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1.
Vestn Oftalmol ; 136(3): 100-105, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32504484

RESUMEN

Approximately 470 thousand cases of cataract surgery with implantation of intraocular lens (IOL) are performed annually in Russia. The distribution of IOL power in the Russian population has not been studied sufficiently, which makes the IOL procurement planning imperfect. PURPOSE: To analyze the distribution of implanted IOL power and optimize the IOL procurement system. MATERIAL AND METHODS: Retrospective analysis of cataract surgeries performed from 2014 to 2015 in the ophthalmic department of Volga District Medical Centre of the FMBA was conducted. Inclusion criteria: age from 20 to 99 years, no refractive surgery in patient's medical history, primary IOL implantation with an A-constant of 118.4, achievement of planned refraction. The studied parameters were IOL power, gender and age of patients. To assess the effectiveness of the procurement system, we analyzed the number of additional «unplanned¼ purchases and exchanges of IOLs over the course of 5 years (2014-2018). RESULTS: According to the inclusion criteria, 1009 medical records were selected, the age of the patients was 68.7±10.9 years. The distribution of IOL power was similar, but different from the normal, characterized by the mismatch of the median and the mean, left-sided asymmetry and peaked shape. Comparison of 2014 and 2015 samples showed no significant differences and low variability of IOL power. Regression analysis revealed a weak correlation between the IOL power and age and no correlation with gender, a trend was observed for IOL power to increase in patients after 50 years. The use of a procurement planning system based on a mathematical model of the IOL power distribution allows reduction of the additional purchases and exchanges of IOLs with the supplier from 5-7% to 1-2% of the total purchases. CONCLUSION: The specific features of the IOL power distribution are related to the distribution of biometry parameters in the population. The use of a scientifically based procurement system reduces staff time and laboring costs, releasing economical and time resources.


Asunto(s)
Implantación de Lentes Intraoculares , Lentes Intraoculares , Adulto , Anciano , Anciano de 80 o más Años , Biometría , Humanos , Persona de Mediana Edad , Óptica y Fotónica , Refracción Ocular , Estudios Retrospectivos , Federación de Rusia , Adulto Joven
2.
Vestn Oftalmol ; 135(6): 100-107, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-32015314

RESUMEN

Peripapillary and macular retinoschisis is one of the rare manifestations of advanced glaucoma of different types. The article presents a case report and a mini-review. Peripapillary and macular retinoschisis with visual deterioration was diagnosed in a patient with advanced decompensated open-angle glaucoma and pseudoexfoliation syndrome. Surgical treatment of glaucoma led to intraocular pressure normalization, gradual regress of retinoschisis and improvement of visual functions. The retinal structure fully restored 1.5 years after the operation. The observation period was 3 years, retinoschisis did not recur. The article discusses the pathogenesis and potential algorithm for the treatment of the disease. Risk factors for the development of retinoschisis include high intraocular pressure, significant visual field defects and a wide range of diurnal intraocular pressure fluctuations. The source of the intra-retinal fluid is the vitreous body. Management of the patient consists of medical, laser and surgical normalization of intraocular pressure and regular monitoring. In case of persisting retinoschisis, patient undergoes vitreoretinal surgery or barrier laser coagulation. Retinal structure recovers gradually after the intervention and takes on average 1 year.


Asunto(s)
Glaucoma , Retinosquisis , Humanos , Presión Intraocular , Tomografía de Coherencia Óptica , Campos Visuales
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