism, toric IOL, centroid analysis, keratometry, cataract surgery
{"title":"Comparative evaluation of surgical correction of corneal astigmatism by toric IOL implantation using various keratometric data and calculation methods","authors":"E. Boiko, S. Shukhaev, S. S. Kudlakhmedov, I. Litvin","doi":"10.25276/0235-4160-2022-4-36-44","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4-36-44","url":null,"abstract":"Purpose. Compare the effectiveness of regular corneal astigmatism correction with toric monofocal IOL using various keratometric data and calculation methods. Material and methods. The study included 28 patients (31 eyes) with age-related cataracts and regular corneal astigmatism who underwent phacoemulsification (n=31) with implantation of a monofocal toric IOL (EnVista Toric). Two groups were formed according to the type of calculation and possible options of keratometric data: 1) keratometric data of IOL-master 500 + online manufacturer's calculator; 2) keratometric data of the anterior and posterior corneal surfaces (Pentacam HR) + Barrett's toric calculator. Results. The mean absolute deviation of the predicted residual astigmatism from the actual one was distributed as follows: 1st group – 0.62±0.62 D, 2nd group – 0.41 ± 0.71 D. The values of the mean absolute vector and mean centroid error in diopters were: 0.80±0.59 D and 0.06 D in 1st group, 0.48±0.65 D and 0.02 D in 2nd group, respectively. Conclusion. When using the measured astigmatism of the anterior and posterior surface of the cornea, Barrett's toric calculator showed the best result. The most accurate forecast of residual astigmatism was obtained using the Barrett calculator in combination with Pentacam keratometry data (AxialSagittal (Front), AxialSagittal (Back)). Key words: corneal astigmatism, posterior corneal astigmatism, toric IOL, centroid analysis, keratometry, cataract surgery","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114162006","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 : 2022-12-19DOI: 10.25276/0235-4160-2022-4-51-55
I. Frolychev, D. V. Borisova, N. Pozdeyeva
Purpose. Analysis of the first clinical and functional results of treatment of patients with macular holes using the two-port vitrectomy. Material and methods. An analysis of treatment of 15 patients with a diagnosis of macular hole, operated by the method of two-port vitrectomy, was carried out. According to the Gass classification, 7 patients were diagnosed with stage 3 macular hole, and 8 patients with stage 4. All patients underwent microinvasive vitrectomy according to the developed technique. At the beginning of the operation, two ports were installed – one for the infusion cannula with a built-in illuminator (chandelier), the second for the vitreotome. Next, the epiretinal membrane (ERM) (if any) and the internal limiting membrane (ILM) were removed, and plateletrich plasma (PRP) was used at the end of the operation. Intra- and postoperative complications were not registered. Results. The maximum period of observation of patients after treatment was 3 months. In all cases, an anatomical result was achieved – complete closure of the macular hole according to optical coherence tomography (OCT). Mean BCVA results 3 months after treatment were 0.32±0.08. In all cases, improvement in visual functions was achieved (p=0.035). Conclusion. The method of two-port vitrectomy in the treatment of macular holes allows to achieve a good anatomical result, improve visual functions, while minimizing surgical trauma. Key words: macular hole, platelet-rich plasma, two-port vitrectomy.
{"title":"Two-port vitrectomy in the treatment of patients with macular hole","authors":"I. Frolychev, D. V. Borisova, N. Pozdeyeva","doi":"10.25276/0235-4160-2022-4-51-55","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-4-51-55","url":null,"abstract":"Purpose. Analysis of the first clinical and functional results of treatment of patients with macular holes using the two-port vitrectomy. Material and methods. An analysis of treatment of 15 patients with a diagnosis of macular hole, operated by the method of two-port vitrectomy, was carried out. According to the Gass classification, 7 patients were diagnosed with stage 3 macular hole, and 8 patients with stage 4. All patients underwent microinvasive vitrectomy according to the developed technique. At the beginning of the operation, two ports were installed – one for the infusion cannula with a built-in illuminator (chandelier), the second for the vitreotome. Next, the epiretinal membrane (ERM) (if any) and the internal limiting membrane (ILM) were removed, and plateletrich plasma (PRP) was used at the end of the operation. Intra- and postoperative complications were not registered. Results. The maximum period of observation of patients after treatment was 3 months. In all cases, an anatomical result was achieved – complete closure of the macular hole according to optical coherence tomography (OCT). Mean BCVA results 3 months after treatment were 0.32±0.08. In all cases, improvement in visual functions was achieved (p=0.035). Conclusion. The method of two-port vitrectomy in the treatment of macular holes allows to achieve a good anatomical result, improve visual functions, while minimizing surgical trauma. Key words: macular hole, platelet-rich plasma, two-port vitrectomy.","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127548319","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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