[Combined laser treatment of glaucoma]. / Kombinirovannoe lazernoe lechenie glaukomy.

The main objectives of glaucoma treatment are normalization of IOP and slowing of the progression of glaucomatous optic neuropathy. They are achieved using conservative (medicated), surgical and laser methods. PURPOSE: To study the effectiveness of non-penetrating hypotensive laser sclerotomy (NHLS) in patients with non-stabilized primary open-angle (I-III) b glaucoma with previous laser trabeculoplasty and who are receiving drug therapy. MATERIAL AND METHODS: The study included 54 patients (102 eyes) with initial (38 eyes), developed (46 eyes) and advanced (18 eyes) glaucoma who were examined and operated on. 26 patients (46 eyes) were instilled a combined drug containing brinzolamide and timolol, 28 patients (56 eyes) received prostaglandin F2α analogues (PGA). Intraocular pressure (IOP) levels were 27±2.4 mm Hg. RESULTS: Reduction of IOP was observed in 89% of patients 2 weeks after NHLS with gradual improvement during the first 3 months of the follow-up; in 71% of patients the results preserved by the 6th month. Patients receiving combination of brinzolamide and timolol had more pronounced IOP reduction after NHLS amounting to 2.4±1.8 mm Hg in the first 3 months. By the end of the observation period IOP levels remained within normal range, drug therapy was ceased in 16 patients (21 eyes, 20.6%), 32 patients (67 eyes, 65.7%) achieved normalized intraocular pressure with antihypertensive therapy, and 9 patients (9 eyes, 8.8%) were referred to surgical treatment. CONCLUSION: Non-penetrating hypotensive laser sclerotomy (NHLS) allows measured reduction of IOP in various glaucoma stages achieving controlled and persistent hypotensive effect. In the group of patients receiving combination of brinzolamide and timolol, the effect is statistically significant and clinically superior when compared with patients receiving PGA.

[Combination therapy in patients with concomitant macular edema and proliferative diabetic retinopathy]. / Kombinirovannaia terapiia pri sochetanii makuliarnogo oteka i proliferativnoi diabeticheskoi angioretinopatii.

Diabetic macular edema (DME) is a serious complication of diabetic retinopathy. Numerous multicenter studies of the effectiveness of various treatment methods for DME do not give unambiguous recommendations for the treatment of refractory DME, and combinations of various forms of therapy continue to be actively studied. PURPOSE: To study the effectiveness of the combination of intravitreal administration of the drug Ozurdex with subsequent individually selected laser therapy in the treatment of the proliferative stage of diabetic retinopathy in patients with concomitant chronic DME, and its relationship with morphological changes in the retina observed with optical coherence tomography. MATERIAL AND METHODS: This retrospective study included 18 patients with insulin-requiring type II diabetes mellitus complicated by diabetic retinopathy in the proliferative stage and refractory DME. According to morphological changes observed with optical coherence tomography of the retina, the patients were divided into 3 groups: 6 patients with diffuse macular edema, 6 patients with cystic macular edema, and 6 patients with serous detachment of the retinal neuroepithelium. All patients underwent intravitreal injection of 0.7 mg Ozurdex followed by panretinal laser coagulation. The choice of laser applicates with the minimal parameters giving a therapeutic effect was carried out according to the procedure described previously (Patent No. RU2611887C1 d.d. 12/25/2015). RESULTS: The combination of intravitreal administration of Ozurdex followed by individually selected laser coagulation is effective against various morphological types of DME. However, the greatest visual acuity was achieved in patients with diffuse macular edema and retinal neuroepithelial detachment. CONCLUSION: The higher the initial visual acuity, the better the functional outcomes of the treatment. Baseline retinal thickness did not affect the effectiveness of the proposed method of treatment. Cystic macular edema was an unfavorable prognostic factor for improving visual acuity.

[Effects of low-intensity infrared laser irradiation on the eye (an experimental study)]. / Vozdeistvie nizkointensivnogo infrakrasnogo lazernogo izlucheniia na organ zreniia (éksperimental'noe issledovanie).

Safe doses of low-intensive infrared laser (LIIL) exposure for the structures of the eye were searched for in rabbit experiments, and the potentials of such lasers in ophthalmology were assessed. Uzor, a therapeutic laser device with gamma = 0.89 mm, was employed. The doses varied from 0.0001 to 1.0 J/cm2, this corresponding to exposure duration of 0.3 to 45 min. Experiments were carried out on 20 animals. The right eyes were exposed, and the left ones were control. An increase of intraocular pressure was recorded at a dose of 0.1 J/cm2 (4.5 min) and higher; morphological study showed dilated, well-filled and newly formed vessels in the ciliary body and iris, as well as edema and destruction of the external layers of the retina. Exposure to a dose of 0.05 J/cm2 and lower did not lead to destruction of ocular structures and increase of intraocular pressure. The maximal LIIL dose causing no side effects for the organ of vision was established at 0.05 J/cm2, this corresponding to 2.5 min exposure.

[The importance of a study of the tears in the early diagnosis of infection in penetrating eye injuries]. / Znachenie issledovaniia slezy v rannei diagnostike infitsirovaniia pri pronikaiushchikh travmakh glaza.

Status of tears was studied in patients with penetrating wounds to the eyes using polarization optic microscopy to assess the type of morphological types of crystals, measurements of secretory IgA to assess local immunity status, and screening methods to estimate protein level from the relative coefficient. A total of 122 patients with penetrating corneal and corneoscleral wounds were examined, 48 of these without clinical signs of infection and 74 with clinical manifestations of an infection. For control 88 subjects without somatic diseases or ocular diseases were examined. Crystallography revealed predominance of two morphologic types, Nos. 3 and 5, whose crystal structures were taken as the normal types. Their detection rate was reduced in penetrating wounds to the eye. Secondary morphologic types Nos. 14 and 16 reliably predominated in "pure" injuries and a secondary morphologic type 14 M in patients with developing infection (in 19 patients this type predominated during the preclinical form of infection of the eye). Increased IgA levels were observed in patients with noninfected injuries and reduced ones during infection. An infection was found associated with reduced protein level.

[Low-intensity helium-neon laser irradiation in multimodal treatment of corneal injuries]. / Nizkointensivnoe gelii-neonovoe lazernoe izluchenie v kompleksnom lechenii porazhenii rogovitsy.

He-Ne laser stimulation was used in multiple-modality treatment of 512 patients with various corneal conditions: 217 with perforating wounds, 75 with chemical and thermal burns, 48 with ulcers of various origins, and 162 with endothelial-epithelial dystrophy resulting from cataract extraction with implantation of the intraocular lens. A course of treatment consisted of 6 to 10 daily 3 min exposures at radiation power density of 50-100 micro W/cm2 on the cornea. The effect achieved by laser stimulation was significantly superior to that of routine methods of treatment used in the reference groups. He-Ne laser stimulation was conducive to a sooner reduction of the inflammatory processes, to recovery of the corneal sensitivity and epithelialization, and to shortening hospital treatment.