In review presents data of various authors regarding the subjective results excimer laser correction of myopia by LASIK. It was revealed that a group of patients with a high degree of dissatisfaction amounts to 4.6% of the total in all studies. High subjective results are confirmed by the positive dynamics of the «quality of life» of the patient.

The reason for the progressive vision reduction at diabetes mellitus (DM) is diabetic retinopathy (DR). When type 2 diabetes combined with hypertension (Ht), it increases the risk of vision loss by 25 times. In the pathogenesis of DR is important to endothelial dysfunction and a variety of biochemical processes (an excess of intracellular sorbitol, non-enzymatic glycation of proteins, oxidative stress). there is a decrease in generation vasodilating factors, nitric oxide, with a simultaneous increase of endothelin, which causes vasoconstriction. Key processes underlying the development of DR, such as increased vascular permeability, edema, neovasculariza- tion, inflammation and associated with the effects of kallikrein-kinin system. In the pathogenesis of DR can be involved independent intraocular renin-angiotensin system, which is an important mediator of angiogenesis and increased vascular permeability. Damage to the endothelium of retinal vessels leads to ischemia of the retina. there is growth and development of newly formed blood vessels, which may provoke recurrent bleeding.

Purpose: to assess the effectiveness of pre-operative therapeutic eyelid hygiene in the prevention and treatment of dry eye and meibomian glands dysfunction following excimer laser vision surgery.
Methods: In enrolled 144 patients (288 eyes), ocular surface and meibomian glands functions were evaluated before and following refractive surgery (LASIK and REIK). In pre- and post-operative period, standard ophthalmological studies were performed, including best-corrected visual acuity determination, biomicroscopy, Schirmer’s test and Norn’s test (tear break-up time). In pre-operative pe- riod, ocular surface microbial profile was assessed. Subjective symptoms of impaired tear production were revealed via questioning. In study group (70 patients, 140 eyes), therapeutic eyelid hygiene using Blefarogel 1 or Blefarogel 2 (Ltd. Heltec-Medica, Moscow, Russia) was prescribed one week before surgery. In control group, no therapeutic eyelid hygiene was prescribed. All patients were received antibacterial treatment including Vigamox (Alcon, Fort Worth, tX). In both groups, Natural tears and Systane Ultra (Alcon) were used as tear replacement therapy.
Results: Complex treatment, including therapeutic eyelid hygiene in study group, significantly improved tear film and ocular sur- face health as well as meibomian glands functions. Inflammatory complications rate was estimated as 5.7% in study group and 10.6% in control group.
Conclusion: therapeutic eyelid hygiene is highly effective in the prophylaxis and treatment of post-operative complications duу to ocular surface pathology and meibomian glands dysfunction. the procedure is safe and can be recommended as a part of complex preventive treatment before excimer laser vision correction.

Purpose: to evaluate the efficiency and tolerance of drops replacing tear with hyaluronic acid 0.15% (Hylabak, thea, France) for the treatment of tear film diseases, in particular blepharoconjunctival form of dry eye syndrome.
Methods: 32 patients (range 38 to 72 years) with blepharoconjunctival form of dry eye syndrome were treated lubricant Hylabak 2-4 times a day during 7-30 days.
Results: After treatment was detected the elimination of complaints in 30 of 32 people, increasing the stability of the tear film (increasing values of the samples Norn test from 7.3 ±0.5 to 10.1±0.6 seconds), as well as normalization of Schirmer test (from 8.8±0.4 to 15.2±0.5 mm).
Conclusion: the study was showed high efficacy of lubricant Hylabak and subjective tolerability at blepharoconjunctival form of dry eye syndrome.

The investigation of the drug Midrimax in order to assess its efficacy and safety in the preoperative preparation for cataract surgery. It is established that the drug causes long-lasting mydriasis in a short period of time, does not affect the level of intraocular pressure. Patients receiving continuous therapy with antihypertensive drugs, there is no increase in blood pressure and heart rate.
thus, the Midrimax can be used in patients with chronic diseases in the compensation stage, including in patients with glaucoma.

Purpose: to evaluate outcomes of the half-top-hat keratoplasty.
Methods: the study included 58 eyes that had bullous keratopathy and underwent half-top-hat keratoplasty.
Results: 40 (69%) patients had clear corneas whole period of observation. Graft rejection occurred in 1 eye. Mean BSCVA was
0.47±0.21. Average astigmatism was 5.0±2.1 D. Mean cell endothelial count in 2 years was 2189±399 cell/mm2.
Conclusion: Half-top-hat keratoplasty is effective method for bullous keratopathy surgical treatment. the operation is equal pen- etration keratoplasty in refractive results and operation time. But time of rehabilitation is shorter, sealing is better, cell endothelial
count is greater.

Purpose: Morphological examination of the efficiency of the influence of various doses of riboflavin-UV induced crosslinking on the state of the corneal stroma in experimental animals.
Methods: In the work were used rabbits males breed Chinchilla mass of 1.5-2.0 kg. the experiment was conducted on 20 eyes of 10 animals, which performed the routine crosslinking. Experimental animals, depending on the power UV-laser irradiation, were divided into 4 groups: the animals of the 1 group with the minimum intensity of radiation (30 minutes, 0.27 J), animals 2 group with medium intensity of radiation (15 minutes, 0.34 J)), animals 3 groups with high intensity of radiation (30 minutes, 0.34 J)), the control group 4 (without UV-radiation). Date of dynamic observation of the experimental animals was 5 days, after which the animals were taken out of the experiment. Morphological investigations were carried out by means of light and electron microscopy.
Results: In groups of experimental animals with the impact of riboflavin UV-radiation in the stroma of the cornea were found the appearance of the areas of cross-stitched collagen fibers and fibrils. In the zone of the crosslinking were found activated keratoblasts.
Near the membranes of these cells the contents of the vacuoles are released and filaments finish building of the collagen fibers. the epithelium of the corneas of all experimental animals recovered fully, with no morphological signs of endothelial damage has been found. Electron-microscopic investigation of stroma of corneas of the experimental animals of the control group after the experiment showed the presence of keratocytes in an inactive form and collagen fibers of stroma, packed in the form of plates or beams with a characteristic orientation.
Conclusion: Studies have shown that UV-irradiation of the cornea leads to the appearance of linking between the fibers of collagen and actively synthesizing cells in the stroma of the cornea, which points to a possible stimulation of collagen producing processes. When in excess of the threshold values of the energy of the UV-irradiation we have not identified any morphological signs of damage of the endothelial layer of the cornea.

 

Purpose: Evaluation of the clinical features of simple myopic astigmatism.
Methods: In the framework of the follow-up observation of surveyed 64 patients (128 eyes) with the phenomena of simple myopic astigmatism in both eyes without concomitant ocular pathology.
Results: the most common are weak (up to 1.0 D — 42%, 1.25-2.0 D — 28%) of the value, expressed astigmatism (more than 2.0 D) is observed in 30% of cases. In terms of direct myopic astigmatism up to 1.0 D the most characteristic visual acuity is 0.6-0.7, when the value of astigmatism from 1.25 up to 2.0 D the most frequently noted visual acuity is 0.3-0.5. the indicator of «primary use» statistically significantly depended on the indicator «astenopic complaints» (correlation coefficient was 0.59 is 0.72, p<0.0001).
Conclusion: the emergence of the patient with visually-intensive work (especially working in conditions of shortage of time) re- quires of excimer laser correction for the preservation of visual capacity and the required level of professional reliability, as well as the extension of the professional longevity of the body of view.

Purpose: to examine results of a new method of iridocyclodialysis and posttraumatic lens damage treatment directed at intraocu- lar pressure normalization and visual recovery.
Methods: 7 patients with ocular postcontusional hypotension, iridocyclodialysis, traumatic cataract and lens subluxation were ex- amined. Ultrasound biomicroscopy and optical coherence tomography were used to evaluate the status of anterior segment of the eye.
Results: All patients underwent two-stage surgery. As a first stage iridocyclopexia was made. Second stage was cataract extrac- tion in different modifications with iridoplasty. Follow-up period of 1-1.5 years and results of UBM and OCt showed intraocular pres-
sure normalization, regression of hypotension and visual recovery.
Conclusion: Worked out surgery of iridocyclopexia with following cataract extraction is an effective and safe method of postcon-
tusional iris and ciliary body damages treatment. two-stage complex surgery allows to get intraocular pressure normalization at the
distant times, to recover visual functions and can prevent secondary postcontusional glaucoma development.

Purpose: to investigate hypotensive efficiency of new surgical intervention at terminal primary and neovascular glaucoma.
Methods. Operation has been executed on 35 eyes of 35 patients with terminal primary (23 eyes) and secondary (12 eyes) neo- vascular glaucoma. A fornix based conjunctival flap was prepared in inferior part of a limbus. 1.5 mm transparent scleral incision 3 mm from limbus was performed. Goniocyclodialysis with spatula was carrying out. then 0.3 ml of viscoelastic solution was entered in cyclodialysis cleft. On sclera put cryoapplications, located in two ranks (on 6 in everyone). the period of postoperative follow-up has averaged 15.6±1.3 months.
Results: In 1 month IOP did not exceed 25 mm hg and the painful syndrome has been stopped in all cases. In 1 year after operation normalization IOP took place on 27 eyes (77.2%), from them on 8 was local hypotensive therapy added. With 8 patients (22.8%) IOP instillation of 2 preparations remained at level of 28-30 mm Hg, however the painful syndrome was absent.
Conclusion: Long-term hypotensive effect of new operation is reached at the expense of the double mechanism: reduction of production of aqueous humor for the account cryopexy of ciliary body and improvements aqueous outflow for formations cyclodialysis cleft.

Purpose: to access the possibilities of new biodegradable drainage implant Glautex in the original method of glaucoma surgical treatment.
Methods: 152 patients (158 eyes) have had a penetrating and nonpenetrating antiglaucoma surgical treatment with the use of Glautex. Patients were divided in 3 groups: 1st group — 90 patients (93 eyes), where valve trabeculectomy with the use of biodegrad- able drainage Glautex has been performed. 2nd group — 33 patients (35 eyes) with refractory glaucoma (previously operated glau- coma, postkeratoplasty, neovascular glaucoma etc.) with the same type of antiglaucoma surgery. 3rd group — 29 patients (30 eyes) with deep non-penetrating sclerectomy with the use of Glautex.
Results: Stable IOP has been obtained in all cases within 6 to 12 months’ time. Complete biodegradation of the implant took place in 4-5 months, which was confirmed by ultrasound biomicroscopy. We have obtained no cases of inflammation in postoperative period. No cases of blebitis and cystoid blebs have been noted. the choroidal detachment, requiring surgical treatment was noted on 7 eyes (7.5%) in the 1st group; in the 2nd group — on 3 eyes (8.6%). the 3rd group (nonpenetrating glaucoma surgery) had 2 cases of flat choroidal detachment, which have successfully cured after medical nonsurgical treatment.
Conclusion: Use of the new biodegradable drainage implant Glautex provides stable decrease of IOP due to prevention of sclero- conjunctival and sclero-scleral adhesions. Glautex may be used in all cases of glaucoma surgery (penetrating and nonpenetrating) with the scleral flap formation. the proposed new method is applicable for all types of glaucoma. 

Purpose: Show the results of treatment of secondary glaucoma after severe eye burns.
Methods: We observed 70 patients (108 eyes) with severe burns the eyes and their consequences, secondary glaucoma was observed in 40 patients (58 eyes). All patients with secondary glaucoma received traditional antihypertensive therapy, with its failure to resort to antiglaucomatous surgery. Cataract extraction performed in 24 cases, 16 of them in combination with other surgery: the reconstruction of the anterior chamber, penetrating keratoplasty, sinustrabeculectomy, diode laser cyclocoagulation. Diode laser cy- clocoagulation performed 42 times in 8 of them in combination with other antiglaucomatous surgery: cataract surgery, reconstruction of the anterior chamber. Sinustrabeculectomy in patients with secondary glaucoma was performed in 7 cases, 4 of them with collagen implant drainage. Ahmed glaucoma drainage implant performed in 5 cases.
Results: In 23 out of 58 (39.6%) of long-term compensation glaucoma IOP was achieved antihypertensive therapy without sur- gery. After cataract extraction resistant compensated IOP was achieved in 10 cases, a temporary (1 to 42 months) — in 11 cases, IOP is not reduced in 2 cases. After completing diode laser cyclocoagulation stable normalization of IOP occurred in 16 cases, the temporary (from 1 month to 2 years) — in 20 cases, 4 cases of IOP reduction was not achieved. As a result sinustrabeculectomy in 4 cases IOP decreased, in one case the hypotensive effect is not there. After implantation Ahmed glaucoma valve in 2 cases was achieved stable normalization of IOP, in the 2 cases — the temporary; in 1 case developed endophthalmitis, and the device was removed.
Conclusion: the immediate effect of antiglaucomatous treatment was 96.6%, but the high incidence of IOP decompensation (73.7%) suggesting the need for continuous follow-up patients after severe eye burn injury, and a readiness to use other methods to reduce IOP.

Purpose: Investigation of the parameters of innate immunity in senile group patients with eye injury.
Methods: Standard ophthalmologic and immunologic study of 12 patients aged 63±11 with eye injury complicated by inflamma- tion. Immunological study of peripheral blood, tear and conjunctival scraping from the injured eye and the binate eye was carried out on 1-3 days after the injury. the parameters of innate local immunity was determined in the result of immune-cytological study of the conjunctival scraping by assessing phagocytosis of neutrophils and index of neutrophils/lymphocytes (INL), immunofluorescent counting of NK-cells CD56+ (panel of monoclonal antibodies of company «Sorbent» Ltd., Russia). the concentration of transferrin (a set of «Human» Company, Germany) in the blood and lacrimal fluid was assayed by the biochemical analyzer (Bioscreen MS-500). the results obtained were processed by the method of variational statistics.
Results: As a result of the conducted studies there has been detected a decrease in the amount of transferrin both in blood and lacrimal fluid by almost 2 times (p <0,001). there was recorded the rise in the INL index at the systemic (3,8±0,1) and local (4.9±0.4) level, reflecting a compensatory, more pronounced activity of nonspecific protection factors of general and local immunity in the acute stage of inflammation. the level of phagocytosis in the blood of the examined patients was reduced relative to the control (p<0.001). In the scraping material of the injured eye the phagocytosis percentage was 16.4±0.9%. the results of a comparative study of the content of NK-cells (СD56+), revealed reduction in the average value of this parameter in the blood of the patients with eye injury relative to the control (p<0.001), and in the conjunctival scraping the level of СD56+-lymphocytes increased, amounting to 2-3 in the field of vision.
Conclusion: In the senile group patients with an eye injury there is an activation of nonspecific defense factors, mainly, on the local level: neutrophilic infiltration of the mucosa of the conjunctiva, increase in INL on the average to 4.9, increase in the number of NK-cells. the sharp decrease in the concentration of transferrin in the systemic and local level can serve as an additional diagnostic criterion for inflammatory activity in eye trauma. 

Purpose: to develop a method and a statistical model to estimate individual risk of AMD and the risk for progression to advanced AMD using clinical and genetic risk factors.
Methods: A statistical risk assessment model was developed using stepwise binary logistic regression analysis. to estimate the population differences in the prevalence of allelic variants of genes and for the development of models adapted to the population of Moscow region genotyping and assessment of the influence of other risk factors was performed in two groups: patients with differ- ent stages of AMD (n = 74), and control group (n = 116). Genetic risk factors included in the study: polymorphisms in the complement system genes (C3 and CFH), genes at 10q26 locus (ARMS2 and HtRA1), polymorphism in the mitochondrial gene Mt-ND2. Clinical risk factors included in the study: age, gender, high body mass index, smoking history.
Results: A comprehensive analysis of genetic and clinical risk factors for AMD in the study group was performed. Compiled statis- tical model assessment of individual risk of AMD, the sensitivity of the model — 66.7%, specificity — 78.5%, AUC = 0.76. Risk factors of late AMD, compiled a statistical model describing the probability of late AMD, the sensitivity of the model — 66.7%, specificity — 78.3%, AUC = 0.73. the developed system allows determining the most likely version of the current late AMD: dry or wet.
Conclusion: the developed test system and the mathematical algorhythm for determining the risk of AMD, risk of progression to advanced AMD have fair diagnostic informative and promising for use in clinical practice.

Purpose: Histological evaluation of the influence of PABA on the course of retinal degeneration and the state of outer nuclear layer (ONL) of the retina in rd10 mice.
Methods: the present experiment studied PR model in rd10 mice (Jackson Labs, Maine, USA) homozygous for a recessive mutation in the b-subunit of rod phosphodiesterase. Animals in the treatment group (n = 28) were intraperitoneally injected with PABA in saline (50 mg/kg) 6 times a week from the third day after birth till 4.5 weeks of age. Animals in the control group (n = 24) were intraperitoneally injected with saline using the same protocol. At 3 and 4.5 weeks of age, eyes were enucleated. After fixation and dehydration, the samples were placed in paraffin and serial sections, 4 microns sick, were obtained through the center of the optic nerve. thickness of ONL and the number of rows of photoreceptor nuclei in the ONL of central, middle and peripheral parts of the retina were analyzed to access the morphological condition of retina. t-test was used to compare the dif- ference between two groups (p ≤ 0.05, unpaired two-tailed t-test).
Results: At the age of three weeks, the thickness of ONL and the number of rows of photoreceptor nuclei in the ONL is reducing more than twofold in both experimental groups compared with healthy mice group. there is a tendency toward greater thickness of the ONL and the greater number of rows of nuclei in the central zone and mid-peripheral retina at the age of three weeks in the group of animals that were injected with PABA compared to the control group. At the age of 4.5 weeks both the thickness of the ONL, and the number of rows of photoreceptor nuclei in the ONL were significantly greater in the peripheral retina of the animals in the treatment group compared with the control group (p <0.05).
Conclusion: Systemic administration of PABA has a stabilizing effect on the degenaration process of ONL of the retina in rd10 mice. thus, PABA, with its good safety profile can be an effective addition to the antioxidant therapy of retinitis pigmentosa. 

According to orbit computer tomography, lacrimal gland is involved in autoimmune process in 26.8% of patients with Graves’ orbitopathy. A short orbit is a predisposing factor of the lacrimal gland (LG) involvement in the autoimmune process. In addition to increasing of the size of the lacrimal gland, formed thickening of the optic nerve in 1 cm from the eye posterior pole (in 60% of cases), the increase in x-ray density of orbital portions of optic nerve, proved «shortening» of length in axial projection with reliable reduc- tion of length to width ratio (with increase in width at the same time) up to 5.8±0.2 are roentgenological features of this сlinical form. Change of spatial topography in orbit with reduction of the conversion rate was associated with increased rate of optic neuropathy
development.

Purpose: to design the new combined technique of endoresection with intraoperative intraocular electrochemical lysis at the tumor destruction stage for large posterior intraocular tumors.
Methods: 3 patients (3 eyes) with large choroidal melanomas t3N0M0 (tumor thickness — 8-10 mm, base diameter — 13-15 mm, juxtapapillary localization). Mean age was 55.4 years old. Endoresection with intraoperational intraocular electrochemical lysis of the tumor was performed. Electrochemical lysis was performed with use of the technical unit ECU 300 (Soering, Germany) and the original method of combined intratumoral positioning of two platinum electrodes: anode and cathode.
Results: the tumor was removal completely in all 3 cases. the anatomical retinal reattachment was reached in all patients. Sclera was safe in all 3 cases. Visual acuity was not changed (NLP). At the place of the removal tumor a surgical choroidal coloboma without pigmentation all over scleral bed and periphery was shown in all cases in distant postoperative period (from 1.5 to 3 years). No local recurrences or metastasis were revealed in all patients.
Conclusion: Further investigations in clinical group are necessarily to determinate the real possibilities of the combined method and the indications for endoresection with intraoperative intraocular electrochemical lysis for large intraocular tumors.

 

For the first time in Russia there are presented data on dynamics of morbidity and mortality from malignant tumors of the eye and adnexa (С69). there were demonstrated details of prevalence by age groups of patients, provided characteristics of dynamics of the levels of morphological verification and distribution of patients by stages of tumor process.

Purpose: the comparative evaluation of indicators of quality of life and eyesight capacity among groups of patients with different types of eye mechanical trauma for studying of the possibility of the authentic qualitative and quantitative analysis.
Methods: 120 patients (101 men and 19 women) with a mechanical injury of an eye are included in research. the mean age was 42.3±17.4 years, from 18 to 74 years. Patients are divided according to the type of trauma: with a contusion — 67 patients (group A), with penetrating wounds — 53 patients (group B).
Results: the study shows the expediency of early (at the stage of hospitalization) determination by the patient his own condition, in order to trace dynamics in indicators of quality of life, timely reacting to them, making changes in treatment tactics in the post- traumatic period.
Conclusion: Profound attention from experts for definition of strategy of recovering is demanded by a pain syndrome and a psy- chological stress of patients. the individual approach provides competent application of questionnaires, as tools of the assessment of quality of life.

This work deals with the psychological rehabilitation of patients with anophthalmia having eye protesis as the main role on the problem. Stages of psychological reaction after eye lost and also the difficulties of adaptation of fellows with both eyesight lost is widely discussed. In order to help practitioners, recommendations on dealing this kind of patients has been given.