The data analyzed in this review indicate that an important feature of the natural evolution of diabetic retinopathy (DR) is the possibility of reverse development of its main signs, including newly formed vessels. The term “spontaneous remission”, proposed by M.D. Davis, may be correct for stating this condition. Spontaneous remission can be persistent and its frequency can significantly exceed the generally accepted 10 %. Signs of remission of proliferative diabetic retinopathy (PDR), regardless of the cause of occurrence (spontaneous or resulting from treatment) are: absence of ophthalmoscopically detectable neovessels; increased/appearance of the fibrous component of proliferation, which is accompanied by traction deformation of the retina. Therefore, the scale reflecting the stages of evolution of newly formed vessels and the scale of severity reflecting the degree of threat to visual functions in PDR cannot be identical. Since the development and regression of neovessels is a reflection of multidirectional processes, the identification of the phase of PDR evolution is fundamental in the formation of research design. Due to the possibility of using artificial intelligence for the analysis of “big data”, the effectiveness of the approach to the study of DR will largely be determined by the adequacy of the grouping of the source data. In this regard, the analysis of previous experience is relevant, which allows us to improve some principles of systematization of results. Conclusion: The statement of the phase of evolution of neovessels in PDR is fundamental in epidemiological and scientific studies. The identification of signs indicating the likelihood of spontaneous remission of DR/PDR will allow us to provide a differentiated approach to treatment, as well as to study the association with the dynamics of the patient’s somatic status.

The “gold standard” of modern vitreoretinal surgery is silicone oil tamponade of the vitreous cavity. The lens opacity development is in the list of complications of prolonged silicone oil eye filling (from 2 weeks to 2 years). Polydimethylsiloxanes hydrophobicity, direct contact with the front of the silicone bladder, macrophage and toxic reaction, trophic disturbances are the causes leading to the cataract initiation. This makes the problem of cataract surgery and preliminary intraocular lens calculation in silicone oil filled eyes before its removing very relevant as well as cloudy retina visualization and the necessity of minimization of number of operations through their combination. Certainly, the main error in IOL power calculation is associated with axial length measurement inaccuracy, as the most significant term of an equation. Silicone oil filled eyes biometry errors, and, consequently, postoperative refraction biases remain unresolved problem until now. To date authors report only 58 % of cases in which target refraction was achieved after combined surgery. Some researchers figure out that average calculation error after phacoemulsification with IOL implantation in avitreal eyes was 0.8 D despite of the optical biometry usage. Today it is represented by several methods: partial coherent interferometry, optical low-coherence reflectometry and optical coherence tomography, which are implemented in devices such as IOLMaster 500, Lenstar LS 900 and IOLMaster 700, which have their own characteristics and measurement accuracy. Their advantages as well as creation an accurate IOL calculation method for silicone oil filled eyes could reduce postoperative refraction error that outline significant medical and social problem.

The purpose to assess the benefits of using soft steroids in the treatment of inflammatory eye disorders according to literature data.

Methods. The literature review concerning the administration of the gluco-corticosteroids and combination drugs based on gluco-corticosteroid for the treatment of inflammatory eye disorders. Both Russian and foreign sources for the 1980–2021 period were analyzed.

The results. The combination drugs containing anti-infective drugs and gluco-corticosteroids are actively applied for the treatment of inflammatory eye disorders. That exerts joint ethiopathogenetic effect on the disorder. However, gluco-corticosteroid being a part of such drugs (predominantly dexamethasone) as often as not leads to ocular hypertension. In order to deal with this problem the so-called soft steroids (also classified as gluco-corticosteroids) were introduced. They lessen the possibility of the ocular hypertension and are marked by high efficiency and increased safety profile. One of the representatives of soft steroids is fluorometholone. There is a large evidential base in the modern literature that confirms much lesser influence of fluorometholone on ocular pressure if compared to dexamethasone. At the same time, dexamethasone has a higher anti-inflammatory activity, while on the other hand, its systemic immunosuppressive activity is lower. What is more, in terms of influence on the ocular surfaces, dexamethasone has an additional advantage which is causing mucin expression in conjuctival and corneal epithelium. The above mentioned merits of dexamethasone served as basis for its inclusion into the combination drug called Floas-T which is essentially the combination of tobramycin 0.3 % and fluorometholone 0.1 %. It is used in the treatment of inflammatory eye diseases and diseases of eye appendages, as well as for profylaxis of the diseases in the postoperative period.

Conclusion. Combination drugs containing anti-infective components and gluco-corticosteroids seem to be highly promising for the treatment of inflammatory eye diseases. One of them worth highlighting is Floas-T classified as soft steroids containing tobramycin and fluorometholone. It compares to dexamethasone favourably in terms of efficiency, while contributing less to ocular hypertension.

To this date nonsteroidal anti-inflammatory drugs play a huge role in the treatment of inflammatory eye diseases. Ophthalmologists face the question of choosing between glucocorticoid drugs (GCS) and nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of any inflammatory process. At the same time, these groups can be used both in combinations and in monotherapy mode. Glucocorticoids are widely and effectively used in ophthalmology, but it should be remembered about a number of serious side effects of this group of drugs. When using these drugs, it is possible to increase ophthalmotonus, decrease the immune response and reparative processes, also GCS have cataractogenic and ulcerogenic effects, and therefore it careful use is necessary. NSAIDs are inferior to glucocorticoids in anti-inflammatory activity. Its mechanism of action is associated with blocking cyclooxygenase, inhibition of prostaglandin synthesis from arachidonic acid. In this regard, NSAIDs are the preferred group in the treatment of inflammatory eye diseases. The use of NSAIDs gives a good analgesic effect, this class of drugs is effective for the prevention of macular edema of various etiologies and reducing the risk of inflammation in the postoperative period. One of the most effective and most modern NSAIDs for topical use is a derivative of phenylacetic acid — Bromophenac, which in its formula has a bromine atom, which increases its lipophilicity, penetrating ability into the tissues of the eye, as well as analgesic and anti-inflammatory activity. Bromfenac is effective for relieving pain and all signs of inflammation caused by disease or surgery, suppressing the development of macular edema of various etiologies, has an antimiotic effect. Also, this group can be used after refractive surgery to reduce pain and photophobia, to relieve itching in allergic conjunctivitis. Double use of this drug during the day, the absence of discomfort and minimal side effects contribute to improving the patient’s compliance.

Idiopathic intracranial hypertension (ICH) is a neuroophophthalmologic syndrome, the main ophthalmologic symptoms of which are vision loss and bilateral swelling of optic nerve disks (OD). The article provides a review covering various aspects of ICH. Epidemiology: ICH occurs mainly in women aged 20–45 years with body overweight. In this group of patients world incidence is 12–20 per 100 000 of population per year. In the total population it represents 0.5–2 cases per 100 000 of population per year. The eightfold gender predominance of women with ICH is observed. Etiology is not fully known until present time. The reliable connection between obesity in childbearing age women and menstrual cycle disorders as evidences of hormonal changes has been established. The probable mechanisms of increase of ICP are supposed: hyperproduction of and disturbances of its absorption, CSF mechanical pressure on the optic nerve sheath; restriction of venous outflow from the brain due to the pathology of venous sinuses; stimulating effect of abundant vitamin A in diet resulting in the fat tissue formation with the development of obesity; expression of the protein aquaporin, involved in the regulation of body mass and water metabolism in the subarachnoid space. Clinical manifestations. Ophthalmologic symptoms of ICH: transient visual impairment, sustained loss of visual acuity, photopsy, retrobulbar pain, diplopia. Non-ophthalmologic symptoms: headache, throbbing tinnitus, hearing loss, dizziness. Diagnostics. The valuable diagnostic data can be obtained by visual field investigation, ophthalmoscopic examination with revealing of bilateral OD-edema, OD and retinal optical coherent tomography, orbital ultrasound examination, brain MRI with venography. Treatment. Non-drug therapy: weight loss, lowcalorie diet with limited water and salt intake. Drug therapy: long-term oral use of carbonic anhydrase inhibitors (acetazolamide, topiramate). High doses of steroids (methylprednisone) are used for short-term treatment of patients with fulminant disease type before surgery. Surgery: bypass surgery, cerebral venous sinus stenting and fenestrations of the optic nerve sheath: bariatric surgery with reducing of stomach volume.

A literature review is presented on the comparative assessment of two options for conducting cataract phacoemulsification — monocular phacoemulsification of cataract, (delayed sequential bilateral cataract surgery, DSBCS) and binocular phacoemulsification of cataract (immediate sequential bilateral cataract surgery, ISBCS). It has been established that to date in the literature there is a sufficient amount of data indicating the positive aspects of ISBCS, associated with faster rehabilitation, better functional results, as well as time, financial, and economic aspects. The safety of ISBCS is determined by the minimum likelihood of postoperative bilateral endophthalmitis with careful selection of patients, the required surgeon qualifications and strict adherence to the surgical protocol. Comparatively, in accordance with the results obtained, postoperative refractive indices, the value of the maximum corrected distance visual acuity, the frequency of complications and the degree of patient satisfaction were the same regardless of whether the bilateral cataract surgery was performed simultaneously or sequentially. The effectiveness of ISBCS is determined by quick rehabilitation, the need for only one pair of glasses, a decrease in visits to the clinic, the absence of anisometropia between operations, as well as only one general anesthesia (if necessary). The experience of clinics where such procedures were carried out shows that after ISBCS, minor refractive errors occur, while they are almost always symmetrical, characterized by a slight deviation from the target refraction and rapid recovery of binocular and stereoscopic vision. In financial terms, in accordance with the calculations carried out, the cost of DSBCS in various countries may be higher than the cost of ISBCS by 10.8–47.9 %. In absolute terms, simultaneous cataract surgery on two eyes (Finland) saved €449 per patient in medical costs and €739 after travel and home care costs were included. Taking into account the cost of lost work time, the savings were €849 per patient. The wider distribution of ISBCS is associated with the approval of the ophthalmological community and insurance companies, as well as the development of standardized teaching materials for practicing ophthalmologists.

Child health is a global health priority. The program “Elimination of Eliminable Blindness in the World of Vision-2020” gives the fourth place to the problems of pediatric ophthalmopathology and creates targeted programs for their elimination. The introduction of modern equipment in the clinical practice of pediatric ophthalmologists has expanded the boundaries of traditional diagnostics. Microperimetry is an innovative, quantitative, non-invasive diagnostic study aimed at assessing the functional ability of the retina in strict correlation with morphology. Along with the assessment of light sensitivity, the device allows you to measure fixation parameters, which serves as a reliable criterion for its stability and indirectly reflects the functional organization of central vision. In this regard, the literature review presents the results of domestic and foreign researchers who used microperimetric testing as the main or additional research method for diseases of various etiologies, such as hereditary retinal diseases, amblyopia, and nystagmus. Most authors have demonstrated the high diagnostic significance of this method, the ability to assess photosensitivity of the retina, the detection of fixation disorders, such as eccentricity and instability, even in pediatric patients. The use of microperimetry as a new method of treatment for these diseases has also been shown. Visual rehabilitation based on biofeedback provided by this device has shown high efficiency in diseases of the central region. More research remains to be done to determine future potential applications of this technology, in particular in pediatric practice, and to develop the potential of microperimetry as a tool for the visual rehabilitation of patients.

Purpose. To develop a method of circular buckle length calculation for optimization of circular scleral buckling in retinal detachment surgery.

Methods. At the first stage of the study a formula for calculation of optimal circular scleral buckle length for patients with various axial length (AL) of the eyeball was developed (90 eyes). These healthy eyes were divided into three groups, 30 eyes in each: group 1 — AL 19 to 23.5 mm, group 2 — AL 23.6 to 27 mm, group 3 — AL over 27 mm. In all the groups AL and equatorial diameter of the eyeball were measured with ultrasound A- and B- scanning (Тomey UD8000, Tomey AL 3000). Mathematic estimation of equatorial eyeball diameter dependence on AL was performed using correlation and regression analysis and the formula for optimal circular buckle length calculation was derived. At the second stage the derived formula was used in clinic during retinal detachment surgery in 15 eyes of 15 patients aged 28 to 44 years (37.6 ± 2.6) with subtotal retinal detachment occupying 2 to 3 quadrants. Follow-up period was 1 to 4 months (2.3 ± 0.5). For control, in all patient’s intraoperative measurement of the eyeball circumference in equatorial zone was performed.

Results. The first step of the study revealed high correlation coefficient (r) between AL and equatorial eyeball diameter in groups 1 and 2, 0.89 and 0.87, respectively. In group 3 correlation coefficient was 0.57 which shows moderate correlation between AL and equatorial eyeball diameter. Group 3 (AL > 27 mm) was not included in deriving the formula for circular buckle length calculation. Finally, regression equation was obtained and the following formula for circular buckle length calculation was derived: L = 0.9π (8.05 + 0.66 AL), where L — circular buckle length, π = 3.14, AL — axial length of the eyeball. At the second stage of the study (eyes with AL less than 27 mm) anatomical attachment of the retina was achieved in all 15 cases (100 %), elevation of the buckle was 1.44 to 1.6 mm (1.5 ± 0.02), circular buckle shortening made 10 % of the initial eyeball diameter. Control measurement of eyeball diameter in equatorial zone coincided with calculated values, that is, equaled the data obtained from presented formula and from preoperative ultrasound measurement of equatorial eyeball diameter.

Conclusions. The derived formula for circular buckle length calculation is highly effective for eyes with AL less than 27 mm: provides optimal height of impression roll (approximately 1.5 mm), reduces the risk of postoperative complications, it is simple in use and shortens the operation time. For calculation of circular buckle length for eyes with AL over 27 mm it is reasonable to use the data of preoperative ultrasound A-scan measurement of equatorial diameter of the eyeball.

Purpose: to found the relationship between the obtained postoperative visual acuity, the increase in visual acuity in the lines and the subjective satisfaction of patients with the results of the operation.

Material and methods. The study included 165 patients (186 eyes) who received cataract phacoemulsification surgery with IOL implantation (n = 170) or refractive lensectomy with IOL implantation (n = 16). The average age of the subjects was 70.23 ± 10.14 years. The group included patients without concomitant systemic or ophthalmic pathology, without previous surgical interventions in the eye for any purpose. At least 1 month after the operation, patients filled out a questionnaire in order to find out the subjective satisfaction with the treatment (scale from 0 to 4 points). The results of the questionnaire were compared with postoperative BCVA, and increased vision (postoperative BCVA — preoperative BCVA). Preoperative BCVA — Me 0.4 (Q1–Q3: 0.1–0.68), postoperative BCVA — Me 1.0 (Q1–Q3: 0.95–1.0), increased vision — Me 0.6 (Q1–Q3: 0.3–0.9) according to Snellen’s table.

Results. Visual acuity in satisfaction subgroups: 0 points — Me 1.0 (Q1–Q3: 0.9–1.0) / n = 5 (2.7 %); 1 point — 1 case, postoperative BCVA 1.16 (0.5 %); 2 points — Me 0.95 (Q1–Q3: 0.84–1.0) / n = 14 (7.5 %); 3 points — Me 1.0 (Q1–Q3: 0.9–1.16) / n = 57 (30.6 %); 4 points — Me 1.0 (Q1–Q3: 0.96–1.0) / n = 109 (58.6 %). Postoperative BCVA and increased in visual acuity do not have statistically significant differences depending on satisfaction with treatment (p > 0.05). The correlation between postoperative BCVA and satisfaction is not statistically significant (p = 0.65; rxy = 0.136), as well as between vision improvement and satisfaction (p = 0.55; rxy = 0.141).

Conclusion. There was a lack of a statistically significant relationship between postoperative BCVA and improved vision with subjective patient satisfaction with treatment. Identification of factors affecting subjective assessment requires a deeper analysis. Practicing ophthalmologists should remember the importance of the dialogue between the doctor and the patient at the preoperative stage, informing the patient about the expected results of the operation and the possible course after the operation period.

Purpose: To assess the capsular tension ring implantation effect on the IOL position according to different devices in the long term period after uncomplicated phacoemulsification.

Patients and methods. The study enrolled 234 patients (273 eyes) with cataract without zonular weakness. A standard examination, optical biometry and Sheimpflug imaging were performed preoperatively. In all cases phacoemulsification with IOL implantation, supported by CTR in 11 % of cases (30 eyes) was performed in 1, 3, and 6 months after surgery autorefractometry, visual acuity, biometry, OCT of anterior segment and ultrasound biomicroscopy were provided.

Results. By the 3rd month a small shift of IOL towards the retina was revealed without any refraction changes. In cases with CTR implantation the anterior chamber depth was stable. According to OCT data the angle of IOL tilt in the horizontal meridian gradually decreased, the dynamics was significant from 3 months (p = 0.032). There were no changes in the vertical direction. After CTR implantation IOL position did not significantly change. There was no difference between the groups (p > 0.05) by 6 month. The phenomenon of IOL “deflection” according to OCT data was observed in 20.87 % of cases was in 1 month after operation. In the presence of CTR its frequency decreased to 15.00 %, and in the absence, it increased to 21.63 %. In every fifth case of deformation the measurements did not give us a definite reason to further consider it a “deflection” by 6 months after the operation. In 4.24 % of cases fact of IOL “deflection” was absent at the first month but appeared by the 6 month. There was not any case of CTR implantation among described cases of IOL position change.

Conclusion. Fluctuation of anterior chamber depth is observed up to 3 months after uncomplicated phacoemulsification. Changes in IOL tilt angle occur throughout the observation period with a significant decrease in the horizontal plane by 6 month. Implantation of the CTR should stabilize anterior chamber depth, block the IOL tilt and also reduce the percentage of IOL deflection cases in the defined group.

Relevance. It is well known that asthenopic complaints, such as increased visual fatigue when working at close range, lacrimation, eye pain and headache after corneal refractive operations in recent years are increasingly common at routine ophthalmological practice. They cause significant subjective discomfort in patients and reduce the satisfaction of the surgery. The pathogenesis of asthenopia is a violation of the coordinated work of the accommodation and binocular systems as a result of their overstrain with excessive visual loads.

Purpose. To study the role of the lack of adequate optical correction before surgery in the development of asthenopia in patients with mild and moderate myopia after ReLEx SMILE surgery, as well as to evaluate the effectiveness of drug correction of this condition.

Patients and methods. This study included 84 patients (128 eyes) who spend more than 8 hours at a computer due to their professional activity, without pathology of the visual organ that prevents keratorefractive operations, whose average age was 33.2 ± 1.9 years.

Results and discussion. The ReLEx SMILE operations in all patients were carried out without complications with the achievement of uncorrected visual acuity equal to the preoperative values of the maximum corrected visual acuity in the period of 1 week and 1 month. In the group with a preoperative lack of adequate optical correction, signs of asthenopia were more often manifested than in patients using full eyeglass or contact correction before surgery. The appointment of the drug Mydrimax® allows to improve the subjective state of patients with asthenopia and leads to the normalization of functional parameters.

Conclusion. Corneal refractive operations in patients with the lack of adequate correction of refractive disorders before surgery leads to a significantly significant increase in the initially impaired functional parameters compared to preoperative values, however, it does not reach normal values in most cases and is accompanied by a greater probability of developing postoperative asthenopia.

Objective: to evaluate the results of corneal collagen crosslinking in children with keratoconus.

Patients and methods. Since 2017, 125 children aged 4 to 17 years have been under observation, who have applied to the Eye Microsurgery named after Academician S.N. Fedorov with complaints of reduced visual acuity and, in some cases, the inability to select optical correction. All patients were examined, including using high-tech methods (Sheimpflug camera, OCT). Based on the anamnesis and the data obtained, the diagnosis of keratoconus stage I–III was made. Corneal collagen crosslinking was performed in 30 patients with stage II–III.

Results. The study included 30 eyes of 30 patients (21 (68 %) boys, 9 (32 %) girls) with a median age — 16 (15; 17) years (12 to 17 years), who underwent accelerated “epi-off” crosslinking. No intra-and postoperative complications were observed. 12 months after CXL, there was a slowdown in the progression of keratoconus in children (minimum corneal thickness before surgery 460.00 (445.00; 477.00), after surgery 457.00 (441.00; 477.00), p = 0.112; K1 before surgery 44.60 (43.20; 46.90), after surgery 44.60 (42.90; 46.50), p = 0.481; K2 before surgery 48.30 (47.30; 51.25), after surgery 48.20 (47.21; 49.20), p = 0.779; elevation of the posterior surface before surgery 25.00 (18.00; 42.00), after surgery 26.00 (21.00; 42.00), p = 0.074, and increased visual acuity (NCOZ from 0.30 (0.05; 0.40) to 0.30 (0.20; 0.40) (p = 0.039) and MCOZ from 0.60 (0.40; 0.80) to 0.60 (0.50; 1.00) (p = 0.010)).

Conclusion. 1. Keratoconus is also found in the child population. 2. Timely cross-linking of corneal collagen can slow the progression of keratoconus in children

Aim. To evaluate the results of implantation of a new hydrophobic acrylic monofocal IOL in an automated preloaded delivery system in the short-term follow-up period.

Patients and methods. The prospective study included 89 patients (114 eyes) after bilateral or monolateral Clareon IOL implantation with a mean follow-up of 2.1 ± 0.4 (1–4) months. The age range was 53 to 87 (71.1 ± 5.2) years. A corneal incision of 1.8 mm was used in all cases. For implantation using the AutonoMe® system , the incision was enlarged by 0.2 mm for implantation IOL 26 D and higher. IOL optical power was calculated using the SRK/T formula; retrospective analysis was performed using the Hoffer Q, Haigis, Holladay II, Olsen, Barrett Universal II, and Kane formulas.

Results. In all studied periods (1 day, 1 week and 1 month) there was statistically significant (p < 0.05) increase both of NCDVA (from 0.13 ± 0.02 in the preoperative period to 0.81 ± 0.07 in 1 month after surgical intervention), and BCDVA (from 0.32 ± 0.15 before surgery to 0.94 ± 0.11 after surgery). When assessing the percentage of eyes with an BCDVA of 0.9 or higher, a statistically significant (p < 0.05) difference was shown in all studied periods. The lowest MAE was shown for the Barrett Universal II (0.292), SRK/T (0.312) Kane (0.301), and Olsen (0.325) formulas. For the Hoffer Q and Holladay 2 formulas, MAE values were significantly higher (p < 0.05). The highest frequency of achieving the target refraction of ± 0.25 D was shown for the Barrett Universal II and Kane formulas (68 and 69 %, respectively), and the lowest for the Hoffer Q and Holladay 2 formulas (28 and 35 %, respectively). The primary endpoint of the study (BCDVA = 1.0) was achieved in 95.6 % (n = 109), with a deviation in BCVA of ± 0.1 noted in 4 eyes (3.5 %). No glistening was detected in the follow-up period up to 4 months.

Conclusion. The paper presents an analysis of the first experience with the implantation of new Clareon monofocal IOLs in Russian Federation. The results of implantation of a new hydrophobic acrylic monofocal IOL in an automated preloaded delivery system showed a good clinical and functional effect, a high frequency of achieving the target result and the absence of significant side effects. The Kane, Barrett Universal II, and SRK/T formulas, using the Verion diagnostic navigation system, are recommended for calculating the optical power of the new IOL.

Purpose: the main purpose of study is to obtain a better visual outcome after implantation of a monofocal toric IOLs by accurate measurement, calculations and visual assessment.

Methods. Fifty eyes with astigmatism of more than 2.5 D were included in a hospital-based prospective study. A biometric evaluation is done by Lenstar. Barette's toric calculation method is used to measure toric IOLs power. In a vertical position, preoperative axis marking was done by both bubble marker and direct slit beam. On table, in a horizontal position, axis marking was reassessed. After phacoemulsification, a monofocal Supra Phob toric IOL was implanted and rotated to match corneal axis marking. Best-corrected visual acuity was measured postoperatively at 1 and 3 months.

Results. Reduction of mean of refractive astigmatism was reported postoperatively from 4.0 ± 0.79 preoperatively to 0.7 ± 0.28 at 1 month and 0.6 ± 0.27 at 3 months postoperatively. In whole, 96 % has residual astigmatism less than 1 D at 3 months postoperatively, while 8 % eyes had residual astigmatism more than 1 D. In whole, 76 % patients had IOLs rotation of less than or equal to 5°, 20 % patients had it between 6° and 10° and 4 % eyes had more than 10° at day 7 postoperatively, in which repositioning of IOLs was required.

Conclusion. To reduce postoperative residual astigmatism after toric IOLs and to get better results, accurate measurement of parameters and proper calculation are essential.

Purpose — to study morphological and functional changes in the detection of primary glaucoma progression.

Patients and methods. 128 patients (128 eyes, among them — 64 eyes with primary open angle glaucoma (POAG) and 64 with primary angle closure glaucoma (PACG)) with the initial MD of –6.0 dB were examined at the Ophthalmology Center of the FMBA of Russia from May 2016 to November 2019. The values of corneal-compensated IOP were also considered: minimal (IOPmin), peak (IOPmax) and its fluctuations (IOPfluct). The progression was measured using standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT). During the observation period, each patient received the average of 8.42 ± 2.08 SAP and SD-OCT. Progressive thinning of the retinal nerve fiber layer (RNFL) and its ganglion cell complex (GCC) were evaluated using SD-OCT. If RNFL and/or GCC had a trend of significant (p < 0.05) thinning, the eye was classified as having the SD-OCT progression. The correlation between the rate of progression detected by SAP (ROP1) using thinning of RNFL (ROP2) and GCC (ROP3) with other clinical parameters was analyzed.

Results and discussion. Glaucoma progression was detected in 73 eyes. While the isolated use of SAP did not allow detecting progression, it was possible to detect it in 39 % cases by SD-OCT. The combination of both methods allowed detecting progression in 57 %. In both forms, ROP1 correlated with IOPmin: in PACG r = 0.41, p = 0.023 and in POAG r = 0.43, p = 0.016. In PACG, ROP2 and ROP3 correlated with the foveal choroid thickness: r = 0.46, p = 0.019 and r = 0.47, p = 0.009, respectively. At the same time, ROP3 was associated with peak IOP (r = –0.402, p = 0.025); the correlation of peak IOP with its fluctuations amounted to 0.7 (p < 0.001).

Conclusion. SD-OCT is more informative than SAP in determining the progression of the initial primary glaucoma. The combination of these two methods 1.5 times increases the possibility of detecting progression in comparison with the isolated use of SD-OCT. The choroid thickness, associated with the IOP fluctuations, plays an important role in the progression of PACG.

Thanks to new fundamental data, our understanding of the angiogenesis’ role and its molecular participants has changed. Molecular genetic mechanisms of activation of signaling pathways of proliferation, malignancy, suppression of the tumor cells’ apoptosis, carried out through the interaction of the VEGF molecule with its receptors, have been deciphered. Molecular genetic mechanisms of activation of signaling pathways of proliferation, malignancy, suppression of apoptosis of tumor cells, carried out through the interaction of the VEGF molecule with its receptors, have been deciphered. The doctrine of angiogenesis has changed. Angiogenesis began to be considered in the aspect of the increasing anaplasia mechanism, accelerating proliferation, the formation of a clone of stem tumor cells, highly resistant to chemotherapy and radiation therapy with a high potential for metastasis. It is time to reconsider the role of individual biological markers of angiogenesis in their suitability in predicting disease outcome and evaluating them as a potential target for targeted therapy. In this aspect, uveal melanoma (UM) as a model of an extremely aggressive malignant tumor using its angiogenic phenotype to accelerate hematogenous metastasis is of particular interest. One of the characteristics of the angiogenic phenotype is VEGF-R1/Flt-1. The purpose: to study the expression of the VEGF-R1/Flt-1 receptor as a characteristic of the angiogenic phenotype of UM in correlation with its clinical and morphological indicators and the outcome of the disease. The authors conducted a retrospective study on 98 archival paraffin blocks of the eyes of patients with UM. The following general patterns of Flt expression in UM cells are revealed: Basic expression takes place in the smallest tumor proliferates UM (T1). Moreover, overexpression (IGH-gradation III) of Flt in the nucleus (39.7 %) and cytoplasm (36.3 %) occurred in every third patient with UM in stage T1. The peak of reception for the maximum average percentage of positive cells and the average cellular IGH gradation of expression was recorded at the T2 stage, after which there was a slow decline to the T4 stage. The number of overexpressive Flt in the nucleus and cytoplasm of UM cells increased x 2 times (75.3 %) to the T2 stage. The peak of Flt nuclear expression in terms of the number of immunopositive cells was also recorded at the T2 stage. The authors concluded that VEGF-R1/Flt-1 expression is a very important characteristic of the UM angiogenic phenotype. In the vast majority of UM, there is an expression of the VEGF-R1/Flt-1 receptor in the nucleus and cytoplasm of tumor cells. The revealed correlations of VEGF-R1/Flt-1 expression with the volume and histological type of tumor, disease stage and metastasis allow them to consider Flt-1 an important indicator associated with the pathogenesis and prognosis of uveal melanoma and a potential target for targeted therapy. A prognostic adverse factor in the aspect of the prognosis of the risk of metastases should be considered the index of the ratio Flt C/Flt N ≥ 3.

The problem of chemo/antibiotic resistance in modern medicine remains relevant today. The sensitivity of microorganisms (MO) determines the range of drugs used, which ultimately affects the effectiveness of treatment and the prognosis for the patient. However, taking into account the adaptation process of individual strains of MO, the uncontrolled use of antibiotics will inevitably lead to the maintenance of the so-called crisis of antibiotic resistance throughout the world, as well as the formation of a vicious circle that reduces the functional and anatomical outcomes of the treatment of any inflammatory diseases, including ophthalmological ones. This article presents the process of experimental creation and certification, assessment of the physicochemical properties of quantum dots, as well as biological nanoconjugates as an option for overcoming the antibiotic resistance of certain strains of microorganisms in the treatment of infectious and inflammatory pathology in ophthalmology, in particular endophthalmitis. Also, an animal model has demonstrated the safety of using InP / ZnSe / ZnS 660 quantum dot solutions for intravitreal administration in pure form and in combination with antibiotics.

Purpose. To study the effectiveness of vascular, anti-inflammatory and fibrinolytic therapy, to conduct a comparative assessment with treatment without vascular therapy in patients with angle-closure (ACG) and mixed glaucoma.

Methods. A total of 55 patients with angle-closure and mixed glaucoma, mainly with hypermetropic refraction of varying degrees, were examined: 7 people with acute glaucoma attack, 6 people with subacute glaucoma attack (group 1, with anti-inflammatory treatment), 7 people with acute glaucoma attack and 6 people with subacute glaucoma attack (group 2, with vascular treatment), 14 people with chronic angle-closure glaucoma (group 3) and 15 people with mixed glaucoma (group 4). All patients underwent an ophthalmological examination, which included visometry, refractometry, tonometry, computer perimetry, OCT and OCT angiography, and an ELISA analysis to determine cytokines.

Results. The administration of the drug Pentoxifylline as a cytokine blocker and antiplatelet agent in ACG contributed, in our opinion, to an improvement in visual acuity, perimetry (MD), an increase in the density of capillaries of the deep vascular plexus at the level of lamina cribrosa in the peripapillary zone (%), i.e. improved blood circulation in the vessels of the optic nerve disc and also contributed to the blockade of cytokines, mainly in the 2-nd group of patients. In our opinion, a personalized approach to the treatment of ACG is to maintain the improvement of blood circulation in the peripapillary zone by prescribing a course of treatment with Pentoxifylline for 6 months after surgery. After phacoemulsification, there was a significant increase in the density of capillaries of the deep peripapillary vascular plexus at the level of lamina cribrosa (p ≤ 0.05) (51.0 ± 3.5 %), and after further treatment with Pentoxifylline, the capillary density continued to increase in 2–4 groups in the next 6 months of follow-up. The thickness of RNFL (Retinal nerve fiber layer, structural parameter) decreased due to a decrease in edema in 1–2 groups, slightly increased in 3–4 groups, in our opinion, due to improved blood circulation. Increased reperfusion in the capillaries of the deep plexus during normalization of IOP in glaucoma patients and further treatment with pentoxifylline indicates the effectiveness of the proposed treatment in addition to surgical treatment. The results obtained emphasize the advantages of the proposed therapy for the treatment of patients with angle-closure and mixed glaucoma.

Conclusion. To date, there are no clear recommendations of vascular therapy for the treatment of patients with ACG and mixed glaucoma, which creates the need for its addition to treatment regimens, taking into account the vascular component of ACG and mixed glaucoma.

Aim: to study genotype-phenotype correlations in patients with inherited retinal diseases with mutations in ABCA4 gene in Russian Federation.

Patients and methods. 21 patients from Russian population aged from 7 to 51 years old (mean age 20 ± 11 years with best-corrected visual acuity from 0,02 to 0,6 (0,14 ± 0,11) with ABCA4-associated retinopathy, verified by molecular genetics methods. All patients besides standard ophthalmic examination and photodocumentation were performed Spectral-Domain OCT and fundus autofluorescence on Spectralis ®HRA+OCT (Heidelberg Engineering, Germany). Full-field electroretinogram (ERG), 30-Hz flicker ERG and macular chromatic ERG (MERG) to red stimulus were recorded on electroretinographic system MBN (MBN, Russia). (Russia) Molecular genetic studies were performed using Next Generation Sequencing (NGS) and Sandger direct sequencing. Results: In ABCA4-associated Stargardt disease 1 type (STGD1) genotype [p.L541P, p.A1038V] of «frequent» mutations was revealed in 9 patients, in 2 cases in was associated another “frequent” mutation p.G1961E. In 4 patients with genotype [p.L541P, p.A1038V] “severe” phenotype of Stargardt disease was found: with large defect of the ellipsoid zone and large zone of central reduced autofluorescence, severely subnormal macular ERG (MERG) to red stimulus and subnormal 30 Hz flicker and full-field maximal ERG. In one patient with these mutations in homozygous state ABCA4-associated cone-rod dystrophy (CORD3, clinically looking alike secondary retinal dystrophy is diagnosed. In 2 patients with genotype [p.L541P, p.A1038V] and mutation p.G1961E was found mild phenotype. One patient with homozygous mutation p.R653C autosomal recessive ABCA4-associated retinitis pigmentosa (RP19) was diagnosed. Clinical picture and autofluorescence were polymorphic in all patients.

Conclusions. Our study with ophthalmological, molecular genetics and instrumental methods widens the spectrum of clinical signs of inherited eye diseases associated with mutations in АВСА4 gene, widens the spectrum mutations in Russian Federation and reveals clinicо-genetic genotype-phenotype correlations.

The purpose: to study the species composition of the lacrimal fluid microbiota in patients with endogenous uveitis and the biological properties of dominant species of bacteria.

Patients and Methods. A bacteriological study of the lacrimal fluid of 107 patients (114 eyes) with endogenous uveitis and 28 practically healthy persons (control) was carried out. The research was performed using the conventional methods. The isolated microorganisms were identified up to the species. We studied the main biological properties of bacteria — the presence of persistence and virulence factors of isolated dominant species.

The results. 43 strains of various types of bacteria were isolated from the lacrimal fluid of patients with uveitis, bacteria of the genus Staphylococcus prevailed, S. aureus was isolated in 23.3 % of cases, and the remaining strains were representatives of coagulase-negative staphylococci. The species composition of the bacteria isolated from practically healthy individuals did not differ in essence. Isolated strains of S. aureus had a significant set of virulence factors. All isolates lysed sheep red blood cells, 80 % of the cultures had lecithovitellase and 60 % — DNA-se activity. Representatives of coagulase-negative staphylococci were characterized only by hemolytic activity. In the study of persistence factors, it was found that all the studied strains of S. aureus and the vast majority of representatives of coagulase-negative staphylococci isolated from tears were resistant to lysozyme. Biofilm formation was more typical for S. aureus strains 90 % versus 34.4 % for representatives of coagulase-negative staphylococci (t = 2.194, p = 0.034). Similar patterns were found in relation to complement resistance, 90 % of S. aureus cultures and 37.5 % of coagulase-negative staphylococci (t = 2.055; p = 0.046).

Conclusion. Among the microorganisms isolated from the lacrimal fluid, Staphylococcus bacteria prevailed, from which S. cohnii was most often isolated. S. aureus to a greater extent than coagulase-negative staphylococci had a certain set of virulence and persistence factors. The microbiocenosis of the lacrimal fluid of patients with endogenous uveitis did not differ from practically healthy individuals. The presence of S. aureus in lacrimal fluid is a risk factor for the development of endogenous uveitis in cases of chronic oral and ENT organ diseases.

A prerequisite for the growth, progression and metastasis of malignant tumors of any localization is the development of its own vascular network. Newly formed vessels not only nourish the primary tumor, but also create conditions for the spread of tumor cells through the circulatory system and the formation of distant metastases. Angiogenesis is able to launch a small population of tumors from 100–300 cells that have accumulated genetic aberrations and have begun to express proangigenic molecules. The phenomenon is known as “transformation of tumor cells into angiogenic phenotype”. A tumor with angiogenic phenotype carries a high potential for proliferation and malignization. This pattern has been found in many types of cancer, but studied less in uveal melanoma. Meanwhile, in this aspect, uveal melanoma, metastasizing exclusively in a hematogenic way, with its selective, organotropic nature of metastasis, becomes an attractive model for the study of the molecular “scenario” of tumor angiogenesis studies allow us to say that, UM is subject to the general patterns of the development of malignant tumors. As with many types of tumors, VEGF is an obligate condition for the development and progression of UM. The VEGF molecule’s producers in UM are two cell populations: endothelial vascular cells and tumor cells. VEGF’s expression in UM is cyclical. The cycle is re-initiated, apparently, by increasing cell density in tumor proliferate and the development of hypoxia zones. We found no correlation between the intensity of pigmentation, necrosis, hemorrhage, germination in the corner of the front chamber, ophthalmohypertension on the one hand, and expression of VEGF in UM cells on the other. At the same time, a direct link between the expression of VEGF in tumor cells and EC vessels on the one hand and the thickness, base diameter, as well as the localization of UM, on the other hand, has been revealed. Additionally, VEGF expression in tumor cells was closely correlated with the histological structure of UM, and VEGF expression in EC correlated with the stage of the disease. Thus, the authors showed that UM, like other malignant solid tumors, is prone to transformation into angiogenic phenotype and expression of VEGF.

Myopia is an actual health issue in the world. The World Health Organization estimates that 50 % of the world population may be myopic by 2050. In response to the coronavirus disease 2019 (COVID-19) outbreak, the Russian government started a nationwide school closure as an emergency measure to prevent spreading of the infection since the 23rd of March 2020. The present study was organized to investigate prevalence of myopia in school-aged children during the COVID-19 home confinement in Moscow. The studied group included school-age children: pupils of 1, 5, 11th classes. The inclusion criteria were: myopia — refraction above –0.5 D in conditions of cycloplegia. The results of survey 523 pupils from Moscow schools, the proportion of patients with myopia was 20.1 %, while the proportion of patients with myopia among 1st class pupils was only 8.3 %. In 5th class, the rate was 16 %, in the 11th grade reached 42.1 %, i.e. increased more than 5 times. The trend with an increase in the number of children with myopia in the learning process is explained by the increased visual load of the high school curriculum. Home confinement during the COVID-19 pandemic appeared to be associated with a significant myopic shift for children aged 6 to 8 years due to the visual load increase in and a decrease in time spent outdoors. Further research is needed to evaluate these results and long-term follow-up of these children.

Purpose: scientific substantiation and development of methodological principles of the “quality of life” (QOL) assessment questionnaire in patients with symptoms of computer visual syndrome (CVS).

Material and мethods. As part of the first stage of the study, an individual interview was carried out (according to the standard developed methodology) with 100 patients with visually strenuous labor, according to the results of which the entire spectrum of complaints arising during prolonged work with a computer was determined (44 complaints in total). As part of the second stage, a special questionnaire was developed, in which the identified complaints were transformed into questions. The study involved 96 ophthalmologists aged 32 to 62 years with an average of 17.3 ± 1.4 years. The task of an expert ophthalmologist was to assess the relevance each of the questions in terms of the influence degree on the patient’s QOL, as well as the “severity” of the complaint in terms the of occurrence frequency.

Results. The development of the questionnaire was based on the sequential implementation of five stages (development of a conceptual framework; development of a preliminary version and confirmation of validity content; additional modification; scaling procedure development; psychometric properties determination). The results obtained made it possible to form the questionnaire (22 questions) the final version, which (according to the analysis) meets the requirements of meaningful and constructive validity (specificity, reflection of questions and scales of significance for the patient, the results of an expert assessment by ophthalmologists of the psychometric response scale) with the weight coefficients development, the required values correlation coefficients (according to Pearson) between the relevance assessment of the question from the points according to the symptom severity, as well as the high level of consistency according to the “Cronbach-α” indicator.

Conclusion. The main direction of the assessment QOL improving of a patient with GLC is active participation in the ophthalmologist’s questionnaire development. Our results determine that the expert assessment provides a mathematically confirmed choice of the most significant (in terms on QoL impact) subjective manifestations, which (in conjunction with the development of each patient’s possible responses expert assessments, in points) provides the required level of the questionnaire meaningful and constructive validity. The developed questionnaire can be recommended for further clinical testing.

The problem of drug therapy for bacterial eye infections in children has remained relevant for many years. The greatest interest of ophthalmologists in recent years is associated with the use of fluoroquinolones in the treatment of inflammatory eye diseases of the bacterial etiology. At the same time, new ophthalmic dosage forms of fluoroquinolones that have appeared in recent years naturally require additional research on their effectiveness.

Objective: to study the clinical efficacy of the antibacterial drug Oftocypro (0.3 % cyprofloxacin in ophthalmic ointment) in the treatment of chronic blepharoconjunctivitis in children.

Materials. The study involved 38 children aged 3 to 18 years (mean age 10.3 ± 2.7 years) with clinical manifestations of blepharoconjunctivitis. All patients were divided into 2 groups of equal size: 18 children (36 eyes) — with bacterial blepharoconjunctivitis and 20 (40) — with chlamydial blepharoconjunctivitis. The diagnosis was verified based on the clinical picture of blepharoconjunctivitis and laboratory data: detection of pathogenic microflora in the conjunctival cavity of patients of the first group and chlamydia antigen — in epithelial cells in scraping material from the conjunctiva by immunohistochemical analysis.

Results. The analysis of the data obtained during the examination and treatment of children with blepharoconjunctivitis of bacterial etiology (group I), a reliable dynamics of controlled clinical and laboratory parameters was established. There was a significant positive dynamics of all controlled parameters of the clinical course of chronic bacterial blepharoconjunctivitis against the background of the drug Oftocipro ophthalmic ointment 0.3 % use. All children with chronic chlamydial blepharoconjunctivitis with the background of treatment with Oftocypro, ophthalmic ointment 0.3 %, showed a steady tendency towards relief of the estimated clinical signs of the disease. According to the results of laboratory studies, it was found that on the 28th day of treatment with Oftocypro chlamydia in the cells of the epithelium of the conjunctiva was re-detected in 4 out of 20 patients (20 %).

Conclusion. The high efficacy of the drug Oftocypro ophthalmic ointment 0.3 %, in combination with the absence of pronounced side effects, makes it possible to recommend this drug for wider practical use.

Currently the ophthalmologists meet with corneal-conjunctival xerosis more often in their daily practice. The objective of this research is identifying a new alternative method of treatment of the dry eye syndrome of different severity. In this work there will be a demonstration and the results of usage of BAA Delphanto® in treatment of different cases of the dry eye syndrome. The data collected from a dynamic research of groups of patients reveals the effectiveness of the comprehensive therapy with the use of BAA Delphanto®. Consequently, the research results demonstrate an improvement of the initial data from the biomicroscopy, OSDI index, Schirmer-1 test and the tear break up time. The statistically significant results were received reveal the effectiveness of the use of BAA Delphanto® with a significant improvement of the quality of life. It can be used widely by ophthalmologists for the treatment of corneal-conjunctival xerosis of different severity.

Purpose: to evaluate the effectiveness of plasmapheresis as a method for preventing and treating the graft rejection reaction in corneal transplantation.

Patients and methods. The study involved patients with surgical pathology of the cornea, who underwent a prophylactic course of plasmapheresis procedures and underwent penetrating keratoplasty (Main group); and patients with surgical pathology of the cornea who underwent penetrating keratoplasty, but did not undergo plasmapheresis (Comparison group), whose data were analyzed retrospectively. The control group consisted of conditionally healthy individuals of both genders. Subgroups of patients with high and low risk keratoplasty were also identified within the Main group and the Comparison group.

Results. Patients with keratoplasty who received a course of therapeutic plasmapheresis in the perioperative period demonstrated a statistically significant increase in the number of cases of a decrease in the level of C-reactive protein and a statistically significant decrease in the median values of the mean stimulated cytochemical index and the mobilization coefficient. Depending on the risk group for keratoplasty, the patients showed different dynamics of the levels of the studied interleukins after the course of plasmapheresis and keratoplasty. In patients of the Comparison group who did not receive a course of plasmapheresis in the preoperative period, over a period of 1.3 years, 22 cases (24 %) developed graft disease, while patients of both subgroups of the Main group who received a course of therapeutic plasmapheresis in the preoperative period, didn’t demonstrate any cases of graft disease. In patients of the Comparison group (in total for two subgroups), the maximum number of cases of graft disease (n = 24) was observed in the first 500 days after surgery. At the same time, the patients of the Main group who underwent plasmapheresis had the best graft survival rates: during the observation period, there were no cases of graft disease (in both subgroups).

Conclusion: the obtained data indicate the ability of plasmapheresis, performed in the perioperative period, to prevent the development of graft disease in patients with keratoplasty.

Purpose: to study the state and dynamics of changes in primary ocular disability in the period 2016–2018 by nosological forms. A complete retrospective study was made based on the data of the MSE (medical and social expertise) Bureau’s reporting documents. The following indicators of primary disability (per 10 thousand population) were registered from 2016 till 2018: among the adult population (18 years and older) 69,0–70,7–68,6 respectively; among the able-bodied population 42,8–44,1–41,1 respectively; among the population of retirement age — 125,1–126,4–124,6 accordingly. In the structure of primary disability of the adult population by severity for the period 2016–2018, the dynamics recorded an increase in the proportion of 1 group and 3 group with a decrease in the share of disability of 2 group. In the nosological structure of primary disability of the adult population in 2016–2017–2018, eye diseases account for 3 %, 3 % and 3.2 %, respectively, of all first recognized as disabled. There has been an increase in first-time applicants to the MSE Bureau. In the nosological structure of primary disability, the percentage of glaucoma patients over the past period is 47–33–32.5 % of the total number of primary disability for eye diseases, which determines the 1st rank. There is a progressive increase in the number of people with disabilities due to glaucoma of group 1 and group 2 throughout the study period. In the nosological structure of primary disability for 2016–2018 the percentage of patients with retinal diseases is 25–23–23.8 % of the total number of primary disability for eye diseases, which corresponds to the 2nd rank. There is a progressive increase in the number of disabled people in group 2. A low proportion of persons of working age in the structure of primary ocular disability was noted. A consistently high share of primary disability and a progressive increase in severe disability combined with an increase in persons of retirement age in the Krasnodar region forms an unfavorable forecast for an increase in the number of blind and visually impaired residents of the region.

The article presents expert study results about myopia control. The study was conducted by Russian eye care practitioners in 2019.

Purpose. to summarize the views of eye care practitioners on the problem of myopia control in Russia.

Methods. The study was conducted by mailing (sending) questionnaires to practitioners. The questionnaire contained 9 questions. Base questionnaire was developed by British Contact Lens Association (BCLA) for global study, translated into Russian and updated with items of interest to Russian practitioners.

Results. 356 questionnaires were received and processed. Concern increasing frequency of pediatric myopia was highest (9.0 ± 0.08 on a 10 point scale). Orthokeratology was perceived to be the most effective method of myopia control, followed by myopia control soft contact lenses and increased time outdoors. Perceived effectiveness rated as percentage was 50.7 ± 1.6 %, 44.9 ± 1.8 % и 42.9 ± 1.7 % respectively. Perifocal spectacles correction was perceived to be the most effective method in the Southern area of Russia (56.8 ± 11.1 %), atropine — in the Northwestern Federal District (39.5 ± 7.1 %), scleroplasty — in the Far East (55.1 ± 7.6 %). Under-correction was perceived to be the least effective method in all areas (11.6 ± 1.0 %). Increased time outdoors was a priority for most practitioners (on average 94.0 ± 7.8 prescriptions per month by one practitioner). Practitioners prescribed single vision spectacles as the primary mode of correction for myopic patients (47.2 ± 3.6 prescriptions per month by one practitioner). Phenylephrine instillation was used often (49.4 ± 3.6 prescriptions per month by one practitioner). This trend was in most areas. Vision therapy was used most frequent in Siberia and the Urals and in the Far East (70.4 ± 11.5 и 20.0 ± 5.2 prescriptions per month by one practitioner respectively). The most common reasons practitioners gave for not adopting myopia control strategies were: they were felt to be uneconomical (42.1 %); they considered there to be inadequate information about the modalities (22.2 %). 45 % practitioners from the Far East called the last reason the main one. 42.9 % practitioners from Northwestern Federal District did not believe that these are any more effective methods then single vision correction.

Conclusion. The active promotion and introduction into everyday clinical practice of myopia control methods that have proven to be highly effective could help reduce the frequency of progressive and degenerative myopia

Purpose: to evaluate the effectiveness and safety of the plasma ablation technique of Fugo blade system to enlarge phimotic capsulotomies in the management of anterior capsule contraction syndrome.

Patients and methods. Results of the enlargement of phimotic capsulotomies using the plasma ablation technique in 17 patients with anterior capsule contraction syndrome (10 men and 7 women, 18 eyes; average age — 73.8 ± 9.6 years) were retrospectively analyzed. Surgically, after pupil dilation, the anterior chamber was irrigated with a viscoelastic device (1.4 % solution of hyaluronic acid), and the tip of the Fugo blade was inserted through a 2.0–2.2 mm wide corneal incision. After slightly touching the anterior capsule, the apparatus was activated, and its tip was moved in a concentric manner, excising the required size of the fibrosed anterior capsule in a resistance-free fashion. Finally, the viscoelastic material was aspirated, and the incisions were hydrated.

Results. Phimotic capsulotomies were enlarged in all cases. Except for three cases where the bimanual technique was required to ablate the anterior capsule, all other cases were managed single-handedly. The use of cohesive viscoelastic device (1.4 % solution of hyaluronic acid) made it possible to perform this procedure with minimum trauma and under visual control. No serious complications were encountered during surgery or in the early postoperative period. Patients were discharged 1–2 days after surgery. Corneal edema, which was observed in six eyes, resolved within 3–4 days. Visual acuity improved in all cases, except for 2 patients with complete glaucomatous optic atrophy. IOP remained under control in all cases. No negative effect on the hypotensive results of previous glaucoma surgeries was observed.

Conclusion. The plasma-generating Fugo blade system is an effective and safe tool to enlarge phimotic capsulorhexis in a resistance-free fashion. It is easy to use, mastering of new surgical skills is not required, surgical trauma is minimal, the surgical time is reduced, and the patient’s rehabilitation period is significantly shortened.

Introduction: to evaluate the clinical and functional results of two-stage treatment in a patient with post-infectious Central corneal opacity combined with mixed astigmatism.

Patient and methods. Patient N., 19 years old with postinfectious (postherpetic) Central corneal opacity, mixed astigmatism was examined and operated using two-stage corneal laser treatment. To determine the possibility of surgical treatment of the patient, a complex of General ophthalmology was performed (checking visual acuity near and far in natural conditions and in conditions of drug-induced mydriasis, IOP measurement, autorefractometry, examination of visual fields, A- and Bscanning, ophthalmoscopy with examination of the Central and peripheral areas of the fundus), as well as special (keratopography and Scheimpflug camera examination, optical coherence tomography (OCT) of the anterior segment of the eye with analysis of the epithelial map, quantitative assessment (Schirmer test-1) and qualitative (tear film rupture time) lachrymal products, assessment of the epithelium state when stained with vital dyes and infrared meibography) research methods. To determine the activity of herpetic infection, PCR diagnostics were performed. The follow-up period was 2 years.

Results and discussion. To achieve high visual-functional rehabilitation while preserving the native lens, a two-stage treatment algorithm was developed using technologies of laser corneal refractive surgery. At the first stage, in order to regularize the ocular surface and eliminate Central corneal opacity, an inverted topographically oriented PRK was performed; at the second stage, residual refractive errors were corrected using topographically oriented FemtoLASIK technology.

Conclusion. According to the results of a literature search and analysis of Internet resources, there were no previously recorded and published works using a similar two-stage method. Therefore, the described clinical case justifies the relevance and novelty of the goal and has an evidence-based Foundation for the use of a two-stage laser keratorefractive treatment system in the ophthalmological practice of visual and functional rehabilitation of patients with Central corneal opacity in combination with mixed astigmatism or hypermetropic refraction. The two-year postoperative follow-up period showed stable and high visual-functional results with no recurrence of the inflammatory process.