Given the prevalence of refractive surgery in modern ophthalmological practice, when preparing a patient for this type of surgery, it is important to understand the multifactorial mechanism of the development of dry eye syndrome in this group of patients. Analysis of the literature data made it possible to identify key factors in the disruption of the tear formation process after refractive surgery, which include the intersection of the nerve endings of the cornea, which in turn reduces the frequency of blinking and the distribution of the tear film over the ocular surface, and also causes a violation regarding neurotrophic factors secreted by the nerve endings of the cornea . The presence of a postoperative inflammatory reaction, which has a specific course, manifested in a change in the biochemical properties of the tear, damage to the goblet cells of the conjunctiva during the creation of a vacuum during LASIK and SMILE, leading to a subsequent deficiency of mucin in the tear, changes in the curvature of the cornea caused by laser refractive surgery are factors influencing the development of dry eye syndrome after refractive surgery. When preparing a patient for refractive surgery, to reduce the risk of developing severe forms of dry eye syndrome, including corneal ulceration, it is necessary to take into account a history of systemic diseases and allergic reactions, especially in patients with high myopia. The influence of cosmetic procedures, such as eyelash extensions, eyelid tattooing, blepharoplasty, and the use of botulinum toxin in the periorbital area on the course of the postoperative period during refractive surgery, has been poorly studied. Research in this area opens up a new range of opportunities to reduce the incidence of dry eye syndrome in patients after refractive surgery and improve the quality of life of patients and patient satisfaction with the surgical intervention.

The problem of surgical treatment of cataracts in patients with chronic uveitis is relevant due to a high proportion of intra­ and postoperative complications, despite the development of modern microinvasive technologies. Associated complications of chronic uveitis (adhesions in the anterior eye segment, secondary glaucoma, vitreous opacities, cystoid macular edema, etc.), difficulties in intraocular lens implantation, the need for pharmacological support and subsequent rehabilitation of patients complicate surgery, while many issues remain controversial. Late patients’ recourse for medical aid, severity and duration of the inflammatory process contribute to irreversible changes in the retina, which results in poor functional results of surgery. The development of surgical technologies minimizing the risk of intra­ and postoperative complications is relevant today.

The increasing patient demands for quality of life after surgery necessitate optimization of approaches in the field of surgical intervention, reduction of the frequency of refractive errors and correction of tactics of postoperative interventions. Literature data indicate that refractive errors are possible after surgical treatment for cataracts associated with the presence of dry eye syndrome in the preoperative period. Tear film is used as the first refractive medium, and the size of the refractive change at air­tear film interfaces is the most innovative of any interface in any other optical system. Thus, changes of tear film physiology affect overall vision with higher order aberrations and irregular astigmatism occurring. The presented literature review analyzes data from scientific studies aimed at studying risk factors for the development of dry eye syndrome and diseases associated with it when phacoemulsification of cataracts occurs. Considering the fact that, according to various studies, the incidence of dry eye syndrome after cataract surgery ranges from 9.8 to 96.6% in cataract surgery in collaboration with dry eye surgery, adequate approaches within the framework of preoperative preparation are an urgent development. The lack of clear recommendations for effective preoperative screening and respiratory preparation for surgery, unreliable biometric data, and lack of treatment strategy for postoperative dry eye syndrome are indicators of detectors to obtain the desired results. Adequate diagnosis and preparation of ocular surfaces before biometric measurements can reduce refractive errors after surgery.

The article presents an analytical review of the literature on the possibilities of retinoprotective therapy (RPT) in patients with diabetic retinopathy (DR). The above data, on the one hand, confirm the clinical effectiveness of RPT based on the use of a complex of watersoluble polypeptide fractions of the retina in DR, and on the other, determine the need for further research in the framework of the problem under consideration. It seems relevant to conduct studies to assess the possibilities of using RPT in patients with minimal manifestations of DR (without visual signs of vascular changes), with DR in conditions of macular edema (against the background of anti­-VEGF therapy and delayed laser coagulation of the retina), as well as in patients with proliferative DR after vitrectomy.

One of the most common diseases of the organ of vision, characterized by a loss of homeostasis of the tear film, with a violation of the stability of the tear film and its hyperosmolarity, is the dry eye syndrome (DES). The article presents a review of modern scientific literature, reflecting the prevalence and main factors of the pathogenesis of DES, as well as evaluating the prospects for the use of proteomic mapping, which provides significant assistance in studying the patterns of development and progression of the disease. The methodological foundations of tear collection for research are considered in detail, and current data on changes in the biochemical composition of tear fluid in DES are analyzed.

Perfection of technologies along with extreme diagnostic potential cause high clinical and anatomical effect of surgical intervention for vitreoretinal pathology. However final functional result is not always comparable with the prognostic expectations. Having the knowledge about the changes of the eye tissue at retinal pathology and their interrelation with the stages of healing in response to the operative trauma, it is possible to carry out timely preventive activity to optimize the healing process. Up to date the recognized method of treatment of resistant macular edema and increasing of visual acuity in patients is intravitreal injection of corticosteroids. However, their application is limited both in acute and distant period due to a wide range of side effects. Therefore, the problem of inhibition and complex treatment of traumatic effects on the retina in the course of surgical treatment remains topical. A promising direction in solving this problem is the study of the influence of sulfated glycosaminoglycans (sGAG) on the inflammatory response and repair processes of vitreomacular and retinal interface structures. The purpose of this study was to summarize the experience of experimental studies of the effect of sGAG preparations on pathological processes of various tissues to create a substrate for further studies of their application in the field of vitreomacular and retinal interfaces.

Purpose. To develop a safe and effective endolaserphotocoagulation technology used during vitreoretinal surgery in patients with advanced stage of proliferative diabetic retinopathy.

Methods. We observed 88 patients (88 eyes) aged from 42 to 73 years (59 % women; 41 % men). All patients were divided into 2 equal groups based on age and gender, as well as preoperative functional results, a main group in which the developed technology of precision intraoperative endolaser coagulation was used (46 eyes), and a control group with a traditional technique of performing endolaser coagulation during vitreoretinal intervention (42 eyes).

 Results. Assessment of clinical and morphometric parameters in the main and control groups was carried out after 1, 3 and 6 months. The data obtained indicate a significant increase in BCVA (0.23 ± 0.05) in the group from the 3rd month of observation, no signs of increased IOP, as well as a decrease in retinal thickness in the foveal zone (up to 272.0 ± 27.3 μm) during the observation period up to 6 months. The study of the frequency of complications confirms the safety of the developed technology, which is confirmed by the low probability of developing rubeosis (1 case), neovascular glaucoma (1 case) and recurrence of retinal detachment in the main group of patients (2 cases) during a follow­up period of 6 months.

Conclusion. The developed technology of precision endolaser coagulation is characterized by a higher (compared to the traditional technique) level of safety and clinical effectiveness, which is confirmed by the following main points: a greater likelihood of increasing BCVA; absence of increase in IOP during long­term observation, decrease in retinal thickness in the foveal zone starting from the 3rd month of observation; a significant reduction in the likelihood of postoperative complications.

Purpose: Analysis of results of combined implantation of non­diffractive IOL with extended depth of focus and multifocal IOL.

Materials and methods. The study included 40 patients (80 eyes) after cataract phacoemulsification or clear lens removal with a mean follow­up of 15.4 ± 1.2 (12–22) months. Women accounted for 60 % (n = 24) and men for 40 % (n = 16). 20 patients (40 eyes) with bilateral AcrySof IQ Vivity implantation formed the minimonovision group (group I), and 20 patients (40 eyes) with AcrySof IQ Vivity implantation in the dominant eye (n = 20) and Acrysof IQ Panoptix implantation in the non­dominant eye (n = 20) formed the group of mix­-and­-match implantation (group II).

Results. At the maximum follow­up period of 3 months, UCNVA in group I was 0.61 ± 0.14, in group II — 0.82 ± 0.09 (p = 0.048), BCNVA — 0.66 ± 0.17 and 0.92 ± 0.14, respectively (p = 0.039). No significant differences were found between groups comparing UCIVA, BCIVA, UCDVA and BCDVA (p > 0.1), but slightly higher values were determined in patients after bilateral implantation of Acrysof IQ Vivity IOLs. In group I, 2 patients (10 %) had glare and 2 (10 %) had halo. Patients did not complain about difficulties in driving in the darkness. In 9 cases out of 20 (45 %) patients required spectacle correction for reading. In group II, adverse optical phenomena were identified in 7 patients (35 %), of which 4 patients (20 %) had glare and 3 (15 %) had halo. None of the patients required spectacle correction for reading. In both groups, 95 % of cases (19 patients) rated the surgical outcome as “excellent” and 5 % (1 patient) as “good”.

Conclusion. For the first time in Russia, the results of combined (mix­-and­match) implantation of EDOF and trifocal IOLs in comparison with bilateral IOL implantation in presbyopic patients were analyzed. The advantage of combined implantation for achieving better near visual acuity and comparable incidence of adverse optical phenomena was shown. 

Purpose. Evaluation and refractive results comparison of MIOL-­SOFT-­2­-13 (Reper­NN, Russia) IOL implantation with foreign models.

Material and methods. The study included 816 patients (816 eyes) who underwent phacoemulsification (PE) with IOL implantation, divided into four groups depending on IOL model: MIOL­-SOFT-2-­13 (Reper­-NN, Russia) (n = 199); SA60AT (Alcon, USA) (n = 237); Adapt AO (Bausch&Lomb, USA) (n = 179); Acryfold 601 (Appasamy Associates, India) (n = 201). All patients underwent optical biometry using IOL­-Master 500 (Carl Zeiss, Germany). A month after PE spherical equivalent of refraction was assessed by Topcon­8800 (Japan). Mean calculation error (ME) and mean absolute error (MAE) were used as a IOL calculation accuracy criterion.

Results. Zeroing of ME allowed to determine real a­constant of MIOL-­SOFT­-2-­13 (119.83 instead of 118.4 declared by the manufacturer). MAE in the groups was: 0.39 ± 0.27, 0.33 ± 0.35, 0.38 ± 0.31 and 0.38 ± 0.30 D, respectively (p = 0.068). All IOLs demonstrated hitting the target refraction within ±1.00 D in more than 95 % of cases.

Conclusion. MIOL­-SOFT­-2­-13 has comparable refractive results with other monofocal IOLs used in national medical insurance system. MIOL­-SOFT-­2­-13 achieves target refraction within ±1.00 D in 98 % of cases.

To obtain optimal refractive results, an optimized a­constant of 118.83 is required.

Purpose. Development and evaluation of the clinical effectiveness of a technique for performing phacoemulsification of cataracts (FEC) based on a single tunnel incision.

Patients and methods. We observed 96 patients (96 eyes, age 58.2 ± 1.2 years, 61 men, 35 women), divided into two groups equal in age, gender and visual status: control (CG, 46 patients, 46 eyes), for whom FEC was performed using the traditional method (total incision length 4.6 mm) and the main group (MG, 50 patients, 50 eyes), for whom FEC was performed using the developed method (total incision length 2.2 mm). The basis of the developed technique is to make a tunnel incision 2.2 mm long on the temporal side, followed by capsulorhexis, phacofragmentation, phacoemulsification of the lens nucleus and aspiration of the lens masses through a single tunnel incision. In this case, during phacofragmentation, a longitudinal fracture of the lens nucleus is performed along the axis 0–180°, the lens nucleus is rotated along the meridian 90–270° and another longitudinal fracture of the lens nucleus is performed along the axis 0–180°, and after phacoemulsification of the nucleus, aspiration is performed through a coaxial handle and IOL is implanted. A comparative assessment of the clinical effectiveness of the developed and traditional methods was carried out using clinical, refractive, morphological and biochemical parameters.

Results. A higher clinical effectiveness of FEC using the developed method has been established (compared to the traditional one), which is confirmed by a decrease in the magnitude of surgically induced astigmatism (by 0.13 diopters, p < 0.001) and a tendency towards higher postoperative uncorrected distance visual acuity (by 0.05 rel. units, p > 0.05). Along with this, in the МG, compared with the CG, a pronounced decrease in the incidence of dry eye syndrome (by 3.4 %, p < 0.05), C­reactive protein in the tear fluid (by 1.1 mg/l, p < 0.05) and preservation of the number of endothelial cells (by 4.8 %, p < 0.01).

Conclusion. The developed technique for performing FEC is an effective prevention of surgically induced astigmatism and negative effects on the corneal endothelium and ocular surface, which is associated with a decrease in the total length of the incision (2.2 mm compared to 4.6 mm) and an intraoperative decrease in the total volume of circulating fluid.

Conditionally pathogenic conjunctival microflora is the most frequent cause of endophthalmitis after cataract phacoemulsification (“PEC”).

The purpose. To evaluate the sterility of the surgical field and anterior chamber fluid (ACF) during elective (PEC).

Materials and methods. 75 eyes were examined. Patients in the group I underwent standard treatment of the surgical field, in the group IA — the standard technique was supplemented with mechanical delimitation of the upper eyelid margin, in group II additional treatment of the surgical field with povidone iodine after blepharostat installation was performed. Microbiological material was collected preoperatively from three loci (conjunctival cavity, eyelid free margin, lacrimal ducts) and at different stages of surgery from the conjunctival cavity (after standard treatment, after blepharostat placement, after additional treatment). In addition, anterior chamber fluid (ACF) was examined — also during surgery. Microorganisms were identified by the MALDI­-TOF method, sensitivity was determined by the disc­diffusion method.

Results. S. epidermidis prevails among all microorganisms. The percentage of the surgical field contamination by S.epidermidis after blepharostat setting was 33,33 %, 26 % and 40 % in the I, IA, II groups respectively; after additional treatment 6,6 % in the II group; in the ACF it was found in 23,33 %, 13 % and 0 % in the I, IA, II groups respectively.

Conclusion. The additional treatment of the surgical field is the most effective technique to reduce the contamination of the conjunctival cavity by S.epidermidis after placing a blepharostat and the only one in the study to ensure its absence in the ACF. Standard treatments with and without mechanical delineation are less effective and do not prevent the contamination of the ACF. 

The aim of the article is to develop a clinical classification and an informative retinal map of peripheral degenerations and retinal tears based on multimodal diagnostics of the vitreoretinal interface.

Methods. Multimodal studies of patients with peripheral degenerations included traditional and additional techniques: the ultra­wide­angle fundus imaging with the Clarus 500 camera and wide­field OCT Line scanning using the “sliding method”. .

Results. During the period 2014–2024, 1304 peripheral degenerations and retinal tears were identified through the multimodal examination of 614 patients (959 eyes). Based on these studies, a clinical and topographic classification of peripheral degenerations and retinal tears is presented.

Conclusion. Multimodal studies has facilitated the creation of a retinal map of the most common peripheral degenerations and retinal tears, the potential to improve the timely recognition of vitreoretinal pathology and optimize treatment tactics.

Purpose: to propose a step­by­step treatment regimen for betaherpetic keratitis with a method for monitoring the dynamics of the disease.

Patients and methods. The study group included 40 patients (40 eyes). Each patient had a history of diagnosed unilateral recurrent acute or subacute keratitis, the etiology of the betaherpetic process was confirmed by laboratory diagnostic methods, confocal microscopy, based on the detection of specific “owl eye” cells. All subjects had previously received specific therapy with acyclovir. All patients underwent an ophthalmological examination, and then a two­stage treatment regimen for keratitis was proposed. The main way to assess the dynamics of the disease, the presence of viral load and the need to intensify antiviral therapy was confocal microscopy data. The condition was assessed 1, 3, 6 and 12 months after the start of therapy. Results. As a result of the observation of a group of patients of 40 people, after 12 months, 33 patients achieved stable remission, 4 patients developed neurotrophic keratitis, and 3 patients had a relapse of betaherpetic keratitis. Recurrence of keratitis in 3 patients was detected within 2 to 4 months from the start of observation. Neurotrophic keratitis developed in 4 patients within 3 to 6 months from the start of observation.

Conclusion. 1) The method of in vivo confocal microscopy can be used to monitor the dynamics of betaherpetic keratitis, based on the state of specific cells. 2) Therapy of betaherpetic keratitis requires the use of specific antiviral drugs with mandatory repeated preventive courses. 3) A history of herpesvirus infection requires assessment of the development of neurotrophic keratitis.

Despite the frequent combination of cognitive impairments in patients with cataracts and glaucoma, the latter remain insufficiently studied with various visual deficits. The purpose: to study the association of visual deficits in cataracts and primary open–angle glaucoma with cognitive impairment. The clinical study involved 326 elderly patients with cataracts and 318 elderly patients with primary open­angle glaucoma. The diagnosis of this ophthalmology was performed according to generally accepted methods. The degree of cognitive impairment was determined according to the Mini­-Mental­-State­-Examination (MMSE) scale. Visual deficit was assessed by visual acuity without correction. It was found that with low visual deficit (visual acuity without correction of 0,51–0,60 and over 0,61) in the examined patients with cataract, the average score on the MMSE scale varied from 28,7 ± 0,4 to 28,8 ± 0,6 points, and in patients with primary open­-angle glaucoma from 28,3 ± 0.5 to 28,5 ± 0.6 points with no significant differences in both cases. With severe visual deficit (visual acuity without correction to 0,20 and 0,21–0,30), the average score on the MMSE scale varied from 15,2 ± 0,3 to 17,4 ± 0,4 and from 13,8 ± 0,4 to 17,6 ± 0,3, respectively. The correlation coefficient between visual acuity without correction and the average MMSE score in patients with cataract was +0,436, and in patients with glaucoma — r = +0,482. The presence of an association of visual acuity without correction with cognitive dysfunction is also confirmed by regression analysis, which allows us to consider vision deficiency as a marker of cognitive impairment and can be used in monitoring them in patients with cataracts and glaucoma.

Purpose: to assess the state of the wavefront in children with myopia, who have various manifestations of digital eye strain and symptoms of ocular surface disorders, and to evaluate the diagnostic significance of wavefront criteria for assessing the state of the ocular surface.

Patients and methods. The study involved 76 children (152 eyes) with myopia aged 8 to 18 years who used gadgets and computers for more than 2 hours a day. All patients used glasses as a method of optical correction and were constantly worn. The patients were divided into 2 groups: 1st with symptoms of ocular surface disorder, 2nd — comparison group. Subjective signs were studied using the online questionnaire “State of the ocular surface”. Using the “Keratograph 5M Oculus” the following parameters were assessed: non­invasive tear film breakup time (NTBR), including the first tear film breakup time, average tear film breakup time, breakup time gradient and maximum tear film breakup zone, the same device was used to perform infrared meibography and study of the lipid layer of the tear film. All patients underwent wavefront aberrometry in a darkened room without cycloplegia.

Results. It was found that in the group of patients with the presence of subjective phenomena of disturbance of the state of the ocular surface, identified using the online questionnaire “State of the ocular surface”, rotor aberrations were statistically significantly higher than in the comparison group. At the same time, the indicators of higher­order corneal aberrations have comparable values. Correlation analysis between indicators of the state of the ocular surface and parameters of the wavefront in the group of children with disturbances of the state of the ocular surface showed that a higher level of corneal aberrations corresponds to a higher number of points on the questionnaire of disturbances of the ocular surface and the state of visual comfort, in turn, when comparing data on non­invasive tear film breakup time, a negative correlation was established, which means that with a higher number of points on the questionnaire, and therefore, with a more significant degree of impairment of the ocular surface, the tear film breakup time was shorter.

Conclusion. The structure of the wavefront in children with myopia against the background of a disorder of the ocular surface in combination with CVS and digital eye strain is significantly different from the structure of the wavefront in the comparison group. 

Purpose: to study the effect of various methods of intraoperative keratoprotection on morphological and functional state of ocular
surface system (OSS) in early period after phacoemulsification (PE) in senile cataract (SC). 
Patients and methods. 240 patients (240 eyes) who applied for surgical treatment of SC. Age: 65 ± 4 years. 109 men, 131 women. All patients were divided into three observation groups according to the method of intraoperative keratoprotection: 1st group — 60 patients, corneal irrigation with balanced solution; 2nd group — 60 patients, ophthalmic viscosurgical device was applied to the cornea; 3rd group: 3a subgroup — 60 patients, soft contact lens (SCL) was applied to the cornea; subgroup 3b — 60 patients, SCL impregnated with riboflavin solution was applied to the cornea. In addition to the standard ophthalmological examination, Schirmer I test, OCT-scanning were performed, and tear breakup time (TBUT) was determined. 
Results. Operations were performed without complications. On the 1st day after the operation, the parameters of the Schirmer I test were higher in the eyes of 1st and 2nd groups. On the 5th day after the operation, tear production decreased sharply in all eyes. On the 10th day, an increase in tear production was observed in all groups, the maximum increase — in 3b subgroup. On the 1st day after the operation, TBUT decreased in all examined eyes. The largest significant TBUT decrease was noted in 1st group, the smallest — in 3b subgroup. On 1st day, corneal epithelial thickness (CET) decreased in all eyes, the maximum decrease was detected in 1st group. On the 5th day, CET continued to decrease in all eyes, the minimum decrease occurred in the 3b subgroup. On the 10th day — a decrease in CET in all groups with minimal significant dynamics in 3b subgroup. 
Conclusion. The study showed that the state of OSS in the early period after PE in SC depends on the method of intraoperative keratoprotection. The most optimal method of intraoperative protection of corneal epithelium and prevention of negative morphological and functional state of OSS after PE in SC is using of SCL impregnated with riboflavin.

For the prevention of diabetic retinopathy, it is important to study risk factors, among which, along with the duration of type 2 diabetes mellitus, the level of glycemia, obesity, chronological age is indicated, but biological age is not considered as a potential risk factor, although biological age more objectively than chronological characterizes pathological changes at the cellular level and processes apoptosis. Purpose: to study biological age as a new risk factor for diabetic retinopathy in patients with type 2 diabetes mellitus. 580 patients aged 45–59 years with diabetic retinopathy and type 2 diabetes mellitus, whose biological age was calculated according to the Voitenko V.P. et al. methodology, took part in the study on the basis of the S.N. Fedorov National medical research center “MNTK Eye Microsurgery”. The correspondence of biological and chronological age was established in 124 patients, the excess (acceleration) of the chronological biological age in 357 patients and the excess of the biological chronological age in 99 patients. In the subsequent analysis, the first two groups were considered. Among 45–59­year­old patients with type 2 diabetes mellitus, the incidence of diabetic retinopathy was 19.82 ± 1,32 cases per 100 examined, which is statistically significantly higher (p < 0.001) compared to patients of the same age with type 2 diabetes mellitus with a chronological biological age — 10.24 ± 1.51 cases per 100 examined. Significant differences in the compared groups were also revealed in the values of the chronological age of diagnosis of diabetic retinopathy in this endocrine disease — 47.69 ± 1.24 years in patients with accelerated biological age and 50.23 ± 0.92 years in patients with matching biological and chronological age (p < 0.01). The biological age of diagnosis of diabetic retinopathy, respectively, was 56.13 ± 0.83 years and 49.61 ± 1.11 years (p < 0.001). The difference in the development of diabetic retinopathy in patients 45–59 years old with type 2 diabetes mellitus by biological age was 6,52 ± 1,24 years among patients with accelerated biological age and 0.62 ± 0.09 years among patients with matching biological and chronological age (p < 0.001). Consequently, the acceleration of biological age is a significant and new risk factor for diabetic retinopathy in patients aged 45–59 years with type 2 diabetes mellitus.

Secondary corneal dystrophy is a group of diseases characterized by an inflammatory–dystrophic process in the cornea of the eye. This pathology is accompanied by a pronounced pain syndrome and leads to an irreversible decrease in vision, up to complete blindness. To date, many aspects of pathomorphological changes of the cornea in secondary dystrophies remain insufficiently studied due to the impossibility of conducting an intravital study of the cornea tissue. The article presents a case of morphological analysis of a tissue fragment of a pathologically altered cornea in secondary posttraumatic corneal dystrophy. Destructive changes in corneal tissue revealed during light microscopy indicate the presence of signs of fibrinoid swelling in the shell stroma with gross disorganization of the base substance and neovascularization. The study made it possible to correlate the data of pathomorphological changes and the clinical picture, as well as to evaluate the effectiveness of the chosen method of treatment of this pathology (intrastromal injection of a suspension of autologous mononuclear leukocytes of blood into the stroma of the damaged cornea).

There is a clinical case of eyeball metallosis in the background of a foreign body of the posterior segment of the eye in the article. Patient N, 41, complained of a gradual decrease in vision of the right eye. A duration of open injury to the right eye about eight years ago. At the primary ophthalmic examination, the most corrected visual acuity of the right eye was 0.3. The visual acuity of the left eye was 1.0. Intraocular pressure according to pneumotonometry: OD — 13 mm Hg, OS — 14 mm Hg. According to biomicroscopy of the right eye, it was found: the skin of the eyelids is unchanged, the conjunctiva is hyperemic, the mixed reaction of the vessels, the cornea is transparent, spherical, shiny, the anterior chamber is transparent, uneven, the iris is changed in color, foci of stroma hyperpigmentation are observed, the pupil is deformed, narrowed, displaced along the meridian for 1 hour, artificial. Examination of the central and peripheral parts of the fundus is difficult due to deformation and narrowing of the pupil diameter. Due to difficulty performing ophthalmoscopy, the patient underwent the following studies: static perimetry, ultrasound biomicroscopy (UBM) of the anterior segment of the eyeball, electrophysiological examination, B-­scan, computed tomography of the eyeball and orbit. The static perimetry revealed a concentric narrowing of the OD field of view. According to the ultrasound biomicroscopy, the IOL dislocation was revealed anteriorly. В­-Scanning visualizes the blistering cystic edema of the retina, inside which the induration is determined, giving an acoustic shadow. The electrophysiological examination showed changes in the electrical sensitivity and lability of the retina. According to the results of CT in the vitreous cavity, a foreign body was detected in the lower segment along the meridian 6 hours. In accordance with this, the diagnosis was made: OD — metallosis of the eye. Foreign body of the eye.

Purpose: to provide a clinical case of serous retinal detachment after non­penetrating antiglaucoma surgery. A patient with hypertension and type II diabetes mellitus underwent a non­penetrating deep sclerectomy in our clinic against the background of uncompensated glaucoma. Subtotal serous retinal detachment was found in the early postoperative period. Against the background of steroid therapy, the detachment resolved within 2 weeks. We believe that the cause of serous detachment is a significant gradient in the decrease in intraocular pressure against the background of uncompensated glaucoma as a result of surgery against the background of uncompensated glaucoma and endothelial dysfunction due to common diseases. Patients with comorbidities and initially severe condition require more thorough preoperative preparation, monitoring and correction of treatment in the postoperative period. 

Clinical case present of a complication of retrobulbar anesthesia and a method of its treatment in the practice of a vitreoretinal surgeon. A technique for closing a retinal defect caused by a needle puncture during retrobulbar anesthesia with a flap of the internal limiting membrane is presented. Stages of the operation: A vitrectomy was performed in full, with the closure of the macular hole using the inverted flap method and punctures of the retina with the inner boundary membrane, previously stained with the Vitreocontrast suspension, were detected. The operation was completed by successive replacement of physiological saline with a gas­air mixture 20% С3F8 (3 ml). As a result of successful surgical treatment, the macular hole and retinal punctures were closed with an internal limiting membrane.

This article provides a review of Lanpressun^®, a new formulations of latanoprost micellar nanoemulsion without benzaltonium chloride (BAK). The pharmacokinetics and pharmacodynamics of new formulations are presented. Due to innovative delivery system and absence of detergent preseravative (BAK, poliquaternium and others) Lanpressun^® possess better tolerability and safety to ocular surface, that provides patients adherence to longer therapy. The article presents the results of clinical trials demonstrating high hypotensive efficacy of Lanpressun^®. Literature analysis of studies on safety and effect on ocular surface shows good tolerability of preservative­free latanoprost nanoemulsion. The authors give the assessment of Lanpressun^® future perspectives in treatment of patients with open­angle glaucoma

Objective. To assess tolerability and the time of onset of clinical effect of dual­-action antihistamine agents — Epinepta^® (epinastine 0.05 %) and olopatadine 0.1 % in patients with seasonal allergic conjunctivitis (SAC).

Subjects and methods. This was a prospective multicenter observational study. One hundred fifty patients with SAC (n = 150) were included into the study and divided into two groups (n = 75) in each. Patients in group 1 received epinastine 0.05 %, while patients into group 2 received olopatadine 0.1 %. Evaluation of clinical symptoms severity was performed using itching scale, hyperemia Efrone scale, eyelid swelling scale, lacrimation P. Munk scale, Shirmer test and Norn probe. Patients and healthcare providers satisfaction rate was assessed by Likert scale, patients self-­control diary that helped to assess dry eye severity symptoms. Treatment period lasted 14 days.

Results. Seasonal allergic conjunctivitis treatment with epinastine 0.05 % or olopatadine 0.1 % was equally effective. However epinastine 0.05 % was causing dry eye symptoms in lesser degree than olopatadine 0.1 %. These results refer to all parameters assessed by patients’ self­-control diary — itching, discomfort, burning, eye blockage feeling.

Conclusion. The study evaluated epinastine 0.05 % advantages compared to olopatadine 0.1 % in tear film preservation and causing less pronounced symptoms of dry eye in patients with acute seasonal allergic conjunctivitis. Monotherapy of seasonal allergic conjunctivitis with epinastine 0.05 % demonstrated high efficacy and lead to SAC clinical manifestations regress. Epinastine 0.05 % is recommended as a first line treatment of SAC. 

The purpose of the work was to evaluate the effectiveness of the drug Domizia Duo^® (OTCPharm JSC), which is a fixed combination (dorzolamide 20 mg/ml and timolol 5 mg/ml) in the treatment of patients diagnosed with primary open­angle glaucoma. The multicenter study involved 156 patients (280 eyes) with primary open­angle glaucoma (POAG) (136 patients — 243 eyes), primary angle­closure glaucoma (PACG) (8 patients — 15 eyes), ocular hypertension (12 patients — 22 eyes). 37 doctors from 22 medical institutions took part in the study. Patients aged 55–75 years with first­time POAG stages I–III, PAOG, ocular hypertension, as well as with abnormal intraocular pressure, patients with pseudophakia, if the diagnosis of glaucoma was made before cataract extraction and at least 6 months before the study, were included. According to the study results, intraocular pressure decreased significantly in all groups of patients and at all stages of treatment: primary open­angle glaucoma, primary angle­closure glaucoma, ocular hypertension. In 136 patients (243 eyes) with POAG, a 28 % reduction in IOP was achieved at an initial level of 25 (22–28) mm Hg. In the group of patients with PCOG (8 patients, 15 eyes), a decrease in IOP by 19 % was shown with an initial intraocular pressure of 20.1 (19.1–23.0) mm Hg. The high effectiveness of the drug Domizia Duo^® (OTCPharm JSC) was established at all stages of POAG, so at stage I of newly diagnosed POAG, the reduction in IOP was 35.5 % within a month after the start of therapy, at stage II of newly diagnosed POAG by 28 %, at stage III by 44.4 %, in the group of patients with ocular hypertension, the degree of reduction in intraocular pressure was 27 % at an initial level of 26 (23–27) mm Hg. The data obtained from the study prove the high effectiveness of the fixed combination (FC) Domizia Duo^® (OTCPharm JSC) against the background of good tolerability in patients with primary open­angle glaucoma (POAG) at stages I–III. The drug was also highly effective not only when prescribed as monotherapy, but also when switching from another drug or adding Domizia Duo^® to treatment.

The objective of the study: to analyze characteristics of a standardized model of type B gunshot open global injury (open injury without intraocular foreign body).

Methods: The experiment was carried out on 36 rabbits (71 eyes). Simulation of type B gunshot open global injury (GOEI) was accomplished using pump equipment. The complex of modern standard and high­technology diagnostic methods to study characteristics of type B GOEI in the control period was performed. Biomicroscopy, ophthalmoscopy, optical coherence tomography, electroretinography, ultrasound examination, MRI, enzyme multiplied immunoassay to determine vitreous fibronectin, and pathomorphological study of the eye globe were carried out. Non­parametric statistical methods of data analysis were used.

Results: The above diagnostic methods being used, the GOEI experimental model characteristics were determined, including proliferative vitreoretinopathy (PVR) i.e.incidence rate and dynamics.

Conclusion. High reproducibility (77–100 %) of microlevel signs of type B GOEI experimental model was demonstrated, that evidenced standardization of the developed model. The viability of the use of hyphema and hemophthalmia as the PVR and GOEI predictors was justified on the basis of correlation analysis in experiment. The analysis of proliferative signs being made when using different study methods (pathomorphological, indirect ophthalmoscopy, optical coherence tomography, ultrasound examination and MRI) proved their application as PVR markers possible. The interchangeability of the study methods used for PVR diagnosis was also justified.

Purpose of the study. To analyze the change in the thickness of the sub­lens water layer depending on the time of wearing lenses in patients using scleral lenses using the SkyOptix Laboratory lenses as an example.

Patients and methods. To determine the thickness of the sublens water layer in the vertical and horizontal meridians, a study was performed in 33 people in 46 eyes. Among the patients there were 25 men and 8 women, from 18 to 59 years old (mean 37.3 ± 9.5 years). The main indication for the use of scleral lenses was the ineffectiveness of other methods of vision correction.

Results. The mean sublens water layer thickness reduction in the total group of examined patients using scleral lenses was 9.3 % or 37.73 μm after 1 hour of wear and 20.8 % or 84.48 μm after 4 hours of wear compared to initial values.

Conclusions. The largest and clinically significant changes in the thickness of the sublens water layer occur during the first hour of lens wear, which, according to our study, is approximately 40 microns. Considering the temporal dynamics of changes in the thickness of the sublens water layer, the final calculation of the parameters must be made no earlier than after 1 hour of wearing the scleral lens. The thickness of the sublens water layer should be assessed in relation to the time spent in the scleral lens. According to our survey, over the entire period of observation in all patients using scleral lenses, there is a decrease in the thickness of the sublens water layer over time of wearing, which requires further additional research to determine identifying the exact causes and factors underlying this process.

Purpose. Determine the volume and structure of high­tech ophthalmological care in Azerbaijan.

Materials and methods. Materials from medical histories of patients hospitalized at the National Center of Ophthalmology named after Academician Z. Aliyeva (12 882 cases) for 2019 (from January 1 to December 31) were used. The need of hospitalized patients for high­tech ophthalmological care was determined in accordance with the list of types of high­tech medical care. The volume of demand of the population of Azerbaijan for GPs by type of indications and interventions was established per 100 thousand population with the determination of the average error of the indicator.

Results. 14.5 ± 0.3 % of ophthalmological patients received high­tech ophthalmological care. The main types of high­tech ophthalmological care necessary to meet the needs of the population are transpupillary, microinvasive energetic optical­reconstructive and endovitreal 23.25 gage surgery for vitreoretinal pathologies of various origins (75.3 % of all types of operations; 16.63 ± 0.44 operations per 100 thousand population). The second place in the structure is occupied by complex surgical treatment of glaucoma, including microinvasive energy optical­reconstructive and laser surgery with possible implantation of silicone valve or metal drainage (11.3 % of all operations; 2.48 ± 0.17 operations per 100 thousand population).

Conclusions. In Azerbaijan, the leading reasons for providing high­tech ophthalmological care are: cataracts complicated by lens luxation, glaucoma, pathology of the vitreous body, retina and choroid (27.0 % of all reasons; 5.96 ± 0.26 cases per 100 thousand population); retinal detachment and tears, tractional retinal detachment, other forms of retinal detachment in adults and children, complicated by pathology of the cornea, lens, vitreous body (22.1 % of all cases, 4.89 ± 0.24 cases per 100 thousand population). The most common type of hightech ophthalmological care is transpupillary, microinvasive energetic optical­reconstructive and endovitreal surgery for vitreoretinal pathologies of various origins (75.3 % of all types; 16.63 ± 0.44 cases per 100 thousand population).