Currently, the treatment of neovascular age-related macular degeneration (AMD) includes: intravitreal injections (bevacizumab, ranibizumab, aflibercept, pegaptanib, etc.), photodynamic therapy, surgical treatment (subretinal surgery, recombinant tissue plasminogen activator + gas, macula translocation) and etc. Rehabilitation of these patients is carried out using special optical tools (glasses, magnifying lenses, loupes, electronic devices). Classic external devices for the correction of very poor eyesight are not convenient to use: they are often lost or forgotten at home, not adapted for constant wear, people are embarrassed to use them in public places. This review presents the characteristics and clinical results of the implantation of two intraocular lenses, the Lipschitz Macular Implant (LMI-SI) and the Scharioth Macula lenses, in patients with age-related macular degeneration (AMD). These IOL can be implanted during standard phacoemulsification with the implantation of usual posterior chamber IOL or years after the cataract extraction, which makes them unique among other lenses that are implanted only during the cataract extraction procedure. The Lipschitz Macular Implant (Israel, 2013) is a rigid IOL made of polymethyl methacrylate (PMMA), implanted in a capsular bag, it requires an incision up to 6 mm. A positive feature of the Scharioth Macula lens (1stQ GmbH, Germany, 2017) is the smallest incision needed for implantation — no more than 3 mm. This lens consists of a biocompatible hydrophilic acryl with a UV filter, the peripheral zone of the lens is optically neutral, the square design excludes its free rotation. Also, this lens can be used as therapy for progressive macular dystrophy of various etiologies. The additional macular IOLs do not affect peripheral vision, reduce binocularity when reading, and require complex visual rehabilitation.

The review focuses on modern treatment aspects and prevention of ophthalmic herpes.
The generalized experience of the clinical nucleoside administration, the basic antiviral drugs in the treatment of this pathology, is presented in detail. Information about indications, side effects and various schemes for their systemic and local application is provided. Questions on the duration of nucleoside administration in various clinical forms of eye herpes are considered. A meta-analysis of the comparative therapeutic nucleoside efficacy based on the results of more than 100 placebo-controlled randomized trials is presented. Special attention is paid to the rare but severe eye pathology, the acute retinal necrosis. Also data on the indications and contraindications of corticosteroids and on the current view of immunotherapy of ophthalmic herpes is presented. The question of the modern approach to the disease prevention recurrences is considered in detail, particularly, the results of the nucleoside administration have a high level of evidence, and, herpetic vaccines in the rehabilitation of patients with herpes infection are not widely used due to the lack of reliable methods for evaluating the efficacy. The information on the search for new effective drugs that have a targeted effect on certain patient cell receptors that can inhibit the penetration and spread of the herpes virus that can cause a controlled immune response is provided. Expanding the arsenal of effective and safe antiviral therapy will definitely optimize the treatment of ophthalmic herpes and prevent the occurrence of its recurrence and severe outcomes.

Millions people around the world, especially in old age, lose sight because of cataracts. The age-related cataract affects approximately 37 million people in the world annually, and in 51 % of cases, it is the cause of poor vision. Relevant is the importance of identifying risk factors for the development of age-related cataracts. This literature review is devoted to studies examining the influence of various factors on the development of lens opacities. The paper presents data on the effect of age on the development of age-related cataracts, so the prevalence of cataracts at the age of 52–62 years is 5 %, at the age of 60–69 years — 30 %, at the age of 70 and older — 64 %. Its gender features are highlighted — the frequency of lens opacities in women increases significantly with age, and its appearance coincides with the appearance of estrogen deficiency in menopause. Reflected literature data on the dependence of cataract prevalence on race (revealed a higher prevalence in various Asian populations compared with the population of Western countries). This review also had showed the influence of lifestyle and bad habits on the occurrence of cataracts. It was found that smokers have an increased risk of occurrence of a nuclear cataract and, to a lesser extent, the development of its cortical type. It is noted that the development of lens opacification is also influenced by the amount of alcohol consumed, increasing the risk of cataracts, so when studying individual types of cataracts, it is shown that the consumption of strong drinks and wine is associated with an increased risk of nuclear cloudiness. Presents data from large cohort studies that compare (using odds ratios and confidence intervals) the association of cataracts with such somatic diseases as diabetes mellitus, hypertension, also with body mass index and some medications.

Purpose: to conduct a morphometric assessment of the corneal nerves state after laser keratorefractive surgery using laser confocal microscopy and the software Liner 1.2S. Patients and methods. 40 eyes of 20 patients received LASIK to correct a mean refractive error of –4.5 ± 1.9 diopters (range, –2.25 to –8.25 diopters). The stroma was ablated with a Teneo Technolas 317P excimer laser. Corneas were examined by laser corneal confocal microscopy (HRT III with Rostock Cornea Module) before and in 1, 3, and 6 months after LASIK. Images were analyzed with software that automatically computes coefficients of anisotropy and orientation symmetry of corneal nerves. Result. At 1 and 3 months after surgery, the center corneal nerves were completely absent. At 1, 3 and 6 months after surgery, the paracentral corneal nerves were detected and the coefficient of anisotropy were statistically significantly reduced compared with the preoperative rates. At 6 months after surgery, both central and peripheral corneal nerves were detected and the coefficient of anisotropy were statistically significantly reduced compared with the preoperative rates. Conclusion. As a result of the study, the central corneal nerves were first detected at 6 months after surgery, whereas the paracentral cornea nerves were detected already after 1 month. At 6 months after surgery, the coefficient of anisotropy in the central of cornea statistically significant decreased compared to the preoperative rates. At all stages of the study after surgery, the anisotropy coefficient in the cornea paracentral statistically significant decreased compared with preoperative.

The purpose of the study — to conduct a comparative analysis of structural and functional indicators of the central zone of the retina in patients with diabetic macular edema and epiretinal membrane in the remote period after surgical treatment. Patients and Methods. We examined 97 patients with diabetic macular edema in combination with the epiretinal membrane aged 53 to 68 years (mean age 61 ± 5.4 years). All patients underwent vitrectomy with an internal limiting membrane peeling (ILM). Patients were divided into 3 groups depending on the intravitreal use of an angiogenesis inhibitor. The analysis of the remote anatomical and functional results of patients of different groups during 1 year of observation was carried out. Results. In patients after treatment using the proposed technique, the central retinal thickness was reduced by 16.19 % (p = 0.031) compared with monotherapy and by 11.51 % (p = 0.039) compared with a phased treatment method. Visual acuity significantly increased in the treatment group by the single-step method by 1.53 times (p = 0.024) compared with the group where only vitrectomy was performed, and also 1.44 times (p = 0.029) compared with the delayed administration of angiogenesis inhibitor in avital eye. Patients in all groups have showed an improvement in central photosensitivity 1 month after surgery, followed by a slight decrease in performance. However, by 12 months, the level of central photosensitivity in group 2 was significantly higher than in other groups (p < 0.05). A comparative analysis of the spatial distribution of macular pigment has showed that, along with the development of the pathological process, macular pigments were dispersed in the retinal tissue. On the background of treatment, their concentration was normalized in the central zone of the retina, without increasing the quantitative composition. Conclusion Analysis of the morphofunctional parameters of the retina central section in patients with diabetic macular edema and epiretinal membrane in the dynamics of treatment with various techniques led to the creation of an algorithm for managing patients. It allows to achieve high clinical and functional results in an overwhelming percentage of cases and, thereby, significantly improve medical and social rehabilitation, and also the quality of life of this contingent. 

Purpose: to study the role of human herpesviruses (HHV) in the pathogenesis of prolonged bacterial corneal ulcers. Patients and methods. 117 patients with bacterial corneal ulcer were examined. Two groups were identified: a favorable course-with duration of bacterial corneal ulcer epithelialization for 17 days (62 people) and a prolonged course with a persistent ulcer more than 17 days (55 people). Blood samples (n = 117) and scrapes from corneal ulcer (n = 117) were investigated in polymerase chain reaction (PCR) for the presence of deoxyribonucleic acid (DNA) of Herpes simplex virus (HSV1, 2), Epstein-Barr virus (EBV), Human herpesvirus type 6, 7 (HHV-6, HSV-7). Results. The HSV1, 2 and EBV genomes were detected in the cornea significantly more often in BCU of prolonged course compared with a favorable course (HSV1, 2 p = 0.012; EBV p = 0.012), and HHV-6 was detected not only in the cornea (p = 0.000), but also and in blood (p = 0.007). In patients with HHV DNA in corneal scarps and/or blood, after resorption of purulent infiltrate, corneal epithelialization was absent, and the use of antiherpetic drugs allowed to reduce the completion time of BCU epithelialization. Conclusion. The role of HHV-6, EBV, HSV 1, 2 in the pathogenesis of bacterial corneal ulcer of protracted course was revealed. The expediency of examination of patients with bacterial corneal ulcer on HHV is shown, a method of treatment is proposed, including antiherpetic therapy, which makes it possible to prevent the development of a protracted course.

Purpose. To study the features and results of femtolaser use in congenital cataract surgery in children. Patients and Methods. 35 children (37 eyes) with congenital cataracts aged from 12 months to 14 years (5.38 ± 6.3 years) were examined and surgical treated. The first stage of the operation included femtolaser execution of the anterior capsulorhexis (femtosecond laser Victus™ (Technolas Perfect Vision/Baush&Lomb, Germany). The second stage was the flap of the anterior capsule removal, the performance of hydrodissection, aspiration of lens masses, intracapsular implantation of the IOL. Results. In case of femtolaser capsulotomy, its diameter increased. It depended on the child age and the state of the anterior lens capsule. The obtained disc diameter of the anterior capsule in almost all eyes was significantly less than planned, due to its high elasticity in children. Conclusion. The use of a femtosecond laser in children with congenital cataracts, especially in infants, increase the effectiveness of visual rehabilitation. When conducting an anterior femtolaser capsulotomy in children with congenital cataract, it is necessary to take into account an increase in the diameter of the anterior capsulotomy, depending on child age and the condition of the anterior lens capsule. The first stage of surgery under local anesthesia in older children requires an individual approach.

The term “distant maculopathy” (DM) means the changes in the macular region, when the tumor is located at the distant from it. Purpоse: to study the peculiarities of the DM development, according to the tumor localization and present a possible mechanism of this symptom development. Patients and Methods. The study involved 53 patients with choroidal tumors localized outside the macular area, including 18 patients with neuroepithelial detachment (NED) in the macular area. In addition to the standard eye examination, all patients underwent EDI OCT. Results. In 1/3 cases of extrafoveolar located choroidal tumors according to OCT, exudative changes in the macular zone were revealed. In extrafoveral choroidal melanoma (CM), the biometric tumor parameters in patients with DM were slightly higher than the average in patients of this group, however, there was no correlation between the height of NED and tumor parameters. In extrafoveolar choroidal hemangioma (CH), a significant direct relationship between the height of the NED in the foveolar zone and the biometric parameters of the CH was found. In all cases, there was not choroidal elevation in the foveolar zone. The thickness and structure of the choroid in the subfoveolar zone in CM did not differ from the paired eye and the normal values. The thickness of the choroid in CH also did not differ from the paired eye, however, there was a slight expansion of the outer layers of the choroid (as in the paired eye) and an increase in its thickness compared with the norm. When a tumor is located above the macular zone, there is a “gravitational” mechanism for the development of DM, due to the spread of subretinal fluid (or blood) under the action of gravity. In case of juxtapapillar tumor localization, the appearance of DM is caused by microvascular disorders in the foveo-macular region of the retina and impaired axoplasmic current. In CM, the occurrence of NED may be associated with a retinal tension on the steeper side of the tumor. Conclusion. The development of distant maculopathy in CM is a sign of “active” tumor growth, in CH it develops later and depends on the size of the tumor. In identifying a high prevalent NED in the macular area, a careful examination of not only the central fundus zone, but also its peripheral parts is necessary. 

The purpose is to study the efficacy and safety of repeated UV corneal crosslinking in patients with advanced keratoconus after transepithelial crosslinking performed previously. Patients and methods. A retrospective analysis of the treatment results of 52 patients (52 eyes) with progressive keratoconus stage I-II according to the Amsler — Krumeich classification, which from 2012 to 2014 were treated by transepithelial corneal crosslinking. Based on objective clinical studies, the effectiveness of the treatment and the course of the process were evaluated. In some patients with a progressive course of the process (12 eyes), after the transepithelial crosslinking, a procedure of repeated UV crosslinking of the cornea was performed according to a standard protocol. Results. After transepithelial cross-linking within 24 months in 12 eyes (44 %) progression of the disease was observed, manifested by an increase in the refractive power of the cornea by 0.95 ± 0.18 D, a decrease in the thickness of the cornea from 484 ± 156 to 446 ± 87 microns. Repeated cross-linking was performed and after 6 months and positive dynamics was observed in 10 cases (83.3 %), visual acuity reached the preoperative level, the refractive power of the cornea was 50.3 ± 0.84 D. Stabilization of the process was noted in all 12 eyes, a decrease in the average refractive index of the cornea by an average of 1.1 ± 1.25 D, corneal astigmatism — by 1.2 ± 0.31 D, the cornea thickness to 427 ± 38.7 mc.
Conclusion. The use of modified crosslinking protocols, in particular transepithelial with iontophoresis, has a lower efficiency, showing stabilization in 56 % of cases, compared to the standard, which must be considered when choosing a clinical approach and selecting patients. Performing recrosslinking using a standard protocol showed high efficiency and safety of the procedure in 100 % of cases, however, this approach should be studied on a larger number of observations.

The purpose is to study the fluorescence angiographic signs of posterior aggressive retinopathy of prematurity. Patients and methods. A prospective study of 83 infants with aggressive posterior retinopathy of prematurity (APROP), who were on treatment in the neonatal center in 2012–2018 years. Gestational age was between 22 and 30 weeks. Depending on the diagnostic methods, patients were divided into two groups: 1 (main) — 51 (61.4 %) children who, in addition to standard ophthalmic examination methods, received 132 series of FA using a pediatric retinal camera RetCam3; 2 (control) — 32 (38.6 %) children without FA. After the procedure, the somatic state of the child was monitored for 24 hours for the registration of drug dye side effects. Results. Angiographic predictors of the disease and objective signs of APROP manifestation were presented in group 1 children a week earlier than in the group 2. This made laser treatment possible on 2.0 ± 0.5 weeks earlier in the group 1 (32.8 ± 1.2 weeks) compared to group 2 (34.8 ± 1.7 weeks) (p < 0.05) and to increase its efficiency by 8.2 % (86.3 and 78.1 % respectively). Conclusion. Comparative analysis of angiograms and color fundus images obtained with RetCam3 in the studied groups of children demonstrates the advantages and safety FA for the detection angiographic predictors of APROP, early objective signs of disease manifestation, it provides timely and effective laser treatment of complicated categories of very premature infants.

Purpose: to compare the clinical results of implantations of bi-and trifocal intraocular lenses (IOL) in femtosecond laser-assisted cataract surgery. Patients and methods. The article presents the results of the Acrysof IQ Panoptix trifocal lens implantations in 84 patients (112 eyes) — the main group and Acrysof IQ Restor bifocal IOL implantations in 52 patients (98 eyes) — the control group. All patients underwent femtosecond laser-assisted cataract surgery (FLACS). The following data were evaluated: uncorrected distance visual acuity (UCDVA) , uncorrected near visual acuity (30–45 cm) and at an average distance (50–70 cm) at discharge, after 14 days, 1 and 3 months after the surgery under photopic and mesopic lighting conditions. Postoperative refractometry data; the defocusing curve was performed in patients with a high UCDVA (0.9–1.0) monocularly under photopic conditions using standard optotypes 14 days after surgery; aberrometry indicators. Results. It was shown that both lenses provided high uncorrected distance and near visual acuity in photopic lighting conditions. At the same time, the Acrysof IQ Panoptix lens provided significantly better visual acuity at an intermediate distance and was more resistant to defocusing conditions. Refraction data: after 1 month, emmetropia was observed in 87 % of patients in the main group and in 85 % of control group, after 6 months — 92 and 89 % respectively. There were no significant differences in high order aberrations and total aberrations between patients of the compared groups. Conclusion. The use of the PanOptix trifocal lens made it possible to obtain maximum visual acuity at different distances, regardless of the level of illumination.

The article presents the study results of the local antioxidant status in patients with progressive keratoconus and its dynamics after the ultraviolet corneal crosslinking. Purpose: to study the oxidative activity in the tear of the patients with keratoconus and its dynamics after ultraviolet cornea crosslinking. Patients and methods. To assess the local level of oxidative activity in keratoconic patients according to the levels of total antioxidant status (TAS) and superoxide dismutase (SOD) in the tear fluid, as well as their dynamics after UV crosslinking were investigated. The study included 38 patients (38 eyes) with keratoconus stage I–II (classification according to Amsler), men — 24 (63.1 %), women — 14 (36.9 %). The standard UV crosslinking group (S-CXL) was 20 eyes, and the pulsed accelerated protocol (I-CXL) — 18 eyes. The average age of patients was 32.4 ± 6.8 years. As a control group, 12 practically healthy individuals were selected. The time of observation is before the operation, on the 3rd, 7th, 14th and 30th days after the procedure. Results: On the basis of the conducted studies, it was revealed that keratoconus patients showed a statistically significant decrease in the initial indicator of TAS by 40 % and amounted to 1.68 ± 0.21 mmol/l, compared to healthy people — 2.82 ± 0.15 mmol/l. The SOD level in tears in patients with keratoconus was also lower by 19 % — to 96.7 ± 11.3 ng/ml, compared to the control — 119.1 ± 16.5 ng/ml. The use of S-CXL of the cornea caused a decrease in TAS during the first 3 days with the subsequent restoration of its level. The use of pulse A-CXL also showed a decrease in this indicator, but by the end of 1st month the level of TAS was higher than preoperative and better than when using the standard protocol. A decrease in SOD level after treatment was noted during the first 3 days, however, the use of S-CXL caused a more significant collapse of this indicator compared to the pulsed accelerated corneal crosslinking protocol. Conclusion. TAS data and SOD level had shown a decrease in local antioxidative status in patients with keratoconus. Ultraviolet corneal crosslinking causes the maximum decrease in SOD and TAS on the 3rd day after the procedure, and from the 14th day their gradual recovery to the initial level is observed. The standard protocol contributed to a more pronounced development of local cross-linking damage in patients with keratoconus. It manifests itself in the antioxidant status reduction of the tear compared to the pulsed accelerated method. 

Best’s disease is a relatively rare form of macular dystrophy, characterized by bilateral staged course. The cases of the choroidal neovascular membrane (XNM) formation in the course of the disease development are described, however the true frequency of this complication and the management of such patients are not determined. In recent years, a new promising method of examination — OCT — angiography (OCTA) — has been actively introduced into clinical practice. Non-invasive character and contactlessness of OKTA open wide possibilities of its application in various pathologies, in particular, in pediatric ophthalmology. The purpose of this work was to assess the prospects for using OCTA in the diagnosis and monitoring of Best’s disease. Patients and methods. The data of the standard complex ophthalmological examination and OCTA of the posterior pole of the eye were analyzed in 5 patients with Best’s disease — 4 children aged 5 to 12 years and the 25-year-old woman observed for this disease from childhood. Results. In all patients, the disease was bilateral. In 1 of 9 eyes (1 out of 10 eyes was excluded from the analysis due to the presence of retinal detachment at the time of examination) the disease was at the vitelliform stage, in 2 — at the pseudohypopyon, in 5 — at the vitelliruptive stage, in 1 — at the atrophic stage. Visual acuity at the time of the examination was from 0.02 to 1.0. Clinically, the presence of CNM could be assumed in 4 eyes. According to OCTA CNM was detected in 7 cases, in 3 of them signs of membrane activity were noted. Сonclusion. OCTA provide detection that the formation of СNM in the Best’s disease occured already at the pseudohypopyon stage and in half of cases was not accompanied by the development of clinical symptoms. The study allows to assess the localization, size and activity of the membrane, which is necessary for monitoring and determining the tactics of treatment of this complication. Carrying out further research will determine the true frequency, risk factors for development and features of CNM in Best’s disease, which will allow developing optimal tactics for conducting such patients.

Purpose: tо estimate the effectiveness of complete corneal ring (MyoRing) implantation compared with MyoRing implantation combined with corneal collagen crosslinking (CXL) for keratoconus treatment for 36 months follow-up. Patients and Methods. There were 101 patients (124 eyes) with progressing keratoconus aged 18–59 years in the study. Intracorneal rings were implanted in all patients. The patients were divided into 2 groups. MyoRing implantation was performed in a series of 59 patients (76 eyes) with keratoconus II–III Amsler classification, 42 patients (48 eyes) had MyoRing implantation combined with CXL. Implantation of a MyoRing in the corneal pocket was performed using a PocketMaker microkeratome and corneal intrastromal implantation system. Results. Keratometry was reduced in both groups; after MyoRing implantation for 8,45 D and MyoRing combined with CXL for 7,44 D, the spherical equivalent decreased for 7,72 and 6,29 D respectively, after 36 months. The cylinder decreased to 3,33 D with MyoRing alone and to 3,11 D with MyoRing combined with CXL. The smallest corneal thickness remained stable during 36 months after the procedure. There was an improvement in uncorrected and corrected visual acuity, and the difference in the CRF within the period of up to 12 months after the operation. It can be explained by the pseudochase formation in the group with a combined procedure. Conclusion. The implantation of the MyoRing IRC and the combination of MyoRing with CXL showed efficacy and safety in stabilizing keratoconus stabilization, as well as correction of comorbided ametropia 3 years after surgery. Both MyoRing implantation and MyoRing combined with CXL were effective in the stabilization of progressive keratoconus, as well as the correction of ametropia 3 years after surgery. There was no significant difference in MyoRing implantation and its combination with corneal crosslinking in visual and refractive results. The refractive power of the cornea was only one exeption. Long follow-up and randomized prospective studies with a large number of patients are needed.

Purpose: comparative study of trabeculectomy results with various models of domestic “Glautex” drainage in the surgical treatment of primary open angle glaucoma (POAG). Patients and methods. The results of surgical treatment of 98 (105 eyes) patients with POAG aged 50–83 years who underwent trabeculectomy with various Glautex drainage models were analyzed. There were 43 men (43.9 %) and 55 (56.1 %) women. The second (II) stage of POAG was diagnosed in 49 eyes (46.7 %), the third (III) stage in 56 (53.3 %). All patients were divided into 3 groups. The first (main) group consisted of 34 (37 eyes) patients who underwent trabeculectomy in combination with the implantation of Glautex DDA drainage model. The second (main) group included 29 (30 eyes) patients with trabeculectomy and implantation of the SDA model of this drainage. The third group was the control group and consisted of 35 (38 eyes) patients with the classical method of surgery without using any drainage. Results. There was a significant 71.7 % decrease in IOP compared with baseline data in the 1st patients group after antiglaucomatous surgery, 72 and 74 % decrease was in the 2nd and 3rd groups respectively (p < 0.05). An increase in IOP was noted predominantly in the control and in the second study group within 1 month of follow-up. Normalization of ophthalmotonous pressure was achieved by using needling in 13.3 % (4/30) patients in the second group, in 7.9 % (6/38) cases in the control group. The absolute hypotensive effect in the 1st group was noted in 75.7 % of cases; the relative hypotensive effect was in 8.1 %; total failure was in 16.2 %. In the 2nd group the absolute hypotensive effect of the surgery was in 73.3 % of 30 cases, the relative was in 6.7 %, total failure was in 20 %. In the control group (38 eyes), absolute success was in 63.1 %, the relative hypotensive effect was in 13.2 %, and the total failure was in 23.7 %. Conclusion. Trabeculectomy with Glautex drainage and with various models in case of primary open-angle glaucoma provided a sufficiently high relative hypotensive effect in 82 % of cases in a year after the surgery. The achieved surgery outcomes with this drainage in the studied periods did not depend on applied model: DDA or SDA (83.8 and 80 % respectively), but was higher than the classical trabeculectomy (76.3 %). However, in case of the SDA model, needling was required in 13.3 % of cases in the early postoperative period. 

Purpose: to investigate the average speed and risk factors for the glaucomatous optic neuropathy (GON) progression during longterm observation. Patients and methods. The 10-year data of 750 patients were analyzed. The average GON progression rate was calculated on the basis of perimetry and optical coherent tomography data. Further, according to inclusion and exclusion criteria 128 patients were included into the group of retrospective analysis. Resultes. The following risk factors were established: initial cornealcompensated IOP (IOPcc) > 23.6 mm Hg (AUC 0.7), IOPcc after 5 years > 19.8 mm Hg (AUC 0.83), age > 69.5 years (AUC 0.6), corneal hysteresis < 9.9 mm Hg (AUC 0.6) and retinal nerve fiber layer < 92 μm (AUC 0.6). Patients with pseudoexfoliation syndrome, and patients taking systemic calcium channel blockers (p = 0.01) also had the higher risk of GON progression. Its rate was lower in patients with arterial hypertension (p = 0.015), and in patients who received prostaglandin analogues (risk was 5 times reduced, p = 0.04) and fixed combinations (risk was 2 times reduced, p = 0.018). IOPcc of higher than 17.6 mm Hg in the long-term period is the most pronounced risk factor for the progression of GON. It was determined that the average ROP of glaucoma progression among the patients was 0.6 dB/year for ROP1, 0.62 ± 1.09 μm/year for ROP2 and 0.95 ± 3.28 μm/year for ROP3, also each 1 dB/year decrease in photosensitivity (in group with glaucoma progression) was associated with further loss of RNFL (3.9 µm/year). Conclusion. The use of prostaglandin analogues and fixed combinations reduces this risk.

The purpose: to establish a combined approach to the treatment of patients with epithelial and endothelial cornea dystrophy (EED) based on a comparative study of the results of one-step and two-step methods. Patients and methods. The study included 75 patients (81 eyes) with corneal EED, who underwent surgical treatment at the Ufa Eye Research Institute from 2011 to 2016. The patients were divided into two groups — the main group consisted of 43 (46 eyes, 57 %) patients, who underwent the first stage of the CC before surgical treatment of EED, the second stage after 1–12 months — automated posterior lamellar keratoplasty (APLK). In the control group, isolated APLK was performed in 32 (35 eyes, 43 %) patients. Results. After CC (1–10 days) in the main group an increase in corneal thickness due to edema enhancement in the cornea stroma was observed in patients with stage I–III of the corneal EED. After 3 months, a decrease in corneal thickness was recorded in patients of the main group with I-II stages of the disease (p < 0.05), after 6 months — in all stages of the corneal EED compared with the control group (p < 0.05). According to optical coherence tomography (OCT), a decrease in the total cornea thickness in both зфешутеы groups was noted within 12 months after APLK: in the main group from 667 ± 65 μm initially to 594 ± 31 μm, in the control group, where there was a pronounced corneal edema from 787 ± 56 to 612 ± 67 μm. Conclusion. Corneal cross-linking in patients with I–III stages of corneal EED provides improvement of the cornea, manifested in reducing edema and its thickness. It allows to delay the implementation of the automated posterior lamellar keratoplasty without corneal deterioration in patients with stage I up to 6–12 months, in patients with stage II–III up to 3–6 months.

The purpose is to evaluate the safety of the scleral crosslinking with riboflavin/ultraviolet A (UVA) in an experiment in vivo. Materials and methods. The study was carried out on 34 Chinchilla rabbits (68 eyes). The right eyes were crosslinked (34 eyes), the left eyes were served as controls (34 eyes). Scleral crosslinking (SCXL) was performed with sclera saturation with a photosensitizer (0.1 % aqueous solution of riboflavin) for 20 minutes and its subsequent irradiation with ultraviolet A (wavelength of 370 ± 5 nm, irradiance — 3 mW/cm2), total exposure time — 30 minutes (6 cycles of 5 minutes). The effect of the procedure on the anatomical and functional state of the eye layers was assessed with high-resolution optical coherent tomography (OCT) and electroretinography (ERG) before crosslinking, a day, 7 and 30 days after it. Results. OCT did not reveal any pathological changes after scleral crosslinking with riboflavin/UVA. The layers of the retina, choroid and sclera were clearly visualized. The performed morphometric analysis has showed the absence of statistically significant changes in the eye layers thickness after ultraviolet crosslinking. The amplitude-time characteristics and the shape of the electroretinogram of the experimental and control rabbits eyes were identical during all periods of observation, had a classic appearance. All waves of ERG were well expressed. It indicates a satisfactory functional state of the retinal neuroreceptor mechanisms. Conclusion. For ultraviolet crosslinking we used UVA with an irradiance of 3 mW/cm2 for 30 minutes and a 0.1 % aqueous solution of riboflavin without dextran and did not reveal any side effects of the procedure. Thus, scleral crosslinking with these parameters is safe for the eye layers in an experiment in vivo.

Purpose: to consider the main factors that stimulate cataractogenesis and the earlier development of cataracts after laser refractive surgery of the cornea. Patients and methods. The clinical material covers observations of the condition in more than 10 thousand eyes from 1 year to 20 years, after various laser refractive corneal operations (PRK, TransPRK, LASIK, FemtoLASIK). Results. Risk factors for cataractogenesis included high initial ametropia, accommodation disturbance, age, and increased external UV exposure. Clinical observations have shown that with laser correction of high degrees of ametropia, the number of cataractogenesis risk factors and their total value increased. Any laser refractive corneal surgery was accompanied by oxidative stress in all structures of the anterior eye and aseptic inflammatory response. The cornea thinning after refractive surgery increased the external UV load on the lens and created the conditions for the accumulation in it of an excessive amount of peroxide radicals. This was one of the important factors predisposing to the earlier development of cataracts. Conclusion. For clinically significant early cataract development after laser refractive corneal surgery, a combination of several cataractogenic factors is needed, such as the degree of severity of oxidative stress in the anterior eye tissue in the early postoperative period, cornea thinning, high corrective ametropia, lack of accommodation, and the patient age over 40 years old.

Optical coherence tomography (OCT) is a noncontact method that provides two-dimensional (three-dimensional for some models) highresolution images of the anterior eye segment, with an axial resolution in the range from 3 to 20 µm. Two OCT diagnostics platforms are available: time-domain and spectral OCT. OCT provides a qualitative and quantitative assessment of the most important structures involved in the glaucoma pathogenesis: the state of the optic nerve head, the thickness of the nerve fiber layer, the anterior chamber angle and the trabecular apparatus. The OCT advantage is the ability to visualize surgically formed outflow tracts in the early postoperative period after antiglaucoma surgery. The OCT studies of the antiglaucomatous surgery zone are presented in detail in the literature, namely, the assessment of such biometric parameters of filtering bleb (FB) as wall thickness and reflectivity, radial length and height. According to the literature, the presence of a multi-layer filtration cushion 6 months after the operation indicates a favorable prognosis for the duration of the hypotensive effect of the operation. Such signs as low reflectivity of the filtration cushion wall and the presence of episcleral fluid are in most cases associated with a successful outcome of trabeculectomy. OCT studies of a filtration cushion after trabeculectomy make it much easier to choose an area for revision and nidling. In addition, OCT is used to assess anatomical features in the field of surgical intervention with drains and drainage devices. Currently OCT is widely implemented at the prehospital stage, however, engineers did not stop at the achieved level and carried out the integration of spectral OCT with an operating microscope. The possibilities of intraoperative imaging with cataract phacoemulsification (FEC) and trabeculectomy, implantation of the Ahmed valve, reconstruction of the anterior chamber angle, revision of the filtration bag and nidlinge are described in the literature. Conclusion. OCT is a very valuable method of intravital imaging of the antiglaucoma operation zone. It allows assessing the level of retention of intraocular fluid, determining the functional activity, the location of drains and drainage devices both in the early and late postoperative period. 

Purpose: to compare the efficacy and safety of Ahmed and Molteno-3 drainage devices implantation in the surgical treatment of refractory glaucoma. Patients and methods. Two groups of refractory glaucoma patients underwent surgery. In the first group (48 patients, 48 eyes) drainage device Molteno-3 with a site size of 175 mm2 was implanted. The average IOP in the group before surgery was 31.9 ± 7.7 mm Hg. The average number of glaucoma medications was 3.3 ± 0,44. In the second group (51 patients, 51 eyes) implantation of Ahmed Valve FP7 model was performed. The average level of IOP in the group before surgery was 34.7 ± 8.07 mm Hg. The average number of glaucoma medications was 3.08 ± 0.4. Results. In the first group the average intraocular pressure level 1 month post-op was 14.6 ± 6.1 mm Hg, 3 months post-op 18.8 ± 5.2 mm Hg, 6 months post-op 16.5 ± 4.7 mm Hg. IOP сompensation (≤ 21 mm Hg) in 6 months was achieved in 91.6 % of cases and in 1 year in 100 % of cases. The total success was achieved only in 8.3 % of patients. However, the number of glaucoma medications was reduced to 1.6 ± 0.8. In the second group the average IOP level 1 month post-op was 21.25 ± 7.3 mm Hg, 3 months post-op 17.9 ± 5.3 mm Hg, 6 months post-op 15.7 ± 4.1 mm Hg. IOP сompensation in 6 months was achieved in 82.4 % of cases and in 1 year in 86.3 %. In the second group complete success was achieved in 19.6 % of patients. The number of glaucoma medications was 1.4 ± 1.1. In the first group complications were revealed in 22.9 % of cases (11 patients). Ciliochoroid detachment was revealed in 9 patients (18,8 %) and hyphema in 2 patients (4,2 %). In the second group complications were revealed in 19.6 % of cases (10 patients). Сiliochoroid detachment was revealed in 4 patients (7.8 %), diplopia in 5 patients (9.8 %), hyphema was detected in one case (1.9 %). In the first group IOP compensation (≤21 mm Hg) was achieved after 6 months in 91.6 % of cases and after 1 year in 100 % of cases. The complete success was achieved in only 8.3 %. In the second group, IOP compensation in 6 months was achieved in 82.4 % of cases and 86.3 % — in 1 year. In the second group, complete success was achieved in 19.6 % patients. There was no significant difference in complications between two groups. Conclusion. High level of safety and effectiveness of refractory glaucoma surgical treatment with implantation of Molteno-3 and Ahmed drains was confirmed.

Purpose of the study is to assess the state of the demarcation line of the stroma after accelerated and pulsed accelerated ultraviolet cornea crosslinking. Patients and methods. Clinical observations included 24 patients (31 eyes) with keratoconus (KC), aged 18–46 years, men — 11 (45.9 %), women — 13 (54.1 %). Accelerated (a-CXL) crosslinking was carried out in continuous mode with a power of 18 mW/cm2 for 5 minutes (13 eyes), pulsed accelerated (i-ACXL) with a power of 18 mW/cm2 for 10 minutes, in mode 1 sec light / 1 sec pause (18 eyes). Conducted generally accepted and additional methods of ophthalmic research. The follow-up periods were 1, 3, and 6 months after surgery. Results. According to optical coherent tomography, the demarcation line was detected in all cases after a-CXL and i-ACXL. At 1 month after the crosslinking, there were no significant differences between the a-CXL and i-ACXL groups in terms of uncorrected visual acuity, corrected visual acuity, maximal correction. The average depth with demarcation at 1 month after the procedure in the central zone of the cornea was 216.41 ± 36.67 μm in the a-CXL group and 236.41 ± 37.08 μm in the i-ACXL group. Using confocal microscopy in vivo in both groups 1 month after surgery apoptosis of keratocytes and stromal edema were detected. A gradual restoration of the cornea to its original state was observed after 6 months. Conclusion. Research results have shown that accelerated and pulsed accelerated cross-linking are safe and effective technologies to stabilize the progression of keratoconus. Both crosslinking protocols provide a significant reduction in the duration of the procedure compared to the traditional one. Revealed deeper arrangement of the demarcation line when performing pulsed accelerated crosslinking compared to the accelerated. Further long-term and more extensive studies of accelerated and pulsed accelerated cornea ultraviolet crosslinking will provide improved information on their effectiveness in the long-term.

Objective: to evaluate the functional results of the surgical treatment of pterygium using a femtosecond laser. Рatients and methods. The study included 115 patients (141 eyes) with a diagnosis of primary and recurrent stage I–III pterygium, of which 17 (19 eyes, 10.6%) had a relapse of the disease. The patients’ age was in average 54 ± 6 years, among them men and women — 56 and 44 % respectively. The same surgeon operated all patients with a femtosecond laser and fibrin glue. Results. The technique is simple to perform, the separation of the autograft from its own conjunctiva does not cause difficulties due to an accurate cut of the femtosecond laser, which helps to obtain optimal functional results in the long-term period. The size of an autograft manufactured using a femtosecond laser averaged 6 × 7 ± 1.0 mm. The edges of the graft in all cases were smooth, its thickness was the same over the entire area and amounted to 80 ± 15 μm, which facilitated the work with it and subsequent fixation. The graft was fixed using fibrin glue, the advantage of which is its hypoallergenicity, the absence of discomfort in patients and the simplicity of its use by the surgeon. Glue resorption is completed from 2 weeks to 1 month. Intra and postoperative complications were not observed in any case. The offset of autograft in the early postoperative period was also not observed in any case. Conclusion. The use of a femtosecond laser in primary and recurrent pterygium I-III surgery allows the formation of an autograft of the required thickness and size with minimal damage to the conjunctival vessels and the absence of scarring of the bulbar conjunctiva in the area of the material intake. The use of fibrin glue for fixing the autograft promotes rapid healing. The absence of relapses during the observation period and obtaining optimal functional results indicate the promise of using femtolaser technologies in pterygium surgery.

Purpose. Analysis of the AMD prevalence in the Republic of Bashkortostan, depending on the disease stage, gender and the nature of the respondent settlement. Methods. A population-based study of Republic of Bashkortostan residents “Ural Eye and Medical Study” was conducted on the basis of the State Budget Institution “Ufa Research Institute of Eye Diseases of the Academy of Sciences of the Republic of Bashkortostan”. There were 5899 participants in the study, 2581 (43.7 %) were men, 3318 (52.3 %) were women. There were 2501 urban residents (42.3 %), rural residents — 3398 (59.7 %). Study design: cross-sectional one-stage analytical research. Statistical data analysis was performed using the IBM SPSS statistic application package. Results. AMD was diagnosed in 550 individuals (11.5 %): early stage — in 392 (7.9 %), intermediate — in 119 (2.4 %), later — in 39 individuals (0.8 %). The number of men with AMD was 210 (10.8 %), women — 340 (11.4 %). Among men, an early stage was observed in 144 (7.4 %), intermediate — in 52 (2.7 %), later — in 14 individuals (0.7 %). Among women, early AMD was observed in 248 (8.3 %), intermediate — in 67 (2.2 %), later — in 25 individuals (0.8 %). The number of urban residents with AMD was 194 individuals (9.7 %), rural residents — 356 individuals (12.1 %). At the same time, among urban residents, an early stage was observed in 138 (6.9 %), intermediate — in 43 (2.2 %), and later stage — in 13 individuals (0.6 %). Among rural residents, the early stage of AMD is in 254 (8.6 %), intermediate — in 76 (2.6 %), later — in 26 individuals (0.9 %). Conclusion. The prevalence of AMD in the Republic of Bashkortostan according to the “Ural Eye and Medical Study” is 11.1 %, which exceeds the global figure. The lack of prevalence of the AMD among women (among women — 11.4 %, among men — 10.8 %) is a distinctive feature for this region. The prevalence of this pathology among rural residents (12.1 %), among urban (9.7 %). The influence of population characteristics for the prevalence of AMD in regions with a peculiar ethno-cultural composition, geographical features.

Professor V. Odintsov is a surgeon, researcher, teacher and organizer who made an enormous contribution to the development of country and world ophthalmology. In 1925, V. Odintsov was invited to Ufa for the management of Eye Infirmary and became the founder of the Bashkir Trachomatous Research Institute which was the centre of elimination trachoma in the republic. The development of the ophthalmology in the republic of Bashkortostan is connected with his name.