Non-infectious uveitis is one of the main and insufficiently studied causes of disability and blindness in patients with immuno-inflammatory diseases. Uveitis associated with spondyloarthritis, Behcet’s disease, juvenile idiopathic arthritis, systemic sarcoidosis and Vogt-Koyanagi-Harada syndrome are described more often and better than others, but the pathogenesis of different variants of their course is not well understood. Also, there remains a need to study the clinical and pathogenetic features of uveitis in rare autoimmune inflammatory diseases. Despite the currently existing diagnostic and therapeutic schemes, further study of the pathogenesis of uveitis associated with immune-inflammatory diseases is required, the research of a personalized approach and an algorithm for joint multidisciplinary diagnosis by specialists in various fields. A deeper understanding of the specific pathogenetic mechanisms will reveal new possibilities in the treatment of patients with autoimmune uveitis. This article is devoted to the current clinical and differential diagnostic aspects, common features and distinctive features associated with various variants of the course of non-infectious uveitis in patients with immuno-inflammatory diseases. 

Nowadays medicine has great opportunities for a detailed study of organs and systems, quick and accurate diagnosis of norm or pathology. Many diagnostic procedures are universal and are used by doctors of different specialties. Pupillography is a method of studying pupillary reactions, which is based on registering changes in its magnitude by photographing or filming. This study has found wide application in many areas of medicine, such as ophthalmology, neurology, narcology, general medical practice, for the diagnosis of different pathological conditions.

Currently, in all areas of medicine, preference is given to objective diagnostic methods. In our country, much attention is paid to the development and introduction into medical practice of new technologies and minimally invasive research methods which purpose is timely accurate diagnosis and effective treatment of various diseases. The visual analyzer transmits visual information to the center of the parasympathetic division of the autonomic nervous system, which is responsible for the work of the sphincter of the pupil and to the center of the sympathetic division, which is responsible for the work of the dilatator. In the pathology of the visual organ, there is a violation of the correctness of information transmission, which can be used for basic research not only in ophthalmology but also in other specialties. Science and technology provides opportunities for ultra-thin, specific diagnostics and monitoring of various physiological and pathological states of organs and systems, the results of which are taken into account in many analyzing programs of the latest devices. Therefore, the importance of studying pupillary reactions is of great interest for many areas of medicine, and more specific studies can improve the accuracy of the diagnosis. This article describes the history of the development of pupillometric and pupillographic methods of research from the middle of the XVIII century and till modern devices. The importance of the study of pupillary reflexes for assessing the state of the visual analyzer and the possibility of using chromatic pupillometry is discussed, the main indicators of the pupillomotor system and their norms are given. Pupillometry provides the ability to accurately quantify changes in pupil size for clinical and research purposes. 

Saltzman’s nodular degeneration is a rare, non-inflammatory, slowly progressive degenerative disease of the cornea characterized by bluish-white nodules elevated above the surface of the cornea. More often nodules are located in the mid periphery of the cornea, they can spread into the optical zone. Sometimes localize along the limbus. They consist of dense heterogeneous collagen tissue with hyalinization, localized between the epithelium and Bowman’s layer. Can penetrate deeper into the stroma. The exact pathophysiological mechanism of the lesion is unclear. It is considered that this condition is associated with a violation of the structural relationship of epithelial cells against the background of chronic inflammation of the ocular surface, which leads to the destruction of the Bowman’s layer, the activation and migration of fibroblasts anteriorly, and the deposition of a disorganized extracellular matrix in subepithelial nodules. Clinically, the disease can be manifested by irritation and inflammation of the ocular surface, dryness or decreased vision, more often due to flattening of the cornea and astigmatism. In some cases, the formed tissue can be easily separated from the corneal surface, leaving Bowman’s layer almost intact. In this case, a subsequent phototherapeutic keratectomy may be required to “smooth” the surface. Relapses in these eyes are rare. In other situations (often with extensive peripheral vascularization), the lesions involve the anterior stroma, making it more difficult to remove them while maintaining the smoothness of the cornea. Several laser ablation procedures may be required, but there is a high risk of recurrence with this approach. It may be necessary to treat the meibomian gland’ dysfunction and dry eye syndrome that often accompanies Saltzman’s degeneration to reduce the risk of disease progression. 

Purpose. To assess refractive result of phacoemulsification (PE) with capsular tension ring (CTR) implantation.

Patients and methods. In total, 37 eyes of 37 patients who underwent PE with intraocular lens (IOL) implantation were divided into 2 groups: study group (n = 18) with CTR implantation and control group (n = 19) without CTR. Optical biometry (IOL-Master 500) was performed for each patient before PE. Barrett Universal II Formula was used for IOL calculation. IOL power calculation error was assessed by comparing target refraction and final refraction measured by Topcon-8800 autorefractometer 1 month after surgery.

Results. Despite almost identical preoperative values in both groups refractive result was different. Patients with CTR implantation had more hyperopic IOL power calculation error of +0.41 ± 0.52 D versus — 0.02 ± 0.54 D in the control group (p = 0.037). Refractive result in control group was more predictable (mean absolute error was 0.55 ± 0.34 D and 0.41 ± 0.30 D for groups respectively, p = 0.180).

Conclusion. CTR implantation could help surgeon to perform PE in complicated cases. Nevertheless, CTR implantation could leads to hyperopic shift. To avoid refractive errors optimized A-constants could be used (118.85 for AcrySof SA60AT and 118.47 for Akreos Adapt AO). 

Background. There are a great number publications presenting results of various types of optical and ultrasound biometry before and after scleral buckling (SB).

Patients and methods. Biometry was performed for 22 eyes of 22 patients before and after surgical treatment of rhegmatogenous retinal detachment. We used 4 types of optical (IOLMaster 500, IOLMaster 700, Lenstar LS 900 and REVO SOCT Copernicus) and 2 types of ultrasound biometry (A- and B-scan).

Results. According to the all biometry data, there was an increase in the axial lens (AL) (the maximum value of eye elongation according to IOLMaster 500 data was 0.84 ± 0.69 mm, p = 0.000), swallowing of the anterior chamber depth (ACD) in regard to IOLMaster 700 (0,48 ± 0,32 mm, p = 0.000) and lens thickness (LT) augmentation (according to A-scan data the largest thickening was 0.17 ± 0.59 mm, p = 0.064).

Conclusions. The anatomy of the eye reliably changes after SB implantation due to increase in the AL, ACD swallowing and an LT augmentation, that makes changes in IOL power calculation with modern formulas during combined surgery. Lenstar LS 900 is the preferred method of biometry when planning simultaneously lens exchange with SB procedure. 

Introduction. Intracapsular IOL position is optimal from optical point of view and in anatomical sense results in formation of a new structure — IOL-capsular bag complex (ICBC). Stable IOL position in post-op period in some cases may be disturbed in some cases due to capsular bag fibrosis or progressive involution zonulolysis against the background of pseudoexfoliation syndrome. The disturbance of correct IOL optic part position (tilt/decentration) results in a decrease of visual acuity and appearance of optic aberrations. ICBC is a dynamic structure from architectonic point of view. Fibrosis of capsular sheets and increase of equatorial cortex (Zommering ring) may result to IOL shift in long term post-op period. Accurate definition of these parameters is crucial for estimation of impact on visual functions. The existing methods of IOL position definition are based on various principles, therefore, it is not correct to compare the parameters obtained with various devices.

Pursope. To develop a method of IOL tilt and decentration definition with optical coherence tomography (Optovue, AS-OCT) and to define these parameters after suture fixation of IOL-capsular bag complex to the iris in remote post-op period.

Methods. The parameters of 50 eyes operated from 2014 to 2016 for ICBC dislocation were estimated. The patients were examined again in 5 years or later. Definition of IOL position was performed with optical coherence tomography (Optovue, ASOCT) using Cornea Crossline protocol. For estimation of obtained parameters and their deviation from normal the study group was compared with a control group of 30 pseudophakic eyes with high uncorrected visual acuity.

Results. In the study group the following data was obtained. Mean value of IOL tilt angle was 3.02 ± 2.04° in the horizontal meridian and 2.39 ± 1.4° in the vertical meridian. Decentration from the center of non-mydriatic pupil was 396 ± 222 microns in the horizontal meridian and 455 ± 278 microns in the vertical meridian. In the control group mean value of IOL tilt angle was 3.04° ± 1.28° in the horizontal meridian and 1.43° ± 0.53° in the vertical meridian. Decentration from the center of non-mydriatic pupil was 190 ± 114 microns in the horizontal meridian and 259 ± 108 microns in the vertical meridian. The difference between the groups is statistically significant (p < 0,05).

Conclusion. The developed method allows non-contact definition of IOL position (tilt/decentration) with optical coherence tomography (Optovue, AS-OCT). The obtained data shows stable correct frontal position of IOL optic part in remote post-op period after suture fixation of ICBC to the iris. 

Purpose: to evaluate the clinical efficacy of subthreshold laser treatment of focal DME in continuous and micro-pulse modes using a navigation system based on OCT-A data.

Methods. 33 patients (33 eyes) with focal DME were under observation before and after laser treatment. All patients underwent high-resolution OCT-A using the HD Angio Retina 6×6 mm protocol on RTVue-100 XR Avanti (Optovue, USA) and SOLIX (Optovue, USA) devices. The height of edema in the fovea averaged 304.5 ± 5.4 um in the group, in the area of edema outside the fovea — 336.5 ± 7.5 um. The initial best corrected visual acuity (BCVA) was 0.75 ± 0.06. The central retinal sensitivity (CRS) before treatment was 24.10 ± 0.48 dB. The treatment was carried out on the NAVILAS 577S navigation laser system (“OD-OS”, Germany). The results were evaluated within 1, 3 and 6 months after treatment.

Results. 1 month after laser treatment, the average CRT in the group was: in the fovea — 294.00 ± 5.38 um, outside the fovea — 318.50 ± 6.44 um. The BCVA increased on average to 0.80 ± 0.06; the CRS to 24.65 ± 0.47 dB. After 3 months, a further decrease in the height of edema was observed (CRT in the fovea was 252.50 ± 2.19 microns, outside the fovea 280.50 ± 3.75 microns). The BCVA increased on average in the group to 0.85 ± 0.06, CRS — 25.50 ± 0.30 dB. After 6 months, the average CRT in the group was: in the fovea — 246.50 ± 1.81 microns, outside the fovea — 273.50 ± 4.56 microns. A stable increase in the BCVA indicators was achieved — 0.85 ± 0.06 and CRS — 26.65 ± 0.16 dB. At the time of 1.3 and 6 months after treatment, an increase in vascular density was observed in the deep vascular complex and the superficial vascular plexus.

Conclusion. The preliminary results obtained by us indicate the effectiveness of navigation sub-threshold laser treatment of DME in the micro-pulse and continuous modes, based on targeted topographicallyoriented laser exposure according to OCT angiography. 

Postkeratoplasty glaucoma develops after cornea transplantation in 10–53 % cases. For ophthalmotonus stabilization in patients, it was proposed to use micropulse laser surgery.

Purpose. To evaluate the effectiveness of micropulse laser surgery in patients with secondary refractory glaucoma after keratoplasty.

Patients and methods. The study included 27 eyes after different types of keratoplasty. The average level of intraocular pressure was 33.2 ± 3.7 mmHg, the average number of hypotensive drops was 2.9 ± 0.7. Visual acuity varied from incorrect light perception to 0.3 with correction. Micropulse laser treatment was performed with the standard settings and a power of 2800 mW.

Results. On the first day after laser surgery, 24 patients had a decrease in IOP by an average of 24 % to 25.6 ± 3.3 mmHg. Three patients had a reactive increase in IOP by an average of 5 % to 33–36 mmHg. After 12 months of follow-up, the average IOP level was 24.9 ± 1.8 on the hypotensive drops, a decrease of IOP was 24.5 %, the number of hypotensive drops was reduced to 2.1 ± 0.7. In 6 cases, an increase in visual acuity by 1–2 lines was diagnosed due to a decrease in corneal edema. In 3 cases, 1–2 months after laser surgery, patients underwent second transplantation of the Descemet membrane. However, in 2 patients, an IOP increased again to 27–30 mmHg, and it was decided to conduct a repeated micropulse surgery with a power of 2800 mW. When observed for up to 3 months, IOP respond to the target level and averaged 18-20 mmHg. Using ultrasound biomicroscopy, the dynamics of changes in the thickness of the ciliary body was followed in all patients, the average thickness before surgery was 0.56 ± 0.11 mm. After 12 months, there was no statistical difference with the preoperative thickness, the average values were 0.55 ± 0.10 mm, the safety of its main structures was noted.

Conclusion. Micropulse cyclophotocoagulation is an effective and safe method of treating secondary refractory glaucoma in the eyes both before keratoplasty and after repeated cornea transplantation, which opens up new prospects in the treatment of glaucoma combined with corneal diseases. 

Purpose: to evaluate the effectiveness of ametropia correction in patients with posterior corneal elevation but without signs of subclinical keratoconus, based on postoperative results of transepithelial photorefractive keratectomy (Trans PRK).

Patients and methods. A retrospective comparative study was conducted to analyze the results of surface ablation, which was performed using transepithelial photorefractive keratectomy in 18 patients with posterior corneal elevation (36 eyes). The control group included 18 patients with eyes without these changes (36 eyes). Both groups were comparable in age, gender and refraction. Demographic data, pre- and postoperative refraction, NCOSIS and ICOSIS, maximum ablation, I/S ratio index, central corneal thickness, anterior and posterior keratometry, Biaocci-Versachi index for anterior and posterior surfaces, RMS (mk/mm2) in standard deviation, the highest elevation point of the posterior surface of the cornea — KVB (microns), index of asymmetry of tangential curvature of anterior and posterior were determined and analyzed in all patients the surfaces are SIF (D) and SIB(D), which determines the vertical asymmetry in the upper and lower hemispheres of the cornea.

Results. Observations of the dynamics of these parameters were carried out for 12 months after surgery for patients of both groups, and showed that the conclusion of Trans PRK in patients with posterior corneal elevation leads to similar refractive results compared with normal eyes. The safety and effectiveness indicators for both groups were also comparable. Significant differences in the speed of vision restoration between the groups were revealed, which is manifested by significant differences in visual acuity indicators within 1 month after surgery, but by 1 year the differences are leveled. It was determined that the effectiveness of astigmatism correction in the group with posterior elevation was significantly lower. The refractive results in the elevation group were good. During the observation, there was no pronounced dynamics of the indicators of elevation of the posterior surface of the cornea.

Conclusion: the method of transepithelial photorefractive keratectomy can be recommended for the treatment of ametropia in patients with posterior corneal elevation, but without signs of subclinical keratoconus, however, the development of additional nomograms is required in order to increase the predictability of laser vision correction in patients of this category. 

Irreversible damage to the structure of axons and death of the retinal ganglion cell (RGC) soma in primary open-angle glaucoma (POAG) and Alzheimer’s disease (AD) develop against the background of the already existing clinical manifestation, which is preceded by a slow period of progressive loss of synapses and dendrites of the RGCs. Recent studies have shown that the integrity of the RGC’s dendritic branching can serve as both a target of neuroprotective therapy and a sensitive marker of retinal degeneration in AD and glaucoma. To develop methods of complex neuroprotective therapy, it is necessary to substantiate the targets and tactics of affecting the dendritic tree of the RGCs, the remodeling of which, according to modern concepts, can be closely and antagonistically related to the regeneration of the axon after its damage in trauma and neurodegenerative diseases. RGCs are highly capable of functional modification. Currently, it has been proven that the use of neuroprotective drugs and neurotrophins is promising for maintaining the adaptive plasticity of RGCs and restoring their synaptic contacts at the level of the retina and brain. Understanding the features of the adaptive plasticity of RGCs in AD and glaucoma will make it possible to use technologies to activate the internal potential of neuronal remodeling, including the modification of dendritic branching of RGCs and regeneration of their axons, in the preclinical stages of these diseases. Increasing knowledge about the sequence and mechanisms of early events in the retina’s inner plexiform layer will contribute to the development of targeted neuroprotective therapy and new technologies to detect early POAG, AD, and, possibly, other systemic and local neurodegenerative conditions. 

Purpose. To determine the possibilities of modern ultrasound methods in the detection of uveal melanoma (UM) extrascleral growth (EG).

Patients and methods. The work is based on the results of the examination and treatment of 170 patients with UM who underwent enucleation, including 106 (62.5 %) women and 64 (37.5 %) men aged 15 to 81 years (average — 52.9 ± 12.5). All patients underwent standard and special ophthalmological examinations, including grey scale echography and color Doppler Imaging on ultrasound system Voluson ® 730Pro device using a linear format probe with a central scanning frequency of 10–16 MHz. In all cases, a morphological study was carried out, and in 30 — a molecular genetic study.

Results. UM EG was confirmed histologically in 33 patients — 19.4 % of 170 removed eyes. EG was recorded in all morphological types of UM, but more often in its more aggressive types-epithelioid cell and mixed cell types (χ2 = 6.236, p = 0.044). Significant correlations of EG presence with choroidal localization of UM (r = 0.150, p = 0.048), histological type (r = 0.151, p = 0.05) were revealed. In patients with EG, domed and irregular tumors were more often detected. The results of densitometric analysis of the tumor in patients with and without EG showed significantly higher acoustic density in patients with EG in the area of the base (A1) and central part (A2) of the tumor. In 16 (48.5 %) patients with EG, the growth was detected preoperatively — during ultrasound examination, in other cases-in 17 (51.5 %) patients, EG was established only intraoperatively or after pathohistological examination. The sensitivity of the high-resolution ultrasound technique for detecting EG was 48.5 %, specificity — 97.8 %, accuracy — 87.6 %, efficiency — 71.6 %, prognostic value of positive and negative results — 83.3 % and 97.8 %, respectively. The ROC analysis showed a clinical significance of 0.890 (95 % CI). A characteristic feature of patients with EG in the CDC mode was the visual determination of the total vascularization of the intraocular and extrascleral foci. Of the 30 patients who underwent molecular genetic testing, ERA was detected in 5 cases. All five patients had monosomy of chromosome 3.

Conclusions. The paper presents the characteristic echographic (B-scan and color Doppler mapping) signs of extrascleral tumor growth, which allow us to adjust the tactics of surgical treatment. Data on the full or partial monosomy of chromosome 3 in the studied tumor samples in the presence of its extrascleral growth are presented. 

Purpose. To evaluate the application of the principal component analysis (PCA) and DD-SIMCA in a comparative analysis of the surgical treatment of primary angle closure.

Material and methods. The prospective study included 90 patients. Group 1 — 30 patients with primary angle closure (PAC) with planned laser peripheral iridotomy (LPI). Group 2 — 30 patients with PAC, with planned phacoemulsification with intraocular lens implantation (PE+IOL). Group 3 — 30 eyes without ophthalmic pathology. All subjects underwent SS-OCT. Thirty-seven parameters were analyzed, including intraocular pressure, choroidal thickness in the macula, anterior chamber depth, lens vault, iris curvature and thickness, angle opening distance, and iridotrabecular space at 500 µm and 750 µm from the scleral spur. Since all these parameters correlate with each other, machine learning methods were used: PCA and the DD-SIMCA one-class classification method. For this purpose graphs of scores and loads in the PCA model for groups 1 and 2 were plotted. In the score plot, patients with PAC with average and extreme eye parameters were identified, and in the loading plot, relationships between the parameters of patients with PM were used to analyze correlations in the future. In the DD-SIMCA method, group 1 is taken as representatives of the target class.

Results. A classification model based on 2 principal components with a given type I error α = 0.01 demonstrated a sensitivity of 100 % for patients in its own group and a sensitivity of 93 % for patients in group 2. These results confirm similarity of group 1 and group 2. The specificity for the control group was 100 %, and this group located far from the target group.

Conclusion. Machine learning methods make it possible to compare groups with multivariate and correlated parameters. PCA allows the identification of patients with extreme parameters and the evaluation of correlations between multiple parameters. DDSIMCA confirms the validity of comparing the results of treatment with LPI and FE + IOL. 

The incidence of diabetes mellitus (DM) is steadily growing and today the World Health Organization (WHO) describes this situation as an epidemic. Diabetic retinopathy (DR) is one of the most common complications of DM, as well as one of the main causes of acquired irreversible vision loss. Nowadays the pathogenesis of proliferative DR remains completely unexplored, but many authors think about the important role of biologically significant mediators of this process cytokines and growth factors. Cytokines and growth factors are protein mediators that regulate various functions, both locally and systemically. They carry out the cells’ life cycle, the processes of proliferation, participate in the regulation of the protective inflammatory response of the body, control angiogenesis and other mechanisms. It is proved that the main links in the pathogenesis of DR are oxidative stress, thickening of the endothelial basement membrane in capillaries, loss of pericytes, end products of glycation and inflammation. Chorioretinal hypoxia and ischemia play a major role in the formation of newly formed vessels. Newly formed vessels are defective (with a thin wall devoid of pericytes), often lead to hemorrhages, hypoxia, which in turn closes the pathological circle and causes the production of cytokines and vasoproliferative factors. Frequent complications of DR are intraocular hemorrhages, retinal fibrosis and pathological changes in the posterior hyaloid membrane, traction retinal detachment, etc. This review examines some types of cytokines and growth factors and their role in the light in the pathogenesis of proliferative DR. Modern technologies make it possible to conduct effective studies of intraocular fluids to study the content of biologically active substances both in the moisture of the anterior chamber of the eye and in the vitreous body. To narrow the scope of the review on the subject attention is focused on the works that examined various markers locally in the intraocular fluids in patients with DM. It is worth noting that there are few such studies and their results often differ significantly from each other. This fact is a subject for discussion and encourages further study of this topic. 

Purpose. To analyze the significance of keratotopography, keratopachymetry and optical coherence tomography of the cornea in the differential diagnosis of pellucid marginal corneal degeneration with keratoconus.

Patients and methods. A retrospective analysis of data from outpatient medical records of 62 patients (62 eyes) with keratectasias and the presence of a crab claw keratotopogram was carried out. Optical coherence tomography of the cornea was performed in all eyes and the parameters of keratopachymetry and corneal elevation were studied on the Pentacam.

Results. Optical coherence tomography allowed in all cases to determine the localization of the corneal thinning zone. Only 5 out of 13 indicators of keratopachymetry had statistically significant intergroup differences and can be used in the differential diagnosis of keratectasias.

Conclusion. The analysis showed that, in contrast to keratotopography, keratopachymetry and optical coherence tomography of the cornea make it possible to differentiate the type of primary keratectasia. 

The purpose: to explore the clinical effectiveness of a new cell-based surgical method for the treatment of bullous keratopathy that includes intrastromal injection of autologous mononuclear leukocytes into the posterior third of the cornea stroma.

Material and methods. The study included 58 patients with diagnosis of bullous kerathopathy. They were divided into 2 groups — the main group received surgical treatment by the presented method; and the comparison group received a course of conservative therapy.

Results. In 10 days the patients in the main group had a normal structure of the cornea epithelium, slight edema of the stroma, thin folds of the Descemet’s membrane and moderate edema of the endothelium. Similar results in the comparison group were achieved in 1 month, and it was the best condition of the cornea. Later corneal edema increased. In 3 months the patients of the main group had a normal structure of corneal epithelium, single thin folds of the Descemet’s membrane, slight edema of the posterior third of the stroma only in the optical zone, and slight edema of the endothelium. The achieved results were preserved for 12 months. The best correct visual acuity (BCVA) in the main group was achieved by the 6th month. It increased 10 times from the initial level, and the corneal thickness decreased by 27 % from the initial level by the 9th month. In the comparison group, the BCVA was achieved by the 1st month. It increased 2.7 times from the initial level; the maximum decrease in the index of pachymetry by 6.7 % was achieved by the 3rd month from the initial level, and then these parameters increased.

Conclusion. The using of a surgical method for the treatment of bullous keratopathy, including intrastromal injection of suspension of autologous mononuclear leukocytes, contributes to the relief of corneal syndrome, increases the transparency of the cornea and restores its normal thickness. These changes are accompanied by increase of BCVA in the postoperative period compared to the course of conservative therapy. 

Corneal lesions account for at least 1/4 of all ocular pathologies. This frequency is due to the fact that the outer eye’ shell is constantly exposed to adverse environmental factors and is quickly involved in the pathological process. The most spread disease is corneal erosion, the main treatment of which is the prevention of infectious complications. The widespread prevalence of corneal erosion and antibiotic resistance, which develops with the use of antibacterial drugs, led to the search for alternative therapies, one of which is lactoferrin.

The purpose of our work was to study the effect of lactoferrin solution on the rate of corneal erosion epithelization in the experiment, to assess the effect of lactoferrin solution on the growth of pathogenic microflora against the background of corneal deepithelization in the experiment. An experimental model of corneal erosion was reproduced on 12 male chinchilla rabbits, divided into 2 groups (lactoferrin group and placebo group). Total scarification of the cornea was performed with an eye scalpel after preliminary epibulbar anesthesia with 0.4 % oxybuprocaine solution. Inoculations from the conjunctiva of the rabbits’ eyes to whey broth were carried out on the 0th, 3rd and 7th days of the experiment using sterile glass rods in the clinical diagnostic center of the city of Ryazan. Complete epithelialization of the cornea occurred in group 1 from 3 to 5 days, in group 2 — from 4 to 7 days. The average period of epithelialization in group 1 was 3.75 ± 0.62 days. In the second group — 5.42 ± 0.79 days. The use of a lactoferrin solution at a concentration of 0.5 mg/ml 3 time per day led to an acceleration of corneal epithelialization. In both groups, regardless of therapy, complete epithelialization of the cornea occurred by the 7th day. As a result of the experiment, there was no growth of microflora against the background of corneal de-epithelialization. Our data indicate that the use of a lactoferrin solution led to the suppression of the growth of pathogenic microflora, while placebo did not affect the growth of pathogenic microorganisms. 

Purpose: to study the prevalence and nature of visual dysfunctions in patients with primary hypothyroidism and thyrotoxicosis.

Material and methods. The material for this study was the results of a survey of 54 patients (108 eyes) with thyroid dysfunctions: 32 people (64 eyes) with primary untreated hypothyroidism and 22 people (44 eyes) with primary untreated thyrotoxicosis. Static automated perimetry and dedicated shortwave infrared (blue-yellow) perimetry were performed. The average total value of the photosensitivity of each (n = 74) tested point of the field of view was analyzed, the topography of the location of focal defects was studied, and the severity of impairments to photosensitivity was assessed by aggregate signs.

Results. Reliably high sensitivity (92.6 %) and specificity (50.0 %) of short-wave infrared perimetry in relation to static automated perimetry were revealed. In thyroid dysfunctions, the prevalence of optic neuropathy reaches 93 % according to the data of short-wave infrared perimetry versus 7 % of static automated perimetry. It is manifested by a diffuse decrease in light sensitivity to blue stimulus with an increase in the depth of depression from the center to the periphery in both types of thyroid dysfunction. Against this background, with primary hypothyroidism, focal defects appeared in the form of first-order scotomas, and with primary thyrotoxicosis, second-order scotomas. Scotomas were located at the periphery of the central visual field, 20–30° from the fixation point. In the analyzed groups, high average group indices of the maximum corrected visual acuity were established, which allows us to speak about the safety of the photopic (cone) component of the visual analyzer.

Conclusion. The pattern of photosensitivity disorders, the topography of the location of the loci of local defects revealed by the short-wave infrared perimetry, indicate that the earliest signs of optical neuropathy are manifested at the level of photoreceptors — selectively in the S-cones. Decreased sensitivity to blue stimulus (440 nm) refers to an acquired color anomaly called tritanopia; which can be present with high visual function, is most often associated with a decrease in the number of S-cones and a deficiency of retinol (the source of cyanolab synthesis). 

Purpose: to study the informativeness and appropriateness of liquid biopsy in uveal melanoma (UM).

Material and methods. Performed a liquid biopsy (synonym: vitreous fluid biopsy, CST) of enucleated eyes with UM. CST samples were used to quantify the concentration of pro-(IL-8, angiogenin, TNF-α, VEGF, bFGF) and antiangiogenic (IFN-α, TGF-β, IFN-γ) growth factors by multiplex flow cytometry. Compared with the indicators of patients with senile cataracts.

Results. Liquid biopsy provided valuable and reliable information about the spectrum of cytokines and their quantitative indicators in the CTZ of the eyes with UM. Compared with senile cataracts in the vitreous fluid of the eyes with UM, there was a significant increase in the frequency of detection and level of proangiogenic cytokines TNF-α (80.0 % vs. 47.5 %, p < 0.05; Msr ± m: 4.3 ± 1.1 pg/ml against 1.4 ± 0.3 pg/ml, p < 0.05), IL-8 (100 % vs. 75 %, p < 0.01; 323.2 ± 227.9 pg/ml versus 8.5 ± 1.5 pg/ml, r < 0.001), angiogenin (11704.9 ± 1767.7 pg/ml versus 2820.15 ± 1404.90 pg/ml, r < 0.01), VEGF (100.0 % vs. 68.2 %; p < 0.05; 471.49 ± 154.60 pg/ml vs. 18.4 ± 3.2 pg/ml, p < 0.05; 471.49 ± 154.60 pg/ml vs. 18.4 ± 3.2 pg/ml, p < 0.05) and bFGF (60.0 % vs. 26.7 %, p < 0.05; Msr: 44.6 ± 16.2 vs. 2.7 ± 1.0, p < 0.001). In both groups of patients, the antiangiogenic factor TGF-β was not detected, but the concentration of IFN-γ was found in five of the eight samples at the level of 14.9 ± 12.2 pg/ml, and the levels of IFN were 4 times higher: 17.6 ± 3.9 pg/ml against 4.4 ± 0.4 pg/ml (p < 0.05).

Conclusions. Liquid eye biopsy with UM using multiplex flow cytometry can be a valuable and highly informative tool for studying UM phenotypes, in the development and selection of molecular targets for antiangiogenic or other targeted therapies. Elevated levels of proangiogenic growth factors (IL-8, angiogenin, TNF-α, VEGF and bFGF) in vitreous fluid in UM indicate the presence simultaneously of three mechanisms for stimulating angiogenesis, two of which are independent of VEGF, act independently, and may show synergism. Insufficiently high levels of interferons (IFN-γ and IFN-α) against the background of the absence of TGF-β in the vitreous fluid allow us to think that the secretion and control of the regulation of the natural angiostatic link of angiogenesis in the eyes with choroidal melanoma is suppressed. High levels of cytokines with pluripotent (proangiogenic and pro-inflammatory) properties indicate that in choroidal tumors, inflammation may play the role of a promoter of angiogenesis. 

Purpose. Comparative assessment of the dynamics of visual performance (VP) of a patient with visually intense work with binocular cataract after various technologies of cataract phacoemulsification (PEC).

Methods. There were 300 patients with binocular cataract under our observation. Patients were divided into three equals in number (n = 100), age (from 38 to 66 years, mean age 55.8 ± 1.3 years), gender (78 % — men; 22 % — women), refractive values of the group who underwent PEС using the following technologies: delayed sequential bilateral cataract surgery (DSBCS), immediate sequential bilateral cataract surgery according to the traditional (trISBCS) and developed algorithms (maISBCS). Examination of the state of vision of patients in all groups was performed before and 3 months after surgery according to clinical (BCVA in terms of the difference between the first and second eye) and the following ophthalmo-ergonomic indicators, which were assessed using special computer programs: “Visual productivity”, “Glazomer”, “Visual search”.

Results. Differences between the clinical outcomes of the first and second eyes with maISBCS and DSBCS are practically insignificant (UDVA within 0.02 rel. units), after trISBCS they are statistically significant (by 0.08–0.09 rel. units, p < 0.05). After the operation, a pronounced (p < 0.001) increase in VP was noted in all groups. At the same time, there were differences between the groups of patients who underwent maISBCS and trISBCS, manifested by a decrease in VP in the trISBCS group according to the “Visual Search” and “Eye Meter” tests, by 16.1–22.1 % (p < 0.05).

Conclusion. The postoperative level of VR achieved during maISBCS and and DSBCS is almost identical. It has been determined that with an increase in the level of complexity of the ophthalmo-ergonomic tests presented (“signal-response”; “selection of a signal from several — response”; “selection of a signal in conditions of time pressure”), there is a corresponding increase in the difference in the level of SR between groups of patients who were maISBCS and trISBCS, were performed (by 1.5 %, p > 0.05; 16.1 %, p < 0.05; and 22.1 %, p < 0.05, respectively), which may be associated with the occurrence of postoperative anisometropia. 

The work is devoted to one of the actual problems of ophthalmology — the study of spatial perception in children with ophthalmopathology.

Purpose of the work is to study the characteristics of spatial perception in children with ophthalmopathology using the technique of copying Taylor’s and Rey–Osterrieth’s figures.

Patients and methods. 284 children aged 6 to 8 years were observed: 1) 135 children with operated convergent non-paralytic strabismus; 2) 53 children with organic pathology of the retina and optic nerve; 3) 96 children of the control group (without ophthalmopathology). The characteristics of spatial perception were evaluated according to the results of copying complex geometric figures — Taylor’s (with a right hand) and Rey–Osterrieth’s (with a left hand).

Results. It is found that the distinguishing particularities of the group of children with non-paralytic strabismus are the smaller number of children copying the figures starting from the whole contour (using a deductive strategy) and the reduced quality of drawing compared to those in the group of children without ophthalmopathology. It is also shown that in children with organic ophthalmopathology these features relate to copying Rey–Osterrieth’s figure to a greater degree than copying Taylor’s figure, which may reflect a shift in interhemispheric relations in them towards more pronounced left-hemisphere activity.

Conclusion. Thus, the method used in the work is informative, allows to identify the features of spatial perception in children with different ophthalmopathology and conduct a comparative analysis of its characteristics. 

The work is devoted to one of the most relevant problems of ophthalmology and neurophysiology which is the study of interhemispheric interactions in children with ophthalmopathology.

The purpose of this work is to study lateral phenotypes in children with ophthalmopathology.

Patients and methods. 374 6–15 years old children were observed: 1) 160 children with non-paralytic strabismus; 2) 111 children with organic pathology of the retina and the optic nerve; 3) 103 children of the control group (without ophthalmopathology). The lateral phenotype (LP) was determined according to the scheme “dominant hand — dominant ear — dominant eye”.

Results. Different LP ratios were obtained in the examined groups of children (p < 0.001). The ratio of right-handers / left-handers / ambidextrous children was most uniform in the group of children with non-paralytic strabismus (43,8 / 22,5 / 33,7 %). In the group of children with organic ophthalmopathology it was “shifted” to the right-hand side (65,8 / 10,8 / 23,4 %). In the control group the number of left-handers was minimal, and the number of ambidextrous was maximal (51,4 / 3,9 / 44,7).

Conclusion. It was found that children with organic ophthalmopathology are characterized by the most pronounced predominance of right-sided LP, and children with non-paralytic strabismus are characterized by a relatively uniform distribution of right-sided, left-sided and symmetrical LP. The identified features may reflect increased left-hemispheric activity in children with organic ophthalmopathology and adaptivecompensatory increase in right-hemispheric activity in children with non-paralytic strabismus. 

Diabetic retinopathy occupies a special place among the causes of the progression of decrease and loss of visual acuity, significantly impairing the quality of life and age-related viability, an integral indicator that is considered allostatic load. However, the allostatic load in patients suffering from diabetic retinopathy, as well as in other ophthalmological diseases, has not been practically studied and biomarkers characterizing the allostatic load of patients with diabetic retinopathy remain unknown.

Purpose. To study of allostatic load in patients with diabetic retinopathy and the identification of biomarkers that most determine it.

Patients and methods. Allostatic load was studied in 78 elderly patients with diabetic retinopathy and in 62 patients with type 2 diabetes mellitus without diabetic retinopathy. Allostatic load was analyzed according to systolic and diastolic blood pressure, body mass index, glycated hemoglobin, total cholesterol, triglycerides, albumins, C-reactive protein, homocysteine in the blood and glomerular filtration rate.

Results. The most pronounced and statistically significant excess in patients with diabetic retinopathy compared with patients with diabetes mellitus without diabetic retinopathy was found to be the content of glycated hemoglobin in the blood up to 10.2 % versus 7.4 % and homocysteine up to 15.5 mmol/l versus 7.9 mmol/l, respectively. The value of the allostatic index was significantly higher in patients with diabetic retinopathy, amounting to 4.6 ± 0.4 points, versus 2.9 ± 0.3 points in patients with diabetes mellitus without ophthalmopathology under consideration (p < 0.001). Factor analysis made it possible to identify biomarkers of allostatic load in patients with diabetic retinopathy — glycated hemoglobin, homocysteine, triglycerides and albumins.

Conclusion. These biomarkers are proposed to be used in assessing the age-related viability and effectiveness of rehabilitation measures carried out among patients with diabetic retinopathy.

Patiens and methods. We observed 111 patients with various forms of prolonged herpetic keratitis and inflammatory ENT pathology. All patients underwent a study of biological secretions (tear, saliva, blood and urine) for the presence of DNA of herpetic viruses by PCR, systemic antiviral therapy was prescribed. All patients underwent a standard otolaryngological examination, СТ scan of the paranasal sinuses (if necessary), microbiological study of nasopharynx swabs. Local therapy of herpetic keratitis included anti-inflammatory and antibacterial components.

Results and discussion. Isolated sinus infalanmmation occurred in 59 % of cases (65 patients), in 38 % of cases (42 patients) there were variants of combinations of sinus inflammation (sinusitis, sphenoethmoiditis, pansinusitis). In 24 % of those included in the study (n = 27), during examination, in addition to the presence or absence of sinusitis, chronic tonsillitis was determined. In 30 % of cases (more often than in other secrets), herpetic viruses were detected in saliva, coccal flora dominated in swabs from the nasopharynx. A marked reduction in ophthalmological symptoms correlated with start of ENT therapy.

Conclusions. This clinical and laboratory study showed a close pathogenetic relationship of anterior ophthalmic herpes and concomitant inflammatory pathology of the paranasal sinuses and oropharynx. Active etiotropic therapy of sinusitis and tonsillitis promotes short-term reduction of ophthalmic symptoms. 

Purpose. To analyze the indicators of blood flow in the macular region and the peripapillary region in patients with a combination of glaucoma and axial myopia.

Patients and methods. The paper analyzes the results of a study of 186 patients (343 eyes): 51 patients (92 eyes) with axial myopia (mean AVR 26.3 ± 1.9 mm) and diagnosed with primary open-angle glaucoma of various stages (Glaucoma + Myopia group), 42 patients (78 eyes) with axial myopia (mean AVR 26.5 ± 1.8 mm) without other ophthalmopathology (Myopia group), 48 patients (86 eyes) with refraction close to emmetropic and primary open-angle glaucoma of various stages (Glaucoma group), 45 patients (87 eyes) without any ophthalmopathology and refraction close to emmetropic (Emmetropia group).

Results. With the development of glaucoma, a decrease in the density of capillary perfusion and the density of vessels of the superficial plexus in the macular region was revealed, with a predominant decrease in the parameter in the lower sector, with a progressive decrease with the glaucoma severity. More pronounced deviations from the indicators of the control groups were recorded in the group of combined glaucoma and axial myopia. In the peripapillary region of patients with glaucoma, a decrease in capillary perfusion density and capillary flow index in the upper and especially in the lower sector was recorded, with more pronounced changes in the combination of the disease with axial myopia.

Conclusion. The tomographic indicators of blood flow in the macular and peripapillary areas from this study can be used to obtain the most complete picture of the course of the glaucoma process in patients with different types of refraction, as well as for differential diagnosis and staging of glaucoma in high myopic eyes. 

The purpose: to identify and describe the clinical phenotypes of patients depending on their response to treatment with Aflibercept.

Material and methods. The study had a prospective cohort design, including 92 eyes (n = 84) with a newly diagnosed diagnosis of nAMD and signs of disease activity. According to the OCT, the activity and type of macular neovascularization (MNV) were verified. Disease activity was monitored by central retinal thickness (CRT), the presence of subretinal and intraretinal fluid (SRF, IRF), and pigment epithelial detachment (PED). Eyes showing fresh hemorrhage ophthalmoscopically, OCT signs of SRF, IRC or sub-RPE, and dye leakage on the FAG were classified as having active nVMD. Treated with intravitreal injections (IVI) of Aflibercept 40 mg/ml in the “treat and extend” mode. The group with an unsatisfactory response to treatment was divided into 5 subgroups: true non-responders (without changes in activity throughout the course of treatment); partial nonrespondents (minimal regression of SRF and/or IRF) during treatment; dependent on anti-VEGF (complete regression on the background of injections, relapse after 4 weeks (increase in SRF/IRF, sub-RPE fluid, PED size); progression of anatomical changes, with exudation or hemorrhage, despite treatment; decreased response to treatment over time. Studied differences in baseline characteristics between the eyes among respondents and non-respondents and in five subgroups of incomplete respondents.

Results. In the OCT characteristic, 45.5 % of eyes with tachyphylaxis showed normal CRT, lack of SRF (90.9 %) and IRF (90.9 %), high prevalence of fibrovascular PED (90.9 %); 90.0 % of the eyes showed type 1 MNV. In the subgroup of non-respondents with anatomical deterioration, type 2 and 3 of MNV were more often present (p = 0.00001) and fibrovascular-hemorrhagic PED was present in every sixth eye. Half (51.2 %) of the VEGF-dependent eyes (p = 0.0139) had the phenotype SRF+ and IRF- (91.3 % vs. 57.9 %, p = 0.0123), dominated by the OCT phenotype: SRF+/IRF-, as well as type 1 and 2 of MNV (91.3 % and 8.7 %, respectively). The eyes are partially non-respondent in 32 % had normal CRT, in 40 % of the eyes SRF+, in 24 % of IRF+, different types of PED, 1 and 3 types of MNV were present.

Conclusion. The presented descriptions of clinical phenotypes of eyes with nVMD depending on their response to treatment with Aflibercept may be useful in predicting the response to treatment. 

Purpose: To study long-term outcomes in neovascular age-related macular degeneration (nAMD) patients with low visual acuity and nonadherence to a treatment regimen of anti-vascular endothelial growth factor (VEGF) therapy.

Patients and methods. In this study we included nAMD patients with best corrected visual acuity lower than 0.1 decimal equivalent, nonadherent to anti-VEGF therapy (13 eyes, group I), treatment-naïve (15 eyes, group II) or nonadherence to anti-VEGF therapy followed by termination of anti-VEGF treatment (18 eyes, group III). All participants received comprehensive ophthalmic examination and optical coherence tomography baseline and at the end of the follow-up period.

Results: In group I, 7.6 ± 4.3 intravitreal anti-VEGF injections were performed over a mean period of 38.9 ± 27.5 months. In group II, a mean follow-up was 31.7 ± 28.6 months. In group III 4.8 ± 2.2 intravitreal anti-VEGF injections were performed over a mean period of 26.9 ± 26.4 months followed by treatment discontinuation for a mean period of 24.6 ± 18.6 months. None of study groups showed statistically significant changes in BCVA or an increase of central retinal thickness (p > 0.05). At baseline all study eyes frequently demonstrated severe morphological changes in the macula including atrophy of retinal pigment epithelium (RPE), subretinal fibrosis, RPE tear, or giant intraretinal cysts.

Conclusion: In nAMD patients with low BCVA and severe anatomical changes in the macula nonadherence to a treatment regimen of anti-VEGF therapy results in non-superior long-term outcomes compared to natural course of the disease. 

Objective: to study the clinical manifestations of herpetic stromal keratitis with ulceration associated with EBV and HHV-6 reactivation.

Patients and methods. 172 patients with anterior ophthalmic herpes were under observation, of which 43 patients had herpetic stromal keratitis with ulceration with an average duration of complaints of more than 60 days. Tear, saliva, blood and urine samples were used as a material for PCR (qualitative and quantitative) for the presence of HSV, VZV, CMV, EBV, HHV-6, HHV-7 DNA. Local therapy of the acute period included instillation of antiviral, anti-inflammatory agents and lubricants. Systemic antiherpetic therapy included oral use of selective nucleoside analogues: valacyclovir and famciclovir in increased daily dosages.

Results. 87 cumulative positive results were obtained, of which the proportion of EBV and HHV-6 DNA detection was 23 % and 28 %. Complex local therapy with the inclusion of heparin-containing lubricant and a drug containing 5 % dexpanthenol (“Corneregel”) combined with systemic therapy with nucleoside analogues in increased daily dosages led to complete relief of objective symptoms within 14 to 28 days.

Conclusions. EBV and HHV-6 were detected in more than 50 % of cases, which determines systemic antiviral therapy in increased daily dosages and a prolonged course. The pathogenesis of ulcerative defects may be associated with the direct reactivation of HHV-6 and EBV, which requires the use of active reparative therapy from the first days of curation. The phenomenon of a transient viral “surge” detected by PCR during disease course can be observed by adequate systemic therapy and is a normal laboratory pattern indicating the correct tactics. 

This paper presents a case report of Pre-descemet’s endothelial keratoplasty (PDEK) performed on a 72-year-old patient diagnosed with bullous keratopathy, artiphakia, operated open-angle IIIА glaucoma. PDEK is a method of endothelial keratoplasty in which the non-functioning endothelial layer with Descemet’s membrane is replaced with a donor material consisting of Dua’s layer, Descemet’s membrane and endothelium. In the early postoperative period the IOL dislocated into the vitreous body. Both the technique of posterior lamellar keratoplasty and the surgical tactics that were successfully applied in this situation are described in detail. Clinical and functional results were studied with a follow-up period of 6 months. 

Infectious endophthalmitis (EF) is a serious problem in modern ophthalmology, which can lead to irreversible consequences for the patient’s visual functions. Timely diagnosis and timely treatment are the “key” to the successful resolution of the process. Matrix-assisted laser desorption/ionization method using matrix laser desorption/ionization. Time-of-flight mass spectrometry, or MALDI-TOF MS, aimed at determining the mass of the investigated “unknown” molecules by ionization, followed by separation and determination of the ratio of their mass to charge (m/z) with positive and negative signs. The method allows ionizing biological macromolecules (peptides, proteins, DNA, oligonucleotides, oligo- and lipopolysaccharides, etc.) as part of a special substance — a matrix — under the influence of a laser. The resulting ions are separated during the time-of-flight analyzer due to different velocity of movement, inversely proportional to the mass of the ion. Based on the source of the ionization source before the detector, the speed of movement and the ratio of mass to charge (m/z) for each ion are calculated: the heavier the molecule, the longer its flight duration. To identify bacteria, the spectrum of proteins is determined directly from the bacterial cell without preliminary long-term sample preparation. For each type of microorganism, a characteristic set of proteins (biomarkers) is formed, obtained on the basis of analysis of at least 50 mass spectra of this type (almost 100 % accuracy). This mechanism leads to the fact that different biological microorganisms form patterns, or spectra, which makes it possible to identify them by the type of “fingerprint”, while the research time itself is usually not several minutes. This article presents a clinical case of the use of MALDI-TOF MS in the diagnosis of endophthalmitis. 

Flap tears in the peripheral retina are the most dangerous for the occurrence of regmatogenous retinal detachment (61–83 %), as they are always the result of dynamic vitreoretinal traction. The main method of preventing of regmatogenous retinal detachment in patients with flap tears is laser treatment. Prophylactic laser retinopexy is performed to create an area of sufficient chorioretinal adhesion completely surrounding the retinal break. Currently, the method of non-contact navigated laser retinopexy is widely used. It is safe and well-tolerated procedure equally effective to traditional laser coagulation. The reason for the progression of retinal detachment, which occurs despite preventive therapy, may be insufficient fusion around the retinal break, or the active traction force during the progression of posterior vitreous detachment (PVD). The method of flap retinotomy using modern YAG laser systems with coaxial illumination have been reported in the literature, but there are no publications on spontaneous breakaway of tractional flap tear during acute PVD progression. The case of spontaneous breakaway of tractional flap tear during acute posterior vitreous detachment after laser retinopexy is presented. A 55-year-old woman complained of floaters and photopsias in her left eye within a day. Multimodal examination was performed: visometry, perimetry, scanning laser ophthalmoscopy, ultrasound B-scanning, optical coherence tomography of the retina, fundus photoregistration. Laser treatment was performed with the Navilas Laser System 577s using the non-contact ncPRP lens.

Results: The examination revealed a flap tear in the upper nasal segment with subretinal fluid around and spot hemorrhage. Preventive non-contact laser coagulation of the retina was performed in six rows together along the entire border of the tear. 11 days after the operation, the patient applied again with complaints of increased photopsias within a day. During the examination, spontaneous breakaway of the flap from the base, complete retinal attachment, absence of intraocular hemorrhage were revealed.

Conclusion: Timely diagnosis and preventive laser retinopexy of peripheral retinal flap tear contributed to the prevention of development of the rhegmatogenous retinal detachment 

Ulcerative lesions of the cornea and graft in children are a serious problem in pediatric ophthalmology, leading to serious consequences, up to the anatomical death of the eye. The problem of effective treatment of this pathology and corneal tissue regeneration in children remains relevant, despite the large arsenal of drugs. Recently, ultraviolet (UVA) corneal collagen crosslinking has been proposed as an alternative treatment for corneal ulcers in adults. RASK-CXL is the official name used exclusively for crosslinking in cornea inflammatory diseases. In children, corneal collagen crosslinking is still used only for the treatment of keratoconus. We were the first to use this method to treat corneal ulcers and graft ulcers in children.

Purpose: to analyze the results of treatment of ulcerative corneal lesions and graft in children using a new device for local UVA crosslinking.

Material and methods. For dynamic observation of patients, biomicroscopy with a fluorescein test, photo registration and optical coherence tomography of the eye anterior part were used. The procedure of local UVA crosslinking for the treatment cornea ulcerative lesions was carried out using a new device on the basis of the permission of the Ethics Committee of the National Medical Reseach Center of eye deseases named after Helmholtz of the Ministry of Health of Russia (protocol No. 56 of 21.10.2021).

Results. The use of 3–5 procedures of local UVA exposure (against the background of instillations of 0.1 % riboflavin solution) lasting 5–7 minutes with an interval of 1-3 days ensured epithelization of the cornea and the graft and increased visual acuity in children.

Conclusion. The first treatment results of corneal ulcers and graft in children using a new portable device for local UVA crosslinking have shown its high therapeutic efficiency and prospects for further use in clinical practice.