Crosslinking of the cornea was developed at the end of the last century and radically changed approaches to the treatment of progressive corneal ectasia. To achieve the strengthening of the corneal tissue irradiation with ultraviolet light And is combined with the use of Riboflavin. Riboflavin plays a role of a photosensitizer in the process of photopolymerization and ultraviolet irradiation increases the formation of inter — and intrafibrillary covalent bonds. Standard Protocol operation involves the scarification of epithelium, a 30‑minute application of 0.1 % solution of Riboflavin with subsequent 30 min. irradiation with ultraviolet light with A wavelength of 370 nm and 3 mW / cm2. The lack of effect of routine procedures is defined as the increase in refractive power of the cornea by 1 Diopter. after treatment and observed in 8.1‑33.3 % of cases. A relatively frequent complication of the standard procedure of crosslinking (10‑90 %) is corneal haze. A number of cases of infectious keratitis, including bacterial, protozoan and fungal forms is registered. Rare complications after standard procedure of crosslinking are diffuse lamellar keratitis, melting corneal and endothelial-epithelial dystrophy. After instillation of Riboflavin its diffusion in the corneal stroma is limited by a dense contacts between epithelial cells, resulting in crosslinking often resort to preliminary scarification of epithelium. However, this manipulation is the cause of the complications of crosslinking, as intra — and postoperative pain, infectious keratitis and lethargic regeneration of the epithelium. The permeability of the epithelium for Riboflavin can be enhanced in several ways, for example, modifying physico-chemical properties of Riboflavin molecules or increasing the permeability of the epithelium, for example, by instillation of a 40 % strength solution of glucose. It was shown that the conducting electrophoresis with Riboflavin for 5 minutes, allows to reach a concentration in the cornea sufficient to conduct the crosslinking. There have also been attempts to reduce the time of the operation of crosslinking by increasing the power of irradiation of cornea with ultraviolet light. In single studies reported on the successful use of corneal crosslinking combined with photorefractive keratectomy and intracorneal the rings, as well as for the treatment of infectious keratitis and endothelial-epithelial dystrophy of the cornea.

The paper reviews modern methods of evaluating the biomechanical properties of the corneoscleral shell of the eye that can be used both in the studies of the pathogenesis of various ophthalmic pathologies and in clinical practice. The biomechanical parameters of the cornea and the sclera have been shown to be diagnostically significant in assessing the risk of complications and the effectiveness of keratorefractive interventions, in the diagnosis and the prognosis of keratoconus, progressive myopia, or glaucoma. In clinical practice, a special device, Ocular Response Analyzer (ORA), has been used on a large scale. The analyzer is used to assess two parameters that characterize viscoelastic properties of the cornea — corneal hysteresis (CH) and corneal resistance factor (CRF). Reduced levels of CH and CRF have been noted after eximer laser surgery, especially that administered to patients who demonstrate a regression in the refraction effect or suffer from keratoconus. This fact justifies the use of these biomechanical parameters as additional diagnostic criteria in the evaluation of the state of the cornea. At the same time, ORA data are shown to reflect the biomechanical response to the impact of the air pulse not only from the cornea alone but also from the whole corneoscleral capsule. This is probably the cause of reduced CH in children with progressive myopia and a weakened supportive function of the sclera, as well as such reduction in glaucomatous adult patients. It is hypothesized that a low CH value is a result of remodeling of the connective tissue matrix of the corneoscleral shell of the eye and can be an independent factor testifying to a risk of glaucoma progression. Reduced CH in primary open-angle glaucoma occurs in parallel with the development of pathological structural changes of the optic disc, and deterioration of visual fields, which is an evidence of a specific character and sensitivity of this parameter. The values were compared under compensated intraocular pressure. Further improvement of noncontact and noninvasive techniques of the assessment of the biomechanical status of the cornea and the sclera and their introduction into clinical practice will improve the diagnosis of various eye pathologies in any way related to disorders of the supporting functions of the corneoscleral shell.

Treatment of acute bacterial postoperative endophthalmitis (AE) is an actual problem. The frequency of AE is directly influenced by worldwide increase of surgical activity with prevailing outpatient surgery. Somatic status of the patient, structure of his own and hospital microflora, rules of preoperative preparation and postoperative treatment play an important role. Features of AE treatment are extremely delicate and require a complex approach for obtaining a high functional result. The review covers key historical aspects resulting in a significant progress in AE treatment. Positive anatomical result is associated with the period of first attempts of antibiotics (AB) intravitreal injections (IVI) beginning from 1940s. Development of automated systems for manipulations with pathologic vitreous in combination with AB intravitreal injections (IVI) resulted the first positive functional results in 1970s. Further investigations devoted to study of AB pharmacokinetics and pharmacodynamics, development of more advanced vitrectomy systems, complex analysis of pathogenic microflora antibiotic sensitivity, use of optimal criteria and terms of surgical intervention gave a possibility to improve functional and anatomical results of management of this severe postoperative complication. Modern clinical investigations are aimed to achieve the maximal functional results. For this purpose it is necessary to follow several fundamental principles: 1) removal of pathological substratum from the vitreous cavity (3‑port vitrectomy) must be done after diagnosis as soon as possible (during one hour); 2) vitrous cavity and anterior chamber content must be qualitatively taken for microflora cultering and antibiotic sensitivity test; 3) intravitreal antibiotics must cover the entire spectrum of possible pathogenic microorganisms before obtaining of bacterial seeding result; 4) it is necessary to continue one the most effective antibiotic with according to data of microbiologic analysis.

The review includes the publications of the scientific literature on the eye change during long-term spaceflight. The any eye changes such as visual impairment, hyperopic shift in refraction, changes in the intraocular pressure, increased the intracranial pressure, globe flattening, choroidal folding, optic disc edema, and optic nerve kinking and other changes were reported. The main cause of eye disorders, in all probability, is the increase of the intracranial pressure during long-term spaceflight. The reasons of the increased intracranial pressure are a collection of various factors of adaptation mechanisms in the body to weightless conditions. The leading role in the development of intracranial hypertension takes a redistribution of the body fluids (blood and lymph) in the direction of the head, but the opportunities and the effect of other factors are present. Also the displacement and increase of the internal organs volume of the chest can cause external compression of the jugular veins, increasing the pressure of the blood in them, and as the result to lead to the increase of the intracranial pressure. The role of trigger such mechanisms in the development of the intracranial hypertension in the microgravity environment as anatomical predisposition of the body, race, metabolic changes under the influence of high carbon dioxide content in the different compartments of the station, high sodium intake, the enzyme dysfunction, weight exercises of the astronauts was discussed. However, the pathogenic mechanisms is currently still under investigation. An important role in the study of the adaptation mechanisms is given to research not only before and after the flight, but also during the space flight. The accumulated knowledge and experience about the changes in organs and systems in the conditions of human adaptation to microgravity will help answer many questions related to the implementation of the long spaceflights.

Actuality. Glaucoma is an expected complication of many congenital eyeball malformations, such as aniridia, microcornea, consequence of mesenchymal dysgenesis with the formation of Frank — Kamenetz or Rieger syndromes, on the background of postoperative aphakia or after implantation of the «artificial iris — IOL» complex in children with congenital aniridia. Antihypertensive drug therapy gives only a partial effect in these cases, but excessive post-operative scarring nullifies results of fistulizing surgery even with antimetabolites and requires, as a rule, of numerous surgical procedures with transient hypotensive effect and following inexorable decrease of visual function.

Purpose. To assess the level and duration of the hypotensive effect and nature of the complications of Ahmed valve system implantation with various forms of glaucoma in children.

Patients and methods. Retrospective analysis of the effectiveness of implanted Ahmed valve system in 22 children (27 eyes) from 2008 to 2014 was made. 17 of them had previous antiglaucomatous surgery, such as trabeculectomy, cryo- and laser destruction of ciliary body. In 4 patients with congenital aniridia after implantation of the complex «artificial iris — IOL» and in one patient with postoperative aphakia the drainage surgery was the primary intervention and performed on both eyes.

Results. As a result of Ahmed valve implantation in 25 cases the IOP compensation was achieved within 15‑17 mmHg by Maklakov, 23 — without additional medication. In 6 % of cases, the formation of fibrous capsule around the base of the drainage was the indication for needling, which was accompanied by a successful activation of the drainage system. In one case, the epithelial ingrowth with occlusion of the capillary was observed in the course of the wound channel, it required the implantation of a second drainage in free quadrant of the eyeball. Reduced visual function after surgery was observed in only one patient as a result of hemorrhagic choroidal detachment, the cause of it can bea post-operative hypotension and absence of forming structures on the background of aphakia and avitria.

Conclusion. Thus, the implantation of the Ahmed valve drainage is sufficiently safe and effective method of surgical treatment of glaucoma in children and can be recommended as the operation of choice in such forms as secondary aphakic glaucoma and glaucoma in children with aniridia after implantation of the «artificial iris — IOL complex».

Aim. Analysis of effectiveness of IOL calculating formulas and frequency of intra- and postoperative complications of phacoemulsification in patients with eye axial length 24.0‑28.0 mm.

Patients and methods. The study included 39 patients (62 eyes) with varying degrees of myopia and axial length of the eye 24.0‑28.0 mm. All patients carried out phaco (85.5 %) or refractive clear lens exchange (14.5 %) with IOL implantation after a comprehensive survey. Average follow-up was 15.1±3.8 months. Patients were divided into two groups — with axial length 24.0‑25.9 mm (n = 38, group I) and 26.0‑27.9 mm (n = 24, group II). Calculation of IOL was performed according to the formula SRK / T, retrospective comparison — Hoffer-Q, Holladay II, Haigis and Barrett. Amount of surgically induced astigmatism was determined by the program SIA Calculator v.2.1.

Results. There are functional results, mean numerical error and median absolute error (MAE) of refraction after phaco with IOL implantation in the study. In Group I target postoperative refraction (±1.0 diopters in 95 % of cases) met all the studied formulas. Refraction ±0,5 diopters using formulas SRK / T was achieved in 92.3 % of cases, Hoffer-Q — 84.1 %, Holladay II — 91.,3 %, Haigis — 86.5 % and Barrett — 94.2 %. In Group II formulas SRK / T, Haigis and Barrett corresponded to refraction ±1.0, with target refraction of ±0,5 diopters in 90 % of cases, achieved only by using Barrett formula (91.5 %). The value of SIA and frequency of intra- and postoperative complications were not significantly different.

Conclusion. IOL power calculation in patients with eye axial length 24.0‑25.9 mm is possible by using each of five formulas. For eyes with axial length 26.0‑27.9 mm a significantly lower MAE when applying formulas Haigis (0.72±0.45) and Barrett (0.33±0.28) formulas is received, which indicates the high efficiency of these formulas, with the target refraction ±0,5 diopters in 90 % of cases, achieved only by using Barrett formula.

Purpose: To study the short- and long-term results of modified sinus trabeculotomy (STT) in primary open-angle glaucoma (POAG).

Patients and methods: We observed 42 patients (47 eyes) with POAG at 1‑3 stages aged 47‑85 (average age — 67.5 years). There were 27 women (64,3 %) and 15 men (35,7 %). The I stage of glaucoma was diagnosed in 17.0 % (8 eyes), II stage — in 44.7 % (21 eyes) and III stage in 38.3 % (18 eyes) patients. The average level of intraocular pressure (IOP) at the drug therapy was 29.2±1.5 mmHg (results obtained by pneumotonometer). All patients underwent a routine ophthalmic examination before and after surgery. Long-term results for period of 6‑24 months (13.1 months average) were assessed in 39 patients (43 eyes).

Results. The most common early complications were hyphema (10.6 % patients) and ciliochoroidal detachment (6.4 % patents). Long-term results showed normalization of IOP in 93.0 % cases including 7.0 % against the background of additional therapy. Visual acuity preserved in 88.4 % cases, its reduction was observed in 11.6 % and was associated with the progression of glaucoma (7.0 %) and lens opacity (4.6 %). The field of view remained at the preoperative level in 90.7 % patients and narrowed in 9.3 %, mainly due to the progression of glaucoma process.

Conclusion. Cruciate STT with anchoring of the scleral flap apex in suprauveal space in POAG in long-term results (up to 2 years) has a sufficiently high and sustained hypotensive effect (93.0 %), cataractogenic effect (4.6 %) and a relatively small number of complications (especially in case of ciliochoroidal detachment — just 6.4 %). We suggest this surgery in I‑III stages of POAG when the degree of expected postoperative scarring is small.

Purpose: To evaluate the hemoperfusion of Optic Nerve Disk (OND), peripapillary and macular areas, and retrobulbar blood flow in patients with primary open-angle glaucoma using optical coherence tomography with angiography (OCT-A) and Сolor Doppler Imaging (CDI).

Patients and Methods: 65 eyes of patients with primary open angle glaucoma (POAG) and 22 eyes of age-matched healthy subjects were examined using the SD-OCT-А (RtVue xR Avanti with the AngioVue software). Retinal Thickness and Angio Flow Density (AFD) were measured. AFD Disc and Peripapillary Flow Density were measured in OND and in peripapillary area. AFD Retina were evaluated in Macula inсluding Fovea- and Parafovea regions (superficial and deep) of the inner retinal layers. Ophthalmic Artery (OA), Central Retinal Artery (CRA), Posterior short Ciliary Arteries (PCA), Central Retinal Vein (CRV) and Vortex Vein (VV) were measured by CDI. Statistical analysis was performed using SPSS version 21 and MASS library of language R. The value of each diagnostic indicator (z-value) was calculated with the Wilcoxon-Mann-Whitney test and the area under the receiver operating characteristic curve (AUC).

Results: Both OCT-A and CDI indicators were reduced in glaucoma compared to healthy eyes. The following indicators had the largest AUC and diagnostic value (z-value) to discriminate the early glaucoma from normal eyes: AFD Retina Superficial Whole En Face (z = 3,83, p<0,0001; AUC 0,8 (0,69‑0,90), AFD Retina Deep Whole En Face (z = 3,31, p = 0,0007; AUC 0,76 (0,64‑0,88), Peripapillary Vessel Density (z = 3,2, p = 0,001; AUC 0,75 (0,63‑0,87), end-diastolic flow velocity in AO (z = 3,03, p = 0,002; AUC 0,74 (0,61‑0,86) and in TPCA (z = 2,78, p = 0,005; AUC 0,72 (0,58‑0,86); and to discriminate the early glaucoma from the advanced and far advanced stages: AFD Disc Peripapillary Inferior Temporalis (z = 5,61, p<0,0001; AUC 0,94 (0,86‑1,0) and the mean flow velocity in the CRA (z = 4,16, p<0.0001; AUC 0,81 (0,69‑0,92).

Conclusion: The results revealed a deficit of hemoperfusion in ONH and peripapillary and macular areas measured by OCT-A in glaucoma. CDI provides the additional information of a blood flow in the eye leading for better understanding of glaucoma pathogenesis. The both methods complement each other in early glaucoma detection and monitoring.

The aim of the study was to evaluate changes in biomechanical properties of the cornea after conducting transepithelial crosslinking with the prior application of a 40 % glucose solution.

Materials and methods. Just studied the biomechanical properties of the corneas of six rabbits breed Chinchilla (12 eyes). 4 rabbit entered in the experimental group, in which in one eye glucose solution was applied on the cornea and allowed to stay for 10 minutes, followed by the instillation of 0.1 % Riboflavin solution for 30 minutes. On a couple of the rabbit eye was applied a solution of Riboflavin without prior instillation of glucose. Then carried out the procedure of irradiation according to the conventional technology with UV with a wavelength of 370 μm and a beam energy of 3.0 mW / cm2. Two rabbits (4 eyes) were included in the control group, in which crosslinking was not performed. After 1 month the euthanasia of the animals was performed with subsequent enucleation for corneal research on a tensile testing machine. In the control and experimental group compared, the relaxation curves and the following parameters were analyzed: initial stress (MPa), equilibrium stress (MPa) modulus of elasticity.

Results and their discussion. After the crosslinking the rise of the initial stress (in the control group and 0.7+0.1 MPa, in the experimental and 1.5+0.2 1.3+0.3 MPa, respectively). The stress relaxation is fast (equilibrium stress value is reached after 250 sec.) and after the administration of glucose for approximately 75 seconds, which means a greater rigidity of experimental group of samples. In the experimental groups significantly changed and the modulus of elasticity: its value has increased approximately in 2 times in comparison with control samples. The equilibrium stress values in the experimental groups were different from the zero value that also indicates a change in the chemical structure of the samples.

Conclusions. Holding transepithelial of crosslinking with prior instillation of a 40 % solution of glucose facilitates the penetration of Riboflavin into the corneal stroma and improves its biomechanical strength. Our data indicate promising application in the clinic of this modification of transepithelial crosslinking.

Objective: To assess cataract incidence in the cohort of workers occupationally exposed to prolonged radiation. Material and Methods: Cataract incidence was studied in the cohort of workers of the first Russian nuclear enterprise — the Mayak, who were firstly employed at one of the main facilities (reactors, radiochemical and plutonium production plants) in 1948‑1958 and followed up to the end of 2008 (12210 persons). Total of 3100 cataract cases were registered in the study cohort. All cataract cases were reviewed and verified by experts; the study included only confirmed senile cataracts. All workers of the study cohort were exposed to external gamma-rays; mean cumulative dose from external gamma-rays was 0.91±0.01 Gy in males and 0.65±0.01 Gy in females. Statistical analysis provided non-standardized and standardized incidence rates per 100 000 workers. Standardization by sex and age was performed by indirect method using internal reference.

Results: 2523 cases of senile cataract were included in the study. Mean age of cataract diagnosis was 62.88±0.26 years in males and 64.88±0.28 years in females. Standardized incidence rates of cataract in females were significantly higher as compared to males and increased with workers age. Comparison between the subcohorts of workers with / without diagnosed cataracts demonstrated that among workers with cataracts the proportions of the following groups of workers were significantly higher: workers employed before 1954; workers employed at reactors; smoking workers; workers with the smoking index exceeding 20 pack*years; workers who consumed alcohol; workers with excessive body weight; workers with glaucoma and arterial hypertension. Moreover the mean cumulative dose from external gamma-rays and / or neutron exposure was significantly higher in the subcohort of workers diagnosed with cataracts than that in the subcohort of workers free of the disease. The highest cataract incidence rates were revealed in workers of both sexes aged 60 and above. The cataract incidence rate was significantly associated with non-radiation risk factors (smoking, concomitant glaucoma and / or high myopia). No effect modification by body mass index, arterial hypertension and alcohol consumption status was observed for cataract incidence among members of the study worker cohort. Cataract incidence was significantly increased in workers exposed to external gamma-rays at cumulative dose > 1.0 Gy as compared to workers exposed at lower doses.

Conclusion: The study revealed that cataract incidence in the cohort of occupationally exposed workers was associated with both non-radiation (sex, attained age, concomitant ocular pathology) and radiation (external gamma-rays) factors.

When acute inflammation in anterior eye segment of a forward piece of an eye was stopped, ophthalmologists face a problem of absence of acute inflammation signs and at the same time complaints to the remain discomfort feelings. It causes dissatisfaction from the treatment. The complaints are typically caused by disturbance of tears productions. No accidental that the new group of diseases was allocated — the diseases of the ocular surface. Ocular surface is a difficult biologic system, including epithelium of the conjunctiva, cornea and limb, as well as the area costal margin eyelid and meibomian gland ducts. Pathological processes in conjunctiva, cornea and eyelids are linked with tears production. Ophthalmologists prescribes tears substitutions, providing short-term relief to patients. However, in respect that the lipid component of the tear film plays the key role in the preservation of its stability, eyelids hygiene is the basis for the treatment of dry eye associated with ocular surface diseases. Eyelids hygiene provides normal functioning of glands, restores the metabolic processes in skin and ensures the formation of a complete tear film. Protection of eyelids, especially the marginal edge from aggressive environmental agents, infections and parasites and is the basis for the prevention and treatment of blepharitis and dry eye syndrome. The most common clinical situations and algorithms of their treatment and prevention of dysfunction of the meibomian glands; demodectic blepharitis; seborrheic blepharitis; staphylococcal blepharitis; allergic blepharitis; barley and chalazion are discussed in the article. The prevention keratoconjunctival xerosis (before and postoperative period, caused by contact lenses, computer vision syndrome, remission after acute conjunctiva and cornea inflammation) is also presented. The first part of the article presents the treatment and prevention algorithms for dysfunction of the meibomian glands, as well as demodectic blepharitis.