Recovery and preservation of visual functions during compression in the chiasm-sellar region is possible in the case of early diagnosis of pathology and timely surgical decompression. Today optical coherence tomography (OCT) of the retina is one of the most informative methods for diagnosing pathology of the retina and optic nerve. It can, due to the presence of early diagnostic criteria, promptly detect the compression in the chiasm-sellar region and expand the indications for surgical treatment. The literature review presents the results of optical coherent tomography (OCT) of the retina during compression in the chiasm-sellar region. An analysis of literature data revealed that in patients with chiasmatic compression, the thickness of the nerve fiber layer in the peripapillary and macular areas decreases, the thickness of the macular complex, consisting of the retinal ganglion cell layer and the inner plexiform layer, decreases. Also, there is a change in the value of asymmetry between the GCC thickness indices in the nasal and temporal halves of the macular region. It has been established that a decrease in the thickness index of a macular complex may precede changes in the visual field. According to the results of single studies, a correlation was found between the parameters of the peripapillary RNFL thickness and the the internal capillary retinal plexus density in the same areas. The results of literature sources’s analysis are summarized in the table by the parameters studied, the OCT model; etiology, treating methods and the results of the OCT study. Despite the results obtained, the early specific and sensitive OCT diagnostic criteria for chiasmatic compression have not yet been developed. In addition, a change in the thickness of GCC and RNFL can also be observed in the absence of chiasmatic compression in certain types of tumors and in the presence of comorbidities (arterial hypertension). In this regard, it is necessary to conduct further studies that will reveal the informative OСT-diagnostic criteria for compression in the chiasm-sellar region, develop diagnostic algorithms taking into account the type of tumor, the presence of concomitant pathology. Early diagnostic criteria for chiasmatic compression will expand the indications and improve the result of surgical treatment of patients.

The presence of concomitant corneal astigmatism is the most common cause of low visual functions in patients with surgical treatment of cataracts. The implantation of toric intraocular lenses is procedure of choice in the correction of corneal astigmatism from 1.0 DPT and more in patients with cataracts. Successful results depend on several factors, the most important of which: the correct and stable position of the intraocular lens (IOL) in the capsule bag, the absence of residual astigmatism, the choice of the implanted IOL’s model, taking into account material and design of lens elements. Deviation of the cylindrical component by 10 degrees reduces visual acuity up to 35 %. Repeated intervention for the purpose of toric lens reposition, according to the literature, varies from 0,65 to 9 % and is carried out with the rotation of IOL more than 10°. Femtolaser-assisted phacoemulsification allows partially automate the surgical process, making it more efficient and safe, creating a theoretical advantage over manual techniques of surgery. In practice, the capsulorexis formed by the femtolaser is characterized by a regular rounded shape with a given diameter and provides a coating of optical part of IOL for 360°, which, according to various sources, contributes to a lesser degree of decentralization and tilt of the lens in the capsule bag and can be considered as one of the reasons for obtaining a more accurate refractive result and, as a consequence, higher visual functions. The review presents the results of clinical studies of corneal astigmatism correction during standard and femtolaser-assisted phacoemulsification with implantation of various models of toric IOLs: visual acuity, rotational stability, residual astigmatism percentage, wave front change. Researchers continue to discuss the advantages and disadvantages of modern technologies. However, the problem of increasing the predictability of the surgical outcome in order to obtain a higher refractive result both in the early and in the long-term postoperative period remains unquestionable.

Machine learning is applied in every field of human activity using digital data. In recent years, many papers have been published concerning artificial intelligence use in classification, regression and segmentation purposes in medicine and in ophthalmology, in particular. Artificial intelligence is a subsection of computer science and its principles, and concepts are often incomprehensible or used and interpreted by doctors incorrectly. Diagnostics of ophthalmology patients is associated with a significant amount of medical data that can be used for further software processing. By using of machine learning methods, it’s possible to find out, identify and count almost any pathological signs of diseases by analyzing medical images, clinical and laboratory data. Machine learning includes models and algorithms that mimic the architecture of biological neural networks. The greatest interest in the field is represented by artificial neural networks, in particular, networks based on deep learning due to the ability of the latter to work effectively with complex and multidimensional databases, coupled with the increasing availability of databases and performance of graphics processors. Artificial neural networks have the potential to be used in automated screening, determining the stage of diseases, predicting the therapeutic effect of treatment and the diseases outcome in the analysis of clinical data in patients with diabetic retinopathy, age-related macular degeneration, glaucoma, cataracts, ocular tumors and concomitant pathology. The main characteristics were the size of the training and validation datasets, accuracy, sensitivity, specificity, AUROC (Area Under Receiver Operating Characteristic Curve). A number of studies investigate the comparative characteristics of algorithms. Many of the articles presented in the review have shown the results in accuracy, sensitivity, specificity, AUROC, error values that exceed the corresponding indicators of an average ophthalmologist. Their introduction into routine clinical practice will increase the diagnostic, therapeutic and professional capabilities of a clinicians, which is especially important in the field of ophthalmic oncology, where there is a patient survival matter.

Last years, the problem of using contact lenses (CL) in pediatric ophthalmic practice has become more important. It is associated with an increasing need for contact vision correction in children and with the improvement of its capabilities in relation to pediatric ophthalmic practice. Currently, the indication for contact lenses use in children are the same as for the adults (with certain specific and limitations). But there are also a number of specific indications in children’s practice. The article provides an overview of the domestic and foreign literature data (periodicals and monographs) relating to various aspects of the use of contact lenses in pediatric ophthalmic practice. The contact lenses use for medical indications has a number of advantages over another more traditional method of vision correction — glasses. Rational correction of the most common refractive error — myopia with the help of CL helps normalize accommodation, convergence, reduce the risk of complications associated with the myopia’s progression, helps to slow down the processes of eyeball’s elongation by reducing the peripheral defocus, and during the period of functional formation of the visual organ (up to 15 years) helps to form binocular and stereoscopic vision. Uncorrected ametropia (especially high degrees) in childhood leads to maladaptation of visual perception. Rational correction of refractive errors with CL allows children to adapt to environmental conditions better, have higher indicators of health and psychological comfort among peers in comparison with children wearing glasses. The mode of wearing lenses depends on the purpose of correction, age, type of lens and material, tolerance of correction, manipulation skills, and other factors. The ophthalmologist determines the mode of wearing individually in each case. Modern materials and the use of one-day MCL can reduce the risk of complications. Selection of contact lenses for young children is a complex process and requires joint efforts of the ophthalmologist and parents. The examination algorithm for the CL’s selection is identical to the selection of lenses for adult patients, but contains the use of some additional tests aimed at assessing accommodation and binocular vision. In the process of selecting contact lenses for children, the ophthalmologist may face two main problems: the inability to determine the exact parameters of the cornea and manipulative difficulties associated with the anatomical and psychological characteristics of young patients.

Purpose — to perform a comparative analysis of the clinical efficacy of intrastromal keratoplasty (ISKP) in patients with keratoconus during surgery with and without Verion digital marking device.

Patients and methods. 37 patients (50 eyes) with corneal astigmatism up to -5.0 diopters were included in the study. These patients were operated with the femtolaser method of ISKP with implantation of corneal segments. The average age of the patients was 27.96 ± 3.40 years. The observation period is from 3 to 12 months. All patients were divided into two groups depending on the surgical technique: Verion-assisted, using a digital marking device and taking into account the angle of cyclotorsia, or standard, without taking into account the angle of cyclotorsia. The first main group included 28 eyes (56 %), the second control group included 22 eyes (44 %) accordingly.

Results. The functional results after ISKP in both groups were quite good. Stabilization of functional parameters and keratometric data was noted in the postoperative period, by 3 months. Patients of the main group showed a statistically significant (p < 0.05) increase in average uncorrected visual acuity to 0.50 ± 0.16, and visual acuity with maximum correction to 0.70 ± 0.12 (p < 0.05). The average keratometry of the weak meridian decreased to 44.3 ± 1.4 diopters, the average keratometry of the strong meridian decreased to 50.8 ± 3.2 diopters. Patients in the control group showed a statistically significant (p < 0.05) increase in average uncorrected visual acuity to 0.45 ± 0.12, and visual acuity with maximum correction to 0.60 ± 0.17. The average values of keratometry of the weak meridian decreased to 45.3 ± 1.8 diopters, the average values of keratometry of the strong meridian decreased to 51.8 ± 2.2 diopters. The results of the vector analysis reliably indicate a significantly higher accuracy of the Verion-assisted ISKP. Which is confirmed by the achieved indicators of the “success” index, the calculated astigmatism vector close to the actual postoperative astigmatism vector, the smaller the magnitude of the astigmatism axis difference vector compared to the control.

Conclusion. The use of the Verion-assisted intrastromal technique for keratoconus reduces the risk of erroneous positioning of the corneal segments in the tunnel during transferring diagnostic data to the operating room. Taking into account the angle of cyclotorsia during cutting into the intrastromal tunnel increases the effective correction of the cylindrical component of refraction, which is confirmed by the main coefficients of the vector analysis by N. Alpins.

Purpose: to evaluate the immediate and long-term hypotensive efficacy, the number of complications, and the clinical benefits of a draining autovalve limbosclerectomy (DALS) performed using a kit of disposable instruments in patients with POAG of various stages in comparison with trabeculectomy (TE).

Patients and Methods. The study is based on the analysis of the clinical and functional condition of 127 eyes of 127 patients with primary open-angle glaucoma (stage I POAG was detected in 2 eyes, stage II in 30 eyes, stage III in 88 eyes and stage IV in 7 eyes). Patients were divided into groups: the main group—76 people who underwent DALS using a set of disposable instruments, and the control group—51 people who underwent TE. The average age of patients is 68.9 ± 10.3 years. Before and within 24 months after surgery, all patients underwent standard diagnostic examinations. The initial level of IOP against the background of the maximum antihypertensive mode varied from 24 to 50 mm. Hg. According to gonioscopy, the angle of the anterior chamber was open in all cases (III–IV degree). Patient exclusion criteria: history of laser or surgical treatment of glaucoma, cataract treatment.

Results. After 24 months of follow-up after DALS, the level of IOP in patients with stage I–II of POAG was 14.19 ± 1.83 mm Hg and with III–IV stage of POAG 14.95 ± 2.15 mm Hg, compensation was achieved in 88.2 % of patients without the use of antihypertensive drops. After TE, compensation was received in 72.6 % of patients, the IOP level was 16.9 ± 2.21 and 17.78 ± 2.31 mm Hg. respectively (p < 0.01). After DALS surgery, a decrease in the number of complications was revealed in comparison with TE: a decrease in сiliochoroidal detachment by 9.1 %, hyphema by 2.5 %, ophthalmic hypertension in the early p/o period by 3.2 %, cystic changes in the filtering bleb by 7.1 %.

Conclusion. The standardized DALS operation using a disposable tool kit is a new highly effective and safe method for the surgical treatment of glaucoma. DALS may be the operation of choice in the treatment of POAG of all stages.

Lens material can be detected behind posterior capsule in case of infusion misdirection syndrome development during phacoemulsification. This condition is associated with Wieger ligament damage. There is no accepted management options for this issue. Authors offer original technique of small diameter (2–3 mm) posterior capsulorhexis performed before IOL implantation for evacuation of infusion fluidics and lens material from Berger space. Safety of new technique was evaluated by OCT images analyzing central foveal thickness in 1 day, 3 weeks and 6 weeks after cataract surgery. There were 3 patients groups: I — uneventful phacoemulsification (10 eyes) (control group); II — phacoemulsification with development of infusion misdirection syndrome and lens material behind posterior capsule without performing posterior capsulorhexis (10 eyes); III — phacoemulsification with development of infusion misdirection syndrome performing posterior capsulorhexis for draining Berger space. There was no significant difference in central foveal thickness between patients groups. There was trend of central foveal thickness increase in 3 weeks after surgery in all groups. Central foveal thickness returns to initial values in 6 weeks after surgery in all patients groups. There was no cases of cystoid macular edema in study. In conclusion, small diameter posterior capsulorhexis technique is useful in clinical practice for evacuation of infusion fluidics and lens material from Berger space before IOL implantation.

Purpose: Mathematical modeling of the eyeball vitreous cavity and analysis of the vitreous cavity volume vs. eyeball length correlation dependence; software for automatic calculation of individual doses of antibiotics for intravitreal injection in treating bacterial endophthalmitis.

Materials and methods: The study included three sequential stages: 1st stage — mathematical modeling of the vitreous cavity of human eye based on data of 77 phakic eyes, by the least square method. The data were obtained by Tomey UD-8000 ultrasonography (Japan) and VuMax Sonomed ultrasound biomicroscopy (USA). 2nd stage — study of the vitreous cavity residual volume, free from silicon oil, by measuring a volume of vitreous body substitute injected to 64 pseudophakic patients who underwent a vitrectomy on account of detached retina. 3d stage — development of a computer program based on the data of the vitreous cavity volume vs. eyeball length dependence, vitreous cavity residual volume, and anterior chamber volume, and description of an algorithm for diluting antibiotics for intravitreal injection, based on a required concentration.

Results. Vitreous cavity of eyeball was approximated by ellipsoid. Statistical analysis has shown a linear dependence of eyeball length vs. vitreous cavity volume; vitreous cavity calculation accuracy does not depend on the cavity size, and a relative error of volume calculations that were performed from the resulting data of a single determination of the cavity surface point coordinates, with a probability of 0.866, does not exceed 1 %. Average residual volume of the vitreous cavity subjected to silicon oil tamponade was 332.36 ± 0.02 mm3, and average anterior chamber volume, 246.36 ± 0.06 mm3. The resulting data were exported to the computer program kernel.

Conclusion. The developed original mathematical model of the eyeball made it possible to calculate a vitreous cavity volume vs. eyeball length dependence and whereby to plot calibration nomograms that allow individual doses of antibiotics for intravitreal injection to be precisely calculated, thus providing a desired concentration thereof to suppress bacterial microflora and preventing toxic effect on retinae.

Micro incision vitrectomy surgery with removal of epiretinal and internal limiting membranes is used for treating various forms of vitreomacular traction syndrome.

Objective: to study the condition of retinal microcirculation using the OCTA method in the patients with traction maculopathy and macular ruptures before and after vitrectomy.

Patients and Methods. The study included 160 patients, of which 55 had epiretinal fibrosis (Treatment 1), 60 had macular ruptures (Treatment 2), and 45 with no ophthalmic pathology (Control). Treatment 2 group included two subgroups: 2a — patients with large-diameter ruptures (over 800 μm) subject to inverted internal limiting membrane flap technique (n = 12), and 2b — patients with 430–800 μm ruptures subject to rapprochement of the rupture edges with a platelet mass technique. All patients underwent conventional ophthalmology examinations and optical coherence tomography angiography (OCTA) using Sirrus HD-OCT 5000, Carl Zeiss, Germany.

Results. In the postoperative period, there was an improvement in retinal microcirculation in the Treatment 1 patients, and the values of both perfusion and vascular densities increased. A month later, an additional improvement of these indicators was recorded against the background of a decrease in retinal thickness and restoration of the vitreoretinal interface configuration. In the early postoperative period, Treatment 2 patients showed significant difference in the capillary density of the superficial vascular complex from the control group. A month later, the density of blood vessels in the Treatment 2 patients achieved control group values. Despite an immediate increase in perfusion measurements after surgical treatment, their values in a month were still lower than in the control group.

Conclusions. In the patients with epiretinal membrane and macular ruptures, a statistically significant decrease in both vascular and perfusion densities of the surface capillary complex was revealed by OCTA. The effects of vitreoretinal surgery performed on Treatment 1 and 2 patients with macula traction pathology included increased visual acuity, decreased retinal thickness, and restoration of the proper vitreoretinal profile. Based on OCTA results, we discovered a gradual increase in vascular density of the macula in Treatment 1 and 2 patients after surgical treatment of VMT syndrome. Retinal perfusion in the macular region of Treatment 1 patients achieved the values of the control group within a month, while in Treatment 2 patients they increased, but remained lower than in control group. OCTA is a highly informative method for the diagnostics and monitoring of the eye posterior segment condition in the patients with VMT syndrome.

Purpose. Analysis of refractive errors’ frequency in children with retinoblastoma.

Patients and Methods. A retrospective study included 57 children with retinoblastoma (31 male and 26 female) who received treatment in 2013–2017. The criteria for patient selection was the presence of mono- or bilateral retinoblastoma, as well as autorefractometry of both eyes before treatment. In all cases, the study was performed with cycloplegia. The parameters studied included gender, age at the time of the initial examination, visual acuity, spherical and cylindrical component of refraction, the axis of the cylinder.

Results. Bilateral retinoblastoma was determined in 34 children (59.6 %), the average age of the patients was 18.0 ± 2.6 months. Monolateral retinoblastoma was detected in 23 patients (40.4 %), the average age at the time of check-up was 26.2 ± 3.1 months. In total, anisometropia of more than 2.0 diopters was detected in 14 patients (24.6 %), of which with monolateral RB in 6 patients (26.1 %) and in bilateral patients in 8 (23.5 %). In 26 cases (45.6 %) anisometropia was determined from 1.0 to 2.0 diopters, of which 41.1 % (n = 14) with bilateral lesion and 52.1 % (n = 12) with monolateral. The frequency of hyperopia over 3.0 diopters in the total cohort was 25.2 %, myopia 3.3 %. Significant differences (p = 0.025) were obtained by comparing the frequency of astigmatism determination of more than 1.0 D (39.6 % in the total cohort versus 13.0 % for healthy eyes). When analyzing the frequency of ametropia depending on age, a trend was observed (0.05 < p < 0.1) to reduce the frequency of hypermetropia and increase the frequency of astigmatism. Additionally, an analysis of the astigmatism’s frequency depending on the tumor localization was made. Patients with central or paracentral localization of the tumor lesion amounted to 69.4 % (n = 25), and from the peripheral — 30.6 % (n = 11) (p = 0.002).

Conclusions. In this paper, we analyzed the frequency and nature of refractive errors in children with monolateral and bilateral retinoblastoma. The identified risk factors may affect the development of refractive amblyopia in children with retinoblastoma in more adulthood, which requires the development of an individual approach to the correction of refractive disorders taking into account the localization of tumor foci, the nature of the lesion and the individual characteristics of patients.

Purpose: to assess the inner retinal layer’s changes of the central retina in comparison with bioelectrical activity of macula assessed by MERG and with thickness of photoreceptor retinal layers in patients with retinitis pigmentosa.

Patients and methods: 10 patients (20 phakic eyes) with RP were examined. Mean age was 27.0 ± 18.5 years. Mean best corrected visual acuity was 0.38 ± 0.22. The fundus photography electrophysiological studies were performed besides standard ophthalmological examination. Maximal electroretinogram (ERG) or cone-rod response, ERG to 30 Hz flicker and macular ERG were registered with electroretinograph MBN (Russia). Images were acquired using the protocol of scanning Macula radial (12 lines 9 mm long, each radial image is the average out of 50 scans) with settings ultrafine with automatic segmentation of the retina and calculation thickness. Retinal segmentation with the following calculation of different retinal layers was performed on SD-OCT RS-3000 Advance (Nidek, Japan) with obtainment of the map with 6 mm in diameter in accordance with the Early Treatment Diabetic Retinopathy Study (ETDRS).

Results. We revealed increased thickness of retinal nerve fiber layer (RNFL), decrease of thickness of ganglion cell layer (GCL) (p < 0,05) and normal (p > 0,05) inner nuclear layer (INL) thickness. These structural changes are associated with the decrease of bioelectric macula’s activity measured by MERG (decrease of α- and β-wave amplitude) and decrease the thickness of photoreceptor layers in all zones according to EDTRS.

Conclusion. Increase of thickness RNFL, decrease of GCL’s thickness and normal INL in patients with RP is associated with decrease of thickness of photoreceptor layers in EDTRS zones and decrease of amplitude of MERG.

Purpose. Determining the functional state of the outer and inner retina’s layers in patients with diabetes mellitus (DM) type 1 and 2 before the clinical manifestations and in the early stages of diabetic retinopathy (DR) using the methods of multifocal electroretinography (mfERG) and microperimetry (MP).

Patients and methods. 91 patients were examined (182 eyes). The patients were divided into 4 groups: 1st — 23 people (46 eyes) with diabetes without DR (the duration of the disease is up to 2 years); 2nd — 22 people (44 eyes) with diabetes without DR (diabetes from 2 to 8 years); 3rd — 24 people (48 eyes) with NPDR on the background of diabetes; 4th — 22 people (44 eyes) of the control group (healthy eyes). In addition to the standard ophthalmologic examination, all patients were registered mfERG (FOK1) on the diagnostic equipment EP-1000 Multifocal (Tomey, Germany) and carried out MP using the device “MAIA” (CenterVue, Italy).

Results. According to mfERG, it has been established that the components of mfERG, the biopotential density and the amplitude of P1, are most sensitive to diabetic changes. In groups with type 1 and type 2 diabetes, there is a significant decrease in the density of P1 in comparison with the control group (p < 0.005, Mann-Whitney test), as well as a decrease in the amplitude of P1 on almost all tested rings (p < 0.005). In all groups, there is an increase in the latency of P1 in the central ring (0–2.3°). According to MP data, it was found that patients with type 1 and type 2 diabetes showed a decrease in the average light sensitivity in comparison with the control group, however, our data are within the reference values, regardless of the presence or absence of clinical manifestations of PD.

Conclusion. As a result of the study, early functional and morphological disorders of the neurosensory apparatus of the eye in diabetes were identified. It is proved that mfER and MP allow to detect violations at the preclinical stage of DR and are necessary studies for the dynamic control of the progression of DR.

Purpose: to study the effect of dosed pneumatic vasocompression (DPVK) on the functional parameters of the organ of vision in patients with primary open-angle gluacoma in the complex therapy of this form of pathology.

Patients and Methods. The study included 39 patients with stage II POAG, which were randomized into two groups: main and control. All patients received a conservative complex drug therapy. Patients of the main group were additionally conducted DPVK sessions — twice a week (only 4 procedures during the entire course of treatment). All patients underwent standard ophthalmologic examination, hemostasis and fibrinolysis.

Results. In the main group of patients, 1 hour after the end of compression, an increase (from baseline) in t-PA level (by median — 1.4 times) was observed while reducing the content of PAI-1 (by median — 2.7 times); improvement of hydrodynamic indicators (improvement of the outflow lightness coefficient, by 19.04 % in OD and 20.0 % in OS, decrease in KB by 24.7 % in OD and by 22.3 % in OS from the initial level) and retinal sensitivity (decrease the number of cattle type 1 in both eyes: 1.70 times on OD and 2.14 times on OS, decrease in type 2 cattle by 2.70 (OD) and 2.30 times (OS). In this regard, an increase sites of normal retina’s photosensitivity in 1.14 times on the OD and 1.19 times on the OS, in contrast to patients in the control group, where no significant changes were found.

Conclusion. The obtained preliminary results of the study indicate the prospects for non-pharmacological stimulation of fibrinolysis in the inpatient stage of the addition of conservative therapy in patients with POAG, achieved with a course of dosed pneumatic vasocompression.

Uncontrolled administration and prolonged use of antihypertensive drugs with preservatives often leads not only to subjectively poor tolerance of treatment, but also to a deterioration in the results of subsequent surgery, if required. The manifestations of dry eye syndrome and its aggravation as a result of such drops use can lead the patients to refuse therapy and worsening the prognosis. The manifestations of dry syndrome are often detected before any hypotensive therapy begins, since the functions of secretory cells change with age and there is always the influence of adverse environmental factors. It is necessary to examine the condition of the anterior surface of the eye to resolve the issue of the need to prescribe drugs without preservatives for all patients before the appointment of antihypertensive therapy. However, sometimes it is not possible due to lack of time or equipment. Therefore, it is important to study the condition of the anterior eye surface in patients with newly diagnosed glaucoma before and during treatment with nonpreservative forms of antihypertensive drugs in order to determine the necessity of the first prescription of non-preservative forms of antihypertensive drops to further interpolate its results into practical recommendations. This study revealed that drug treatment of patients with newly diagnosed glaucoma with the drug Timolol-POS® β-blocker on a non-preservative basis along with IOP compensation improves both subjective and objective indicators of the condition of the anterior surface of the eye with maximum effect after 3 months of treatment. This conclusion suggests the importance of the primary appointment for such patients with instillation drops on a preservative basis.

Purpose. to evaluate the efficacy of perioperative antibacterial prophylaxis using eye drops with fluoroquinolones with the evaluation of conjunctival microflora structure with its antibiotic resistance.

Patients and Methods. The study was carried out using the results of one preoperative and four times postoperative swabs taken from the conjunctival cavity in 50 patients (52 eyes) aged 49 to 91 undergoing phacoemulsification. All the strains were undergoing the 16 antibacterial drugs-panel susceptibility testing including the most common ophthalmic dosage form in the Russian Federation. The antibacterial drugs instillations were used during the postoperative period: levofloxacin in group 1 (30 eyes) and moxifloxacin in group 2 (22 eyes).

Results. The structure of conjunctival microflora in the two groups was similar prior to phacoemulsification. In 32 cases (61.5 %) bacterial growth was obtained preoperatively. Among them S. epidermidis strains were detected in 68.8 %, S. aureus strains were detected in 31.2 %. During the use of postoperative antibiotic prophylaxis, the number of positive swabs was constantly decreasing. In 1 hour a qualitative change in the microflora structure was observed. The number of S. aureus strains reduced. The number of S. epidermidis strains increased to 80 %. And previously undetected Corynebacterium spp. strains were found. In 1 day the conjunctival microflora was represented only by S. epidermidis. In 1 week all the swabs were sterile. In 1 month after phacoemulsification, positive swabs were obtained in 7.7 % (mainly S. epidermidis) only in group 1, where levofloxacin instillations were used as the postoperative antibiotic prophylaxis (р < 0,05). Moxifloxacin, gatifloxacin and antiseptic drugs showed the highest in vitro activity against selected strains.

Conclusion. The strains of coagulase-negative staphylococcus S. epidermidis prevailed in conjunctival microflora structure. During the use of postoperative antibiotic prophylaxis, the number of positive swabs is progressively reduced to zero by the 7th day in both groups. A more persistent permanent effect of moxifloxacin, maintaining for 1 month after the operation was found in comparing two patients’ groups received fluoroquinolone eye drops to prevent infection after phacoemulsification.

According to statistical studies in recent decades, there has been an increase of allergic diseases in most countries of the world. Predisposing factors are the deterioration of the environmental situation, the total “chemicalization” of life and the forced use of drugs. Twenty years ago, the World Health Organization called the new century “the century of allergies” and the disease itself as an “epidemic”. As time has shown, these forecasts have come true: from 2001 to 2010, the number of allergic people in the world increased by 20 % and many of these patients suffer from ophthalmic manifestations of the pathology: the eyes are involved in the process in almost every second case. This is due to the fact that the eyes are directly exposed to the environment and a variety of external allergens. The most common disease of an eye-allergic nature is allergic conjunctivitis: approximately 15 % of the total population of economically developed countries suffer from it. Allergic blepharitis, eyelid dermatitis, keratitis, iritis, uveitis, retinitis and optic neuritis are much less common.
The following manifestations are typical for allergic conjunctivitis: burning, lacrimation, pruritus, hyperemia of the eyelids and conjunctiva, photophobia. In the case of a transition to a chronic form, pronounced tissue changes are observed. Therefore, timely diagnosis and effective treatment certainly have a positive effect on the quality of life of the patient and the course of the disease. The treatment of patients with allergic conjunctivitis, first of all, consists in the maximum possible restriction of contact with the allergen. During desensitizing therapy, local and general drugs are used. Numerous studies have proven the advantage of targeted and effective antiallergic local therapy compared with systemic exposure. Currently used local ophthalmic antiallergic drugs belonging to various groups. The tactics of their use is determined by the acuity, severity and etiology of the process. When choosing a drug, in some cases, you should focus on the presence of substances that provide a double mechanism of action: a pronounced antihistamine activity in combination with the stabilization properties of mast cells, which has a quick and long therapeutic effect. This study evaluated efficacy of Vizallergol (olopatadin 0.2 %) application in cases of allergic conjunctivitis in 239 patients was evaluated. The medication arrested the symptoms of allergic conjunctivitis in 89 % of patients, at that the mean period of treatment made 10.7 ± 0.3 days. In the treatment of allergic conjunctivitis, the therapeutic efficacy of Vizallergol 0.2 % was comparable to opatanol 0.1 % and was found to be more comfortable for most patients due to the convenience of a single use.

Purpose: evaluation of the efficacy of the drug Tealose® in the therapy of cornea inflammatory diseases consequences such as dry eye syndrome.

Patients and methods: 34 patients (34 eyes) with dry eye syndrome after inflammatory diseases of the cornea, aged 28–56 years old were included in the study. Two clinical groups were formed: observation group — 20 subjects (20 eye) and comparison group — 14 subjects (14 eyes). The dynamics of such indicators were estimated under therapy: visual acuity with maximal correction, corneal epithelium entity according fluoresceine dye test, tear production according Schirmer and Norn tests, the grade of dry eye syndrome severity according index of OSDI — Questionnarie. The patients in observation group in addition to the basic therapy, which included instillation antiseptics и 4 % taurine solution, were treated with 3 % solution of tregalose (Tealose®, “Laboratuar Thea”, France) by such mode: using of 4 times daily instillations during 1 month, 1 month break, than continuation of the same regimen instillations during 1 month was performed. The patients in comparison group in addition to the same basic therapy were treated with Visomitin® (“Mitotech”, Russia) by the mode, which was used for tregalose.

Results. The improvement of cornea’s epithelization (p < 0,05), increasing of visual acuity with maximal correction (p < 0,05), improvement of tear production (p < 0,05), as well as the OSDI-index (p < 0,05) were revealed in the patients of the observation group. In the patients of the comparison group positive dynamics of these indicators was insignificant and unreliable.

Conclusions. Using of 3 % tregalose solution in patients with consequences of inflammatory diseases of the cornea — keratitis leads to effective treatment of “dry eye” syndrome, reduces the severity of epithelization disorders and tendency to scarring in the corneal tissue.

Purpose: to study the effect of differentiated treatment approach in patients with varying degrees of severity chronic ocular ischemic syndrome (OIS) on clinical course of disease and hemodynamics of eyes in prospective research.

Patients and methods. The research included 20 patients with chronic OIS. Patients were divided into 4 groups due to severity of chronic OIS and type of treatment. 1st group — 7 patients with moderate severity chronic OIS and hemodynamically significant of internal carotid artery stenosis (ICAS); only carotid endarterectomy (CE) of ICAS was performed. 2nd group — 6 patients with severe degree chronic OIS and hemodynamically significant stenosis of ICAS; 2 weeks before CE, panretinal photocoagulation (PRP) of retinal capillary non-perfusion areas was performed. 3rd group — 4 patients with severe degree chronic OIS, complicated by rubeosis iris and increased IOP on hypotensive regimen, on the background of hemodynamically insignificant ICAS; PRP of retina was performed. 4th group — 3 patients with moderate severity chronic OIS with hemodynamically insignificant ICAS; course of neuroprotective therapy was performed. All patients underwent standard and specialized ophthalmologic examination methods. Assessment of blood flow in brachiocephalic vessels, eye vessels was performed by ultrasound scan, spiral computed tomography, OCT-angiography with the AngioVue.

Results. Monitoring of patients’ groups for 1 year after chronic OIS treatment allowed us to determine tactics of patient management depending on degree of ICAS and severity of chronic OIS. Reconstructive surgery at hemodynamically significant ICAS caused positive dynamic in intraocular blood flow, which contributed to improvement and preservation of BCVA in 71 % of patients. Preventive PRP of retina, before performing reconstructive surgery of ICAS, optimized and reduced the time of visual recovery. PRP of retina as independent method of treatment of chronic OIS, complicated by neovascular glaucoma, caused full or partial regression of neovascularization in iris, which increased possibilities of its effective treatment. Neuroprotective pharmacotherapy in early stages of chronic OIS, in absence of indications for reconstructive surgery and PRP of retina, improved the prognosis for patients’ vision.

Conclusion. Differentiated treatment approach in patients with chronic OIS, due to changes of hemodynamics of internal carotid artery, has improved indexes of hemodynamic and visual acuity.

Purpose: to analyze the monitoring of patients with primary and advanced stages of glaucoma, who applied to the private clinic “Tri-Z” (Krasnodar).

Patients and Methods. A total of 3 524 patients underwent screening with a diagnosis of glaucoma for all over 2018 at the clinic, of which 55.6 % were diagnosed with primary and advanced glaucoma. The criterion for inclusion in the study was primary glaucoma of the initial and advanced stages, elimination criteria: high degree of refraction errors, retinal detachment in anamnesis, proliferative diabetic retinopathy, AMD exudative forms, congenital forms of glaucoma, secondary types of glaucoma.

Results: The average age of patients was 68.44 ± 8.142 years, women were 71 %, men — 29 %. The average duration of glaucomatous history was 3.48 ± 3.525 years. POAG was found in 85.3 % of cases, PACG in 14.7 % of cases. Glaucoma without concomitant PEX was observed in 44.7 % cases, with signs of PEX in 55.3 % cases. In stage I of glaucoma, the majority of patients (42.7 %) received APG and in 27.1 % cases a fixed combination of ICA + BB. In stage II glaucoma, the majority of patients (26.5 %) received a fixed combination of ICA + BB, in 18.8 % of cases, the combination of APG + ICA + BB and in 17.7 % — APG. The share of laser interventions: LTP — 14.7 %, SLT — 4.1 %, peripheral iridectomy — 10 %, YAG-GP — 0.8 %, SLT + YAG-GP — 0.8 %, peripheral iridectomy + SLT — 0.5 %. The share of surgical interventions: at glaucoma stage I non-penetrating deep sclerectomy (NPDS) — 3.4 %; at stage II NPDS — 10.9 %, repeated NPDS — 0.5 %, deepsclerectomy — 2.2 %; phacoemulsification + IOL — 21.9 % of cases.

Conclusion: In the study, we noted the following features: use, including as a starting therapy, effective drugs or their combinations; the preferred use of fixed combinations; prioritization of non-preservative therapy; high frequency of laser interventions in the anterior eye segment; use of peripheral laser iridectomy in the overwhelming majority of cases when PACG is detected; early transition to surgical treatment.

Drug dependence is one of important social problems in modern society. It became more actual because of the high morbidity in young working-age patients. The central nervous system is the main target for psychoactive substances. Long-term drug intoxication results in functional and structural brain alterations, it leads to cognitive impairment and disturbances of higher mental functions rendering patients’ disadapted in their work and daily life activities. Eye disorders due to drug abuse are multifaceted and can vary from conjunctival damage to severe endogenous endophthalmitis. Opioid dependence can result not only from intentional self-administration of narcotic drugs, but also from long-term prescribed use of these medicinal products owing to their potent analgesic effect exhibited in somatically ill patients with severe chronic pain. Opioid derivatives act as partial or full agonists of three types of opioid receptors (δ, κ, and µ) extensively expressed by the neurons of the central and, to a lesser extent, peripheral nervous system. The most dangerous complication of intoxication with this group narcotic drugs is opioid induced-respiratory depression resulting in hypoxaemia and hypercapnia. The paper presents a case report of bilateral optic nerve atrophy that developed in a young female patient after a long period of intravenous heroin use. There are practically no reports of optic nerve damage due to heroin intoxication in the current literature. Possible optic nerve atrophy mechanisms under discussion include generalized hypoxia developing against a background of chronic heroin intoxication and direct toxicity of admixtures used to dilute home-made narcotic drugs. In view of the growing use of these substances, physicians have to consider their effects in the differential diagnosis in patients with atypical eye disorders.