[Laser-induced damage to the cornea after YAG laser surgery of anterior segment structures]. / Lazerindutsirovannye povrezhdeniya rogovitsy posle YAG-lazernykh vmeshatel'stv na strukturakh perednego segmenta glaza.

Laser photodestruction (LPD) of tissues is the basis of modern laser reconstructive surgery in ophthalmology. The most common laser technologies based on LPD mechanisms include YAG laser capsulotomy (discission) (LD) of secondary cataract and YAG laser iridectomy (LIE) for glaucoma. Laser reconstructive interventions for secondary cataract, as well as LIE, have a number of advantages over traditional surgery, but at the same time are associated with the risk of complications, including in the cornea. Corneal endothelium is the most susceptible to laser damage, while Descemet's membrane and corneal stroma are injured less often. This review describes cases of iatrogenic perforation and purulent inflammation of the cornea. In the long-term, laser interventions can lead to bullous keratopathy and corneal graft rejection. At this time, the most popular and available among the methods for assessing the cornea after YAG laser interventions is the method of specular microscopy. Ultrasound biomicroscopy is used less commonly. The modern method of corneal confocal microscopy is practically not used for this purpose, and taking into account the risks of developing laser-induced injuries, it indicates its relevance and the need for further research.

[Comparison of visometry by Sivtsev and ETDRS charts]. / Sravnenie vizometrii po tablitsam Sivtseva i ETDRS.

Most foreign authors currently recommend the protocol and charts developed for the Early Treatment Diabetic Retinopathy Study (ETDRS) as the gold standard for evaluation of visual acuity (VA) in clinical trials and studies. Not every medical facility has equipment required for performing visometry by that method, while Sivtsev tables are found universally. OBJECTIVE: To compare ETDRS and the more common Sivtsev visometry methods. MATERIAL AND METHODS: The study included 100 volunteers - students of the Sechenov University. All participants were examined for VA in both eyes without correction using ETDRS "R" chart and Sivtsev table. Visometry with "R" ETDRS chart involved calculation of the number of named letters, then the number was translated into logarithmic notation by the conventional method. Sivtsev visometry findings were translated into logarithmic notation by two methods: first - standard, line-by-line, second - experimental, letter-by-letter. Subjects were divided into two groups: high VA (higher than 0.4 in decimal scale) and low VA - everyone else. RESULTS: The best agreement with ETDRS was found in letter-by-letter method of Sivtsev table interpretation, especially in the group with high VA with the lowest 95% limits of agreement (LoA) of ±0.157 logMAR, or 8 letters on ETDRS. Clinically significant were also LoA in comparison of ETDRS with line-by-line calculation method in the group with high VA and in letter-by-letter method without dividing groups by VA. CONCLUSION: The use of Sivtsev table in standardized multicenter studies is only reasonable when the ETDRS charts are unavailable.

[Possibilities of increasing contact lens tolerance in keratoconus (a clinical case study)]. / Vozmozhnosti povysheniya perenosimosti kontaktnoi korrektsii pri keratokonuse (klinicheskoe nablyudenie).

Optical correction of keratoconus (KC) is intended to simultaneously solve two tasks: elimination of myopic defocus and irregular astigmatism. In terms of the latter, hard contact lenses (HCL) should be considered as the first-choice method for optical correction of KC. HCL are currently the most effective means of optical correction of refractive errors induced by KC. Despite this, it should be noted that adherence of patients to this method of correction does not always correspond to results. Most often, limitations of HCL use in KC are associated with the so-called intolerance of correction. The term «correction intolerance¼ should be considered as a general complex of potential subjective symptoms and clinical manifestations that limit the possibility of using a particular method of optical correction. In this clinical observation, subjective discomfort when wearing lenses was practically eliminated by changing the design of the lens and switching from corneal to scleral HCL. The second problem was caused by clinical manifestations of corneal hypoxia (growth of newly formed vessels in the limbal region of the cornea) and attempts to solve it were associated with improved tear production and increased oxygen permeability of the material HCL are made of. The observed stabilization of the growth of newly formed vessels should be considered as a positive (although in need of dynamic evaluation) result of these therapeutic measures.

[Optical coherence tomography angiography in ophthalmic oncology]. / Opticheskaia kogerentnaia tomografiia-angiografiia v oftal'moonkologii.

The article reviews literature on various methods of optical coherence tomography (OCT). The review also describes clinical aspects of OCT angiography and its applications in ophthalmic oncology.

[Refractive shift after glaucoma surgery]. / Izmeneniia refraktsii posle antiglaukomnoi khirurgii.

Filtering glaucoma surgery can affect certain biometric features of the eye: it can change the axial length and anterior chamber depth, while redistribution of mechanical tensions in the fibrous tunic can alter the shape of the cornea. Among these changes that affect refraction, reshaping of corneal curvature is the principle one. Contrary to the expectations, and in contrast to changes associated with cataract surgery, glaucoma surgery led to decrease in vertical corneal radius (steepening) and development of the with-the-rule astigmatism. A number of studies helped reveal the features of corneal astigmatism that appears after glaucoma surgery: its power, duration, possibility of horizontal meridian flattening, influence of topical cytostatic drugs and drainage devices, etc. Potential reasons of astigmatism development were suggested: conjunctival incisions and sutures in the limbal area, quantity and strength of flap sutures, intraocular pressure level, shift of fistula edges, tissue contraction after cauterization, etc. The key role in pathogenesis of the refractive shift due to change of corneal curvature may belong to particularities of wound healing in the cornea and sclera: healing in sclera is similar to one of connective tissue - its ultrastructure undergoes aging process followed by change of rigidity. At the same time, the main reason for the development of corneal astigmatism after glaucoma surgery remains unclear.

[Modern methods of treatment of amblyopia]. / Sovremennye metody lecheniia ambliopii.

Throughout the history of pediatric ophthalmology, pathophysiological state has always played an important role. It's characterized by reduced central vision, often paired with disruption of binocular vision, which is interpreted as amblyopia. Central vision is necessary for social integration, so its disorders cause great quality of life changes in patients limiting their professional activities and complicating everyday life. Despite large number of proposed methods of treatment, amblyopia still remains a pressing problem and its prevalence has not changed significantly over the years.

[Morphological and clinical aspects of anterior capsulotomy in femtosecond laser-assisted cataract surgery]. / Morfologicheskie i klinicheskie aspekty perednei kapsulotomii v fakokhirurgii c primeneniem femtosekundnogo lazera.

The review covers morphological and clinical aspects of femtosecond laser-assisted anterior capsulotomy in cataract surgery. Literature data suggests that femtosecond laser-assisted capsulotomy is more accurate in size, shape, and centration than manual. Femtosecond laser-assisted anterior capsulotomy improves the accuracy of IOL positioning within the capsular bag.

[Modern methods of minimally invasive glaucoma surgery]. / Sovremennaia mikroinvazivnaia khirurgiia glaukom.

Over the years, glaucoma surgery has improved from iridectomy by A. Graefe and traumatizing procedures performed without magnification tools or microsurgical instrument to high-technology interventions that are not only microscopic, but also pathogenetically oriented. Various modifications of trabeculectomy, initially introduced by J. Cairns back in 1968, had been the gold standard for several decades and were notable for pronounced and stable hypotensive effects. However, there was also a strong association with such complications as choroidal detachment and hyphema, thus, boosting the development of so called nonfistulizing surgeries. Of the latter, the most widely used are non-penetrating procedures, including deep sclerectomy and viscocanalostomy. Although very safe, they appear unable to produce a truly long-lasting hypotensive effect. Moreover, just as fistulizing trabeculectomy, non-penetrating procedures damage the limbus and adjacent conjunctiva reducing the possibility of a second intervention. This fact together with other drawbacks mentioned above, on the one hand, and technical progress, on the other, were essential prerequisites for the appearance of a new type of surgery - minimally invasive glaucoma surgery (MIGS). Parameters that should be met for a procedure to be considered minimally invasive are debated. The main requirement has, however, been established: ab interno approach through a corneal incision. As surgical tools are enhanced and new techniques arise, options for glaucoma treatment widen greatly, ensuring our future move to higher level standards in the field. This review contains all recent data on minimally invasive techniques currently in use in glaucoma surgery or those under investigation. The authors have also analyzed effectiveness reports and present their conclusions regarding the current state of MIGS worldwide.

[Plastic surgery of the inner angle of the palpebral fissure]. / K voprosu o plastike vnutrennogo ugla glaznoi shcheli.

The new method for treating posttraumatic deformations of the internal angle, in contrast to its analogs, helps attain the maximal anatomical correlation between the transposed tissues, is atraumatic, involves a lesser incidence of postoperative complications, and permits fixation of the internal adhesion of the lids with a device including a fixing element and an elastic clip. The fixing element is a metal plate repeating the contours of the internal angle with sharp hook-like holders supplied with compression regulators. The clip is a supporting element (on the contralateral side of the slope of the nose) oriented in the contralateral direction. This device permits the creation and regulation of soft tissue compression in the internal angle of the lid slit during early cicatrization period.