[Dacryocystorhinostomy with a counteropening in the treatment of secondary nasolacrimal duct obstruction after radioiodine therapy]. / Dakriotsistorinostomiya s nalozheniem kontrapertury pri vtorichnoi obliteratsii slezootvodyashchikh putei vsledstvie terapii radioaktivnym iodom.

Among secondary forms of nasolacrimal duct obstruction caused by radioactive iodine therapy, its distal forms localized in the area of the Hasner's valve are predominant. In this regard, during dacryocystorhinostomy (DCR) there is a high probability of developing the sump syndrome, for which the anatomical prerequisite is that the lower edge of the DCR ostium is above the level of obstruction. In such cases, we propose to supplement DCR with a counteropening in the area of the Hasner's valve. PURPOSE: This study analyzes the clinical effectiveness of dacryocystorinostomy with a counteropening. MATERIAL AND METHODS: The outcomes of 49 surgeries (49 patients) with secondary acquired nasolacrimal duct obstruction due to radioactive iodine therapy were analyzed, including 34 DCR and 15 DCR with a counteropening. The clinical outcomes were analyzed over the longest possible period after surgery. The analysis included the severity of tearing on the Munk scale, the characteristic of the formed ostium on the M. Ali scale and the height of the tear meniscus. Differences were considered significant at a confidence level of 95% (p≤0.05). RESULTS: Analysis of the results of the performed surgeries showed that DCR was clinically effective in 30 (88%) cases, DCR with a counteropening - in 15 (100%) cases. The differences were not statistically significant in the total sample, but were statistically significant when comparing the results of surgeries in patients with distal obliteration. CONCLUSION: The developed and clinically tested method of DCR with a counteropening in the area of the Hasner's valve was completely effective in 15 patients with secondary nasolacrimal duct obstruction caused by radioiodine therapy.

[Intravitreal therapy of diabetic macular edema in Russian Federation: current state of the problem]. / Intravitreal'naia terapiia diabeticheskogo makuliarnogo oteka v Rossii: sovremennoe sostoianie problemy.

Currently there is a significant increase in the incidence of diabetes mellitus all over the world, and Russia is not an exception. With the increase in patients with diabetic retinopathy, also rises the incidence of diabetic macular edema, which can lead to persistent loss of vision and disability dramatically affecting the quality of life. Antiangiogenic therapy that is effectively used all over world has specific features for clinical practice in Russia because of its high cost, insufficient public funding, low patient compliance, remoteness of patients from the places of medical care, and low awareness of both patients and doctors about the treatment effectiveness and required regimen. All these problems slow the adoption of this progressive treatment method. Analyzing the causes of low adoption of antiangiogenic therapy and proposing new ways to solve these problems can help reduce the rate of blindness and disability caused by eye complications of diabetes mellitus in Russian Federation, particularly in young and working population.

[Study of lutein and zeaxanthin content in the diet with the assessment of the relationship between the level of alimentary intake of non-vitamin carotenoids and the density of the macular region of the retina at a young age].

Lutein and zeaxanthin are carotenoid pigments that affect the function of the visual analyzer. They selectively accumulate in the yellow spot of the retina, form macular pigment and determine the density of the retina macula. Lutein and zeaxanthin slow down the progression of age-related macular degeneration, a leading cause of senior-age blindness. The main food sources of non-vitamin carotenoids are green leafy vegetables, zucchini, pumpkin, green peas, broccoli. The aim of the study is a retrospective assessment of the levels and sources of alimentary intake of lutein and zeaxanthin in young people and research of the effect of lutein and zeaxanthin in the diet on macula density. A specially designed questionnaire was used to quantify the content of lutein and zeaxanthin in the diet, reflecting the amount of consumption of the main sources of these carotenoids on the day preceding the survey. A non-invasive non-contact method of optical coherence tomography of the retina was used to determine the density of the macula. The study involved 96 students of Sechenov University at the age of 21-27 years. The study found that only 6.25% of the respondents had daily intake of lutein and zeaxanthin of 6 mg or more, 8.33% had 4.6-5.9 mg, 8.33% had 3.0-4.5 mg, in 18.75% - 1.5-2.9 mg, in 45.83% <1.4 mg. 12.5% of respondents didn't include sources of lutein and zeaxanthin in the diet. The more common sources of lutein and zeaxanthin in the diet were eggs and fresh tomatoes. Retinal density indices corresponded to the age standards in the majority of the examined. In 8.3% surveyed the thickness of the retina was decreased, and 4.2% had higher thickness of the retina in comparison with the standards. Significant differences in the Central subfield thickness in men and women were revealed. There was no dependence of the levels of lutein and zeaxanthin coming from food sources on the retina thickness indicators.

[Distortion of vitreous structure in eyes with lens dislocation].

AIM: to study the range of structural changes in the vitreous and to determine spatial position of the lens in case of its dislocation. MATERIAL AND METHODS: A total of 47 patients (94 eyes) with so-called senile cataract aged from 59 to 83 years were examined. The state of the vitreous was evaluated by means of digital ultrasound examination. RESULTS: Combined structural changes in the basis and cortex of the vitreous in eyes with lens and/or its elements dislocation have been analyzed. The possibility of lens evaluation in terms of its integrity and topography as well as spatial position of its elements has been shown. The relationship between the vitreous and lens changes has also been established. CONCLUSION: Digital ultrasound examination is capable of producing a 3D image of the eye, thus, allowing to assess spatial defects of the vitreous and to determine the position of the lens in case of its dislocation.

The fixed combination efficacy assessment in patients with secondary neovascular glaucoma and diabetes mellitus.

PURPOSE: To assess IOP-lowering efficacy of bimatoprost/timolol fixed combination (Ganfort®) in patients with diabetes mellitus (DM) and uncontrolled secondary neovascular glaucoma (NG). MATERIALS AND METHODS: Fifty patients (51 eyes) with uncontrolled secondary neovascular glaucoma and diabetes mellitus were enrolled in the study. All patients with an uncontrolled IOP have been proposed to switch current IOP-lowering therapy to Ganfort®. In case target IOP level was not reached filtration surgery was recommended. Ganfort® administration - once a day in the morning. RESULTS: IOP-lowering has been observed in all patients when switched to Ganfort®. Mean IOP level was almost 3-x lower versus baseline in 72.5% of patients (37 eyes). The patients achieved target IOP of 15-17 mmHg. As a result, no surgical intervention was required. Significant IOP-lowering has been observed in another group of patients (14 eyes, 27.5 %) nevertheless due to glaucoma progression, these patients are still subjected to surgical treatment. CONCLUSION: IOP-lowering fixed combination Ganfort® (Allergan) can be used in patients with secondary neovascular glaucoma and diabetes mellitus as a drug of choice to control the IOP level. Even in cases when target IOP is not achieved, Ganfort® can be administered in pre-operative period and helps to reduce postoperative complications.

[Evaluation of the effectiveness of Ganfort treatment in patients with secondary neovascular glaucoma associated with diabetes mellitus].

PURPOSE: To evaluate the effectiveness of bimatoprost/timolol fixed combination (Ganfort) in decreasing intraocular pressure (IOP) in patients with diabetes mellitus (DM) and uncontrolled secondary neovascular glaucoma (NG). MATERIAL AND METHODS: The study included 50 patients (51 eyes) with diabetes mellitus and sings of uncontrolled secondary NG, which was later confirmed by the results of ophthalmological assessment. All the patients were offered to change their IOP-lowering medications and if the new regimen is still ineffective--to undergo drainage surgery. Therefore they were switched to Ganfort once daily in the morning. RESULTS: After switching the therapy a decrease of intraocular pressure was observed in 100% of cases. In 72.5% of patients (37 eyes) the average IOP was almost 3 times lower than at the baseline and achieved target values (15-17 mm Hg), thus allowing to avoid surgical intervention. In 27.5% of patients (14 eyes), despite a significant decrease of IOP, surgical treatment was considered still necessary due to glaucoma progression and, therefore, drainage surgery was performed. CONCLUSION: The IOP-lowering combination Ganfort (Allergan) can be used in patients with secondary neovascular glaucoma and diabetes mellitus as the treatment of choice. Even if target IOP is not achieved, Ganfort is still useful as a preoperative medication able to reduce postoperative hemorrhagic complications.

[Assessment of the efficiency of different formulae applied to calculating the optic power of an intraocular lens in trans-scleral fixation]. / Otsenka éffektivnosti razlichnykh formul dlia rascheta opticheskoi sily intraokuliarnoi linzy pri transskleral'noi fiksatsii.

The paper is dedicated to assessing the efficiency of various formulae designed to calculate the IOL optic power, when IOL is fixed transscelerally in patients with an inconsistent ligament-capsular lens apparatus. According to an analysis of the obtained data, the closest values were ensured, as regards the practical result, with theoretical formulae, i.e. Binkhorst, Hoffer-Colenbrander and Binkhorst in situ. The postoperative refraction deviation was below 0.1 diopters, which is optimal for such calculation types. Should the use of theoretical formulae be problematic due to a lack of appropriate devices, then it is acceptable to apply the SRK-II empiric formula with a correction by -1.6 diopters to guarantee the postoperative emmetropia.

[Morphological changes in failure of the lenticular ligamentous-capsular system]. / Morfologicheskie izmeneniia pri nesostoiatel'nosti sviazochno-kapsuliarnogo apparata khrustalika.

Morphological changes in case of failure of the lenticular ligamentous-capsular system are described. Histological changes in this complex led the authors to the conclusion that morphological substrata of the "traumatic" and "surgical" lenticular subluxation are similar and are characterized by coarse mechanical changes in the lens capsule, with the relatively intact structure of the ligamentous system at a considerable length. Subluxation of the lens resultant from oral drug therapy is characterized by pronounced changes in the lens capsule and in the short cinnous ligament fibers. Age-associated or involution subluxation is caused primarily by pathological changes in the lens capsule, which seems to experience high strain from the remaining zonular fibers.

[Functional results of aphakia correction by different methods]. / Funktsional'nye rezul'taty razlichnykh metodov korrektsii afakii.

Functional results of aphakia correction by different methods (eyeglasses, contact and intraocular lenses) are compared. The difference of this study from previous is that it was carried out in a group of patients to whom these methods were prescribed in succession. The rightfulness of such an approach to evaluation of functional results of various methods for aphakia correction is dictated by the fact that the norm is a relative parameter for many ophthalmic ergonometric studies, and thus the investigations need to be standardized (e.g., investigations in the same patients). Comparison of the efficiencies of different methods demonstrated that the best results are attained with intraocular lenses.