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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ophthalmology</journal-id><journal-title-group><journal-title xml:lang="ru">Офтальмология</journal-title><trans-title-group xml:lang="en"><trans-title>Ophthalmology in Russia</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1816-5095</issn><issn pub-type="epub">2500-0845</issn><publisher><publisher-name>Ophthalmology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18008/1816-5095-2018-3-242-247</article-id><article-id custom-type="elpub" pub-id-type="custom">ophthalmology-683</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОФТАЛЬМОХИРУРГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>OPHTHALMOSURGERY</subject></subj-group></article-categories><title-group><article-title>Хирургическое лечение буллезной кератопатии: современные подходы и тенденции</article-title><trans-title-group xml:lang="en"><trans-title>Surgical Treatment of Bullous Keratopathy: Modern Approaches and Trends</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4360-793X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Труфанов</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Trufanov</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Труфанов Сергей Владимирович доктор медицинских наук, ведущий научный сотрудник, отдел патологии роговицы</p><p>ул. Россолимо, 11а, б, Москва, 119021</p><p>Участие авторов — концепция и дизайн исследования, написание текста, редактирование</p></bio><bio xml:lang="en"><p>Trufanov Sergej V. MD, leading research associate </p><p>Rossolimo str., 11A, B, Moscow, 119021</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Осипян</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Osipyan</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Осипян Григорий Альбертович кандидат медицинских наук, старший научный сотрудник, отдел патологии роговицы</p><p>ул. Россолимо, 11а, б, Москва, 119021</p><p>Участие авторов — концепция и дизайн исследования, редактирование</p></bio><bio xml:lang="en"><p>Osipyan Grigorij A. PhD, senior research associate </p><p>Rossolimo str., 11A, B, Moscow, 119021</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Саловарова</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Salovarova</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Саловарова Елена Павловна врач-офтальмолог, аспирант, отдел патологии роговицы</p><p>ул. Россолимо, 11а, б, Москва, 119021</p><p>Участие авторов — сбор и обработка материала, статистическая обработка, редактирование</p></bio><bio xml:lang="en"><p>Salovarova Elena P. postgraduate </p><p>Rossolimo str., 11A, B, Moscow, 119021</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баг</surname><given-names>Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Bagh</surname><given-names>R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Баг Рами врач-офтальмолог, аспирант, отдел патологии роговицы</p><p>ул. Россолимо, 11а, б, Москва, 119021</p><p>Участие авторов — сбор и обработка материала</p></bio><bio xml:lang="en"><p>Bagh Rami postgraduate</p><p>Rossolimo str., 11A, B, Moscow, 119021</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1526-3834</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семченко</surname><given-names>К. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Semchenko</surname><given-names>K. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Семченко Ксения Николаевна ординатор  </p><p>ул. Россолимо, 11а, б, Москва, 119021</p><p>Участие авторов — сбор и обработка материала, статистическая обработка, написание текста</p></bio><bio xml:lang="en"><p>Semchenko Ksenija N. resident </p><p>Rossolimo str., 11A, B, Moscow, 119021</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт глазных болезней»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Institute of Eye Diseases</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>04</day><month>10</month><year>2018</year></pub-date><volume>15</volume><issue>3</issue><fpage>242</fpage><lpage>247</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Труфанов С.В., Осипян Г.А., Саловарова Е.П., Баг Р., Семченко К.Н., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Труфанов С.В., Осипян Г.А., Саловарова Е.П., Баг Р., Семченко К.Н.</copyright-holder><copyright-holder xml:lang="en">Trufanov S.V., Osipyan G.A., Salovarova E.P., Bagh R., Semchenko K.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.ophthalmojournal.com/opht/article/view/683">https://www.ophthalmojournal.com/opht/article/view/683</self-uri><abstract><p>По данным ВОЗ слепота, возникшая вследствие поражения роговицы, занимает 4-е место (5,1 %) среди основных причин существенного снижения зрения в мире после катаракты, глаукомы и возрастной макулярной дегенерации. Буллезная кератопатия — это тяжелое заболевание роговицы с прогрессирующим характером течения. В основе заболевания лежит поражение эндотелия, что ведет к хроническому отеку роговицы, снижению остроты зрения, развитию болевого синдрома, образованию стойких помутнений, а также к присоединению инфекции, что может закончиться потерей глаза как органа. Со второй половины 90-х годов XX века в клиническую практику вошли различные модификации современной задней послойной (эндотелиальной) кератопластики, которые получили в дальнейшем широкое распространение для лечения буллезной кератопатии. Развитие эндотелиальной кератопластики было обусловлено использованием современных микрокератомов, которые начали применяться в рефракционной хирургии, а также усовершенствованием микрохирургической техники, что позволило выборочно (селективно) замещать только пораженные слои роговицы на новом качественном уровне, в отличие от традиционной мануальной послойной кератопластики. Необратимые помутнения стромальных слоев центральной зоны роговицы являются противопоказанием для эндотелиальной кератопластики. В этих случаях современные технологии и новое оборудование, в частности фемтосекундный лазер, позволяют выполнять сквозную кератопластику со сложным профилем корреспондирующих краев трансплантата и ложа. Для лечения буллезной кератопатии патогенетически ориентированной операцией со сложным профилем считается обратная грибовидная кератопластика в различных модификациях, что позволяет пересаживать большее количество эндотелиальных клеток при меньшем объеме трансплантируемой ткани передних слоев. В данной статье представлен обзор литературы, посвященной современному хирургическому лечению буллезной кератопатии.</p></abstract><trans-abstract xml:lang="en"><p>According to WHO, corneal pathology is the fourth cause (5.1 %) of blindness among the main causes of significant visual impairment in the world after cataract, glaucoma and macular degeneration. Bullous keratopathy is a serious progressive corneal disease, in which the endothelial lesion plays the main role leading to the chronic corneal edema, reduce of visual acuity, development of pain syndrome, formation of permanent opacities, and various infectious complication, which may result in eye globe loss. Since the second half of 90th XX century various modifications of modern posterior (endothelial) keratoplasty have been introduced in the clinical practice, which were subsequently used widely for the treatment of bullous keratopathy. The introduction of new microkeratomes used in refractive surgery significantly contributed to the development of endothelial keratoplasty microsurgical technique, which enables the high quality, selective replacement of the affected corneal layers in comparison to the manual lamellar keratoplasty techniques. One of the contraindications for endothelial keratoplasty is an irreversible central stromal opacity. In that case, modern technologies and new equipment (particularly femtosecond laser) provide an opportunity to perform the penetrating keratoplasty with a complex-shaped profile and corresponding edges of the graft and its bed. In bullous keratopathy, top-hat keratoplasty represents the pathogenically targeted treatment method that allows transplanting of more endothelial cells with a relatively smaller diameter of graft’s anterior segment. This article reviews the literature on modern surgical treatment of bullous keratopathy.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>буллезная кератопатия</kwd><kwd>дистрофия Фукса</kwd><kwd>эндотелиальная кератопластика</kwd><kwd>DSAEK</kwd><kwd>DMEK</kwd><kwd>PDEK</kwd><kwd>DMET</kwd><kwd>грибовидная кератопластика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>bullous keratopathy</kwd><kwd>Fuchs’ dystrophy</kwd><kwd>endothelial keratoplasty</kwd><kwd>DSAEK</kwd><kwd>DMEK</kwd><kwd>PDEK</kwd><kwd>DMET</kwd><kwd>mushroom keratoplasty</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Mishima S. Corneal thickness. Surv. Ophthalmol. 1968;13:57–96.</mixed-citation><mixed-citation xml:lang="en">Mishima S. Corneal thickness. Surv. 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