[Intracorneal selective stromal transplantation]. / Vnutrirogovichnaya transplantatsiya stromy.

Deep anterior lamellar keratoplasty or penetrating keratoplasty are currently considered the optimal methods of surgical treatment of stromal dystrophies and corneal degeneration. Despite certain advantages and benefits of these methods, they also have significant limitations: involvement of superficial corneal layers in the surgery, need for suturing, development of post-keratoplasty astigmatism etc. PURPOSE: This study aimed to test and describe the new method of closed sutureless keratoplasty (intracorneal selective stromal transplantation), which was indicated in isolated dystrophic and degenerative pathology of the stroma. MATERIAL AND METHODS: Intracorneal selective stromal transplantation was performed in a 62-year-old patient with stromal degeneration and intact corneal layers between the altered stroma and the Descemet's membrane posteriorly, and the Bowman's layer anteriorly. The patient also had immature senile cataract. Corneal stroma was removed and replaced with a graft in the optical center of the lens, while the endothelium, the Descemet's membrane and the Bowman's layer remained intact. RESULTS: The proposed technique of intracorneal selective stromal transplantation makes it possible to replace only the pathologically altered stroma through closed surgical approach, without affecting the anterior and posterior surfaces of the cornea. Best-corrected visual acuity has increased in the patient from 0.01 to 0.6, while mean endothelial cell density has not changed in the course of 24-months follow-up. CONCLUSION: The proposed keratoplasty method can be used in patients with dystrophy or degeneration of the corneal stroma and preserved endothelial cells, intact Descemet's membrane and Bowman layer. Since the superficial corneal layers are not involved during the surgery, intracorneal selective stromal transplantation combined the advantages of both deep anterior lamellar keratoplasty and endothelial keratoplasty. The biologically favorable result in this first clinical case allows a preliminary conclusion on the technical possibility and functional effectiveness of the proposed method, but further long-term observation and more clinical cases are required.

[On the issue of separate designation of the pre-Descemet's layer in the structure of the cornea]. / K voprosu o vydelenii predestsemetovogo sloya v strukture rogovitsy.

Selective exchange of pathologically altered retinal layers is currently considered the most practical approach in corneal transplantation. Deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK) are often performed as pathogenetically substantiated transplantation methods. The technique and the course of surgery, possible complications, and achieved outcomes, among other things, depend largely on the pre-Descemet's layer, which was described more than 10 years ago by several ophthalmologists in varying detail. In view of this, the main issue discussed in literature is the following: is the pre-Descemet's layer (Dua's layer) a separate (new) layer of the cornea, or is it an integral part of the stroma (the Feizi stroma)? This article continues the discussion on «separate designation of the pre-Descemet's layer in the structure of the cornea¼ and presents the view of the authors on this problem based on own experience, literature data, anatomical subdisciplines, as well as specific aspects of ophthalmological terminology, and with the use of extrapolation and analogies.

Analysis of the etiology of the structure of bloodstream infections using the automatic bacteriological analyzer Yunon® Labstar.

The analysis of the etiology of pathogens of blood flow was carried out using an automatic bacteriological analyzer YUNONA® Labstar 100. In the etiology of blood infections, the most common pathogens are gram-negative bacteria 62.3%. Gram-positive pathogens are much less common - 32.1%. Yeast fungi of the genus Candida, as the most common causative agents of invasive mycoses, in terms of frequency of occurrence is not higher than 3.7%. Anaerobic bacteria - 1.9%. A blood test using the automatic analyzer JUNONA® Labstar 100 allows you to expand the species spectrum of pathogens and reduce the time for issuing results. All tested commercial culture media for the automatic analyzer YUNONA® Labstar 100 (SCENKER Biological Technology Co., Ltd., China).