A retrospective analysis of the statistical data for the years 2010‑2012 on mortality and the donor selection of the Bureau of Forensic Pathology of Moscow, Department of Forensic Pathology of Pirogov N. I. Russian National Research Medical University and ILab Eye Bank in order to determine the possible number of keratoplastic surgeries. The results of statistical data analysis testify to the fact that the number of available donor material is not sufficient to meet the needs for keratoplastic material and it is necessary to create eye banks, which would have provided this need. It is necessary to create eye banks, that possess a clear logistics chain of intake donor tissue, preliminary assessment of the donor tissue, laboratory diagnostics of the donor’s blood and delivery of tissue to the Bank. The
eye bank should not only produce preserved material for keratoplasty, but also carry out full morpho-functional assessment of material and its subsequent delivery to consumers in health facilities.

The paper presents an overview of the methods of surgical correction of corneal astigmatism in patients who underwent cataract surgery with IOL implantation, gives an idea of toric IOL, their advantages over other methods of the astigmatism correction, the criteria for patient selection, calculation features, preoperative marking. Besides the concept of rotational instability is sanctified position the IOL within the eye, its causes, methods of detecting the position of the IOL, as well as surgical ways to improve its rotational stability.

Central serous chorioretinopathy is still considered a disease with uncomletely studied etiology and pathogenesis, so there is no single approach to the treatment of this condition. In review the known factors of central serous chorioretinopathy, as well as the basic theories of its formation are presented. In addition, the methods of diagnostics and used to date methods of treatment for both acute and chronic central serous chorioretinopathy are described.

Provides information about the beta-blockers: history, mechanism of action, adverse systemic and local effects, the use in the treatment of glaucoma and ocular basic forms used in Russia.

Purpose: To evaluate the results of DSAEK with thin grafts in patients suffered bullous keratophaty with low preoperative visual acuity.

Methods: DSAEK with thin grafts the thickness of which was 150‑70 μm was fulfilled in 47 patients (47 eyes) suffered bullous keratophaty without visible leukomas in the corneal stroma. Visual acuity prior to the operation with a maximum spectacle correction accounted for an average of 0.05±0.04. Tear film osmolarity of 20 patients (20 eyes) who participated in the research was measured. 

Results: In follow-up period graft kept transparency in 39 patients. Visual acuity in 3 months after the operation, on average, without correction was 0.38±0.16, with a maximum of spectacle correction is 0.51± 0.18. The spherical component varied in the range from 0 to 3.75 D, with an average of 1.63 per±1.1 D. Corneal astigmatism was from 0.5 to 4.0 D, an average of 1.8±0.98 D. At preoperative osmolarity indicators were within the normal reference for both operated and non-operated eyes — 292.3±10.4 и 279.3±3.51. In a first postoperative week osmolarity was not detected while on a non-operated eye it was 278.4±1.4. After 1, 3 and 6 months osmolarity indicators on both eyes were within normal reference. Spherical component ranged from 0 to 3.75 D, averaging 1.1±1.63 D. Corneal astigmatism ranged from 0.5 to 4.0 (D), with an average of 1.8±0.98 D 1.63 per±1.1 D.

Conclusion: DSAEK with thin grafts is an effective modern methods of surgical treatment of bullous keratophaty. For old patients with severe ocular pathology — concomitant eye diseases, repeated surgery of the eye, the developed stage of the keratophaty — we have not noted the apparent correlation between the thickness of the transplant, visual acuity and the time of recovery of visual functions after keratoplasty. Osmolarity in an early postoperative period is a non-informative method of diagnostics. Restoration of osmolarity level to preoperative level is expected within one month after the surgery.

Purpose: To evaluate the results of multifocal contact correction of presbyopia in subjects with myopic refraction.

Methods: The study included 28 patients with myopia (range 43 to 54 years) in conditions of routine contact correction of vision. The examination was repeated a month later after wearing of multifocal contact lenses. The following parameters were assessed: far visual acuity, near and intermediate visual acuity (monocular and binocular), spatial contrast sensitivity, stereo vision (Lang test I&II), area of binocular interaction (binarymeter), visual quality (test VF-14).

Results: The indices if visual acuity in patients with multifocal contact lenses were high at all test distances. The significant increase of near vision was noted: visual acuity with monofocal contact correction was 0.39±0.11, with multifocal — 0.62±0.15 (p<0.05). However the decrease of spatial contrast sensitivity was noted: with monofocal contact lenses 21.96±4.6 dB (total in 4 frequencies), with multifocal — 19.48±1.1 dB, p<0.05. The level of stereo perception in users of multifocal contact lenses remains high, but the decrease of fusion capacity in convergence was noted. The greatest satisfaction with obtained vision was noted by patients, who achieved refraction (-) 0.5 D or difference between eyes 0.3‑0.5 D. The office employees were maximally satisfied with multifocal contact lenses.

Conclusion: Multifocal contact correction of presbyopia allows achieving high functional results at different distances. Patients with myopia, previously used contact lens correction, easy pass to multifocal correction options. The greatest satisfaction with obtained vision was noted by patients, who achieved refraction (-) 0.5 D.

Purpose: Propose a correction of IOL power calculation for the cases of cataract phacoemulsification after preceding subtotal vitrectomy.

Methods: The study enrolled 32 cases (32 patients) cataract phacoemulsification with IOL implantation after subtotal vitrectomy.
Patient age averaged 48±3 years. In all cases, the elastic IOLs were implanted with the value of the constant A from 118.0 to 119.0. Term
evaluation of clinical refraction after phacoemulsification surgery was on average 3 months. A retrospective analysis was performed of refractive outcomes using the inverse method of calculation.

Results: In a retrospective analysis, the error calculated IOL power by an average of 0.8 D, which leads to a shift in clinical refraction towards myopia. IOL after surgery avitreal eye on the average is closer to the top of the cornea by 0.5 mm, relative to the standard situation. 

Conclusion: For preoperative IOL power calculations after subtotal vitrectomy A-constant can be modified as follows: Am = A-0.9.

Purpose: To evaluate the effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular agerelated
macular degeneration (AMD).

Methods: 35 patients with wet AMD undergone intravitreal 0.5 mg ranibizumab injection. Color Doppler Imaging (CDI) and dopplerography
were used to measure hemodynamic parameters including the peak systolic velocity (Vsyst, cm / s), end-diastolic velocity (V diast, cm / s), and resistance index (RI) of blood flow in the central retinal artery (CRA), the short posterior ciliary arteries (PCA), and the ophthalmic artery (OA). All patients were examined before and after injection on day 1‑7 and 30 day during the 3‑month follow up period.

Results: Before intravitreal injection Vsyst was decreased in short PCA (p<0.05), RI in CRA and in short PCA significantly increased in comparison with normal index in same vessels. The peak systolic velocity in OA, in CRA and in short PCA was not significantly changed. After second injection resistance index in CRA and in short PCA was normalized.

Conclusion: There was not impairment of ocular blood flow in retinal and choroidal after monthly intravitreal injection of ranibizumab during the 3‑month follow up period.

Purpose: To compare the results of laser treatment and intravitreal ranibizumab injections in patients with DME consistent with the level of VEGF A in tear fluid.

Methods: The progress of visual acuity, retinal thickness and light sensivity after laser treatment and ranibizumab intravitreal injection has been assessed.

Results: One month after the treatment the main effect of laser was the decrease of retinal thickness, whereas after ranibizumab — the increase of visual acuity. The significant decrease of VEGF A level in tear fluid was found only in ranibizumab group.

Conclusion: Laser treatment of DME leads to permanent retinal thickness decrease and insignificant functional improvement in comparison with ranibizumab IV injection, which leads to temporary morphological and functional improvement.

Purpose: To evaluate the potential of endostatin, tumstatin and PEDF in avasculargenic therapy.

Methods: The avasculargenic potential of the natural angiogenesis inhibitors was explored on the model of alkaline burn, attended with angiogenesis of cornea. The model was developed on 8 rabbits. The injections were performed in calculated and tenfold increased dose after the vascularization had been formed. The injections were made daily, subconjunctively. There were 10 injections in total. The animals were observed for three months.

Results: The clinical findings were obtained which prove the efficiency of the natural angiogenesis inhibitors in avasculargenic therapy. Tumstatin was registered as possessing the maximum clinically significant dose-dependent avasculargenic potential.

Conclusion: The avasculargenic potential of the natural angiogenesis inhibitors — endostatin, tumstatin and PEDF — in avasculargenic therapy has been experimentally explored. As a result there was obtained the evidence of the clinically significant dosedependent avasculargenic potential of tumstatin, the natural angiogenesis inhibitor.

Purpose: To study blood flow autoregulation in normotensive glaucoma using ultrasound dopplerography before and after a neuroprotective
treatment.

Methods: In the period of observation from 2010 to 2012, we examined 94 patients (183 eyes), of which 33 (61 eyes) — with normotensive glaucoma (NG), 31 (62 eyes) — with open-angle glaucoma (OAG) and 30 patients (60 eyes) was the control group. There were 40 men and women — 54. Mean age was 58.5±6.5 years.

Results: Ultrasound dopplerography showed marked reduction of peak systolic, terminal diastolic velocity and an increase in resistance index CRA and SPCA (p <0.001) and OA (p <0.05) in the group of patients with NG compared to the norm.

Conclusion: There is a certain tendency to improvement of hemodynamic parameters after treatment with neuroprotective that at the root does not negate the need for neuroprotection in NG.

The authors analyzed the hormonal profile of patients with Graves’ disease and endocrine orbitopathy with or without autoimmune dacryoadenitis. Presented compelling evidence about the role of hormonal imbalance between thyreoglobulines and thyroidstimulating hormones in the development of autoimmune dacryoadenitis. The availability of this kind of imbalance increases the risk of involvement of lacrimal gland in the pathological process with 12.3 % up to 64.3 % in the population with Graves’ disease and endocrine orbitopathy.

Purpose: To analyze the data, visometry and the thickness of the fovea, patients with dry form of age-related macular degeneration (AMD) after dosing Vitalux Plus.

Methods: We observed 25 patients with dry form of AMD. Visometry and optical coherence tomography of the macula was assessed at 1 and 3 months after treatment Vitalux Plus.

Results: In the study group according to visometry and optical coherence tomography was found a positive trend. In the course of our research in 65.3 % of the thickness of the fovea increased, probably by increasing the layer of pigment epithelium. Improvement in the layer of pigment epithelium was observed mainly in patients with early-stage AMD, and in this group also found improvement in visual acuity and more motivated to treatment and further outpatient observation.

Conclusion: During the observation period, all patients with dry form of AMD, the stabilization of visual acuity. In the main group on the background of the drug Vitalux Plus objective indicators showed improvement according to retinal optical coherence tomography.
In the analysis of the results showed a positive therapeutic effect in patients Vitalux Plus, especially with early dry form of AMD.

Purpose: Assessment of the effectiveness of different methods of treatment accommodation disturbances in patients 18‑23 years old.

Methods: Determination of refraction and the size of the absolute accommodation and reserves of the relative accommodation
before and after the treatment with Midrimax and Irifrin 2.5 % in combination with the course of electrostimulation.

Results: The clinical effect was obtained in all patients. The maximum improvement of visual functions with a lower degree of myopia (1.0‑3.0 D), increase of absolute accommodation (by 2.5‑3,.D) and reserves of the relative accommodation (up to age norms) were observed in the younger age group of patients, wich had received the treatment with Midrimax, especially when combined with electrostimulation.

Conclusion: Instillation of Midrimax in the treatment of violations of accommodation contribute to the effective reduction in the degree of myopia and improve of accomodation in patients 18‑23 years old. The combination of this therapy with functional methods of treatment increase its effectiveness.

Purpose: To evaluate clinical efficiency of systemic usage of artificial tears drops Systein Ultra in the patients with different forms of dry eye syndrome.

Methods: 42 patients (84 eyes) at the age of 21‑84 with different pathogenic forms of ocular xerosis and degrees of it’s severity were investigated. Systein Ultra eye drops in instillations were prescribed to all patients 3 times a day. Complex examination of being investigated was performed before the drug administration, in 7 days and then in 2 weeks.

Results: Positive dynamics after the treatment was reavealed on average in 4‑7 days. There was decrease or absolute reduction of subjective and objective signs in the majority of cases. In the severest cases of the disease all investigated parameters were not changed.

Conclusion: The positive clinical result after artificial tears drops Systein Ultra using, accompanied by eye comfort without significant side effects, allows us to recommend Systein Ultra to the wide application in therapy of different pathogenic forms dry eye syndrome.

The paper presents a sequence of operations for the treatment of diabetic neovascular glaucoma case with high IOP and marked iris neovascularization. In the treatment of combined panretinal laser photocoagulation of retina, injection of anti-VEGF and antiglaucomatous
surgery with implantation of drainage. This algorithm permits to avoid a number of hemorrhagic complications.