[Confocal microscopy of the corneal nerve fibers]. / Konfokal'naya mikroskopiya nervnykh volokon rogovitsy.

This article presents the results of confocal microscopy of the corneal nerve fibers (CNF). The transparency of the cornea provides a unique potential for in vivo visualization of thin unmyelinated nerve fibers at the level close to morphological study. Modern software eliminates the need for manual tracing of the confocal image fragments, allows objectifying the process of assessment of CNF structure based on quantitative indicators characterizing the length, density and tortuosity of the main nerve trunks. Clinical application of structural analysis of the CNF has two potential directions associated with immediate tasks of ophthalmology, as well as with interdisciplinary affairs. In terms of ophthalmology, this primarily concerns various surgical interventions potentially affecting the state of the cornea, and chronic pathological processes in the cornea of different nature. Such studies could analyze the degree of changes in the CNF, or the particularities of corneal reinnervation. The potential for interdisciplinary studies lies in using CNF as biomarkers of systemic polyneuropathies. Relative simplicity, high level of direct visualization of the thin nerve fibers, and the obtained results allow recommending corneal confocal microscopy as a tool for primary screening and consequent monitoring of neuropathies in addition to the conventional methods.

[Current view on the pathogenesis of immune-mediated inflammatory diseases associated with ocular manifestations]. / Sovremennyi vzglyad na patogenez immunovospalitel'nykh zabolevanii, assotsiirovannykh s glaznymi proyavleniyami.

This literature review discusses the new concept of pathogenesis of systemic immune-mediated inflammatory diseases (IMIDs), presents their classification and analyzes their association with ocular manifestations.

[Correction of refractive disorders after surgical treatment of recurrent pterygium (case study)]. / Korrektsiya refraktsionnykh narushenii posle khirurgicheskogo lecheniya retsidiviruyushchego pterigiuma (klinicheskoe nablyudenie).

Lamellar keratoplasty is the most effective and safe method of surgical treatment of recurrent pterygium, providing restoration of the corneal frame and optical properties and a high anti-relapse effect due to the barrier properties of the lamellar graft. However, potential postoperative changes in the regularity of the anterior and posterior surfaces of the cornea (especially in case of advanced stage of fibrovascular tissue growth) do not always allow achieving high functional results of treatment. The article presents a clinical case that demonstrates the effectiveness and safety of excimer laser correction of refractive disorders after surgical treatment of pterygium.

[Morphological evaluation of the results of laser activation of scleral hydropermeability in the treatment of glaucoma]. / Morfologicheskaya otsenka rezul'tatov operatsii lazernoi aktivatsii gidropronitsaemosti sklery v lechenii glaukomy.

PURPOSE: The study attempted to experimentally substantiate the possibility of using the laser activation of scleral hydropermeability (LASH) technique in glaucoma treatment by morphological evaluation of treatment outcomes. MATERIAL AND METHODS: The pulsed-periodic radiation from an Er-glass fiber laser (λ=1.56 µm) was used. The model experiment consisted of evaluating ultrafiltration of fluid through the tissues of human sclera autopsy specimen according to the original technique using neodymium chloride-based labeling agent and scanning electron microscopy. The clinical part of the study consisted of optical coherence tomography (OCT) and laser confocal microscopy of the sclera and conjunctiva (CMSC) performed in vivo immediately after laser treatment in the laser application sites in 5 patients (5 eyes) aged 57 to 68 years with uncompensated advanced (IIIb-c) stage of glaucoma who had previously underwent LASH surgery. RESULTS: Results of morphological evaluation after LASH revealed structural changes indicating increased transscleral ultrafiltration: increased intrastromal hyporeflective areas in the sclera, thinning of collagen fibers, formation of porous structures. Using an original technique involving neodymium chloride-based labeling agent and scanning electron microscopy, we were able to prove the enhancement of transscleral ultrafiltration. The results of the experiment were confirmed by in vivo OCT images of the sclera and CMSC performed in 5 patients with advanced glaucoma after LASH surgery, in which tissue decompaction in the laser-exposed areas was clearly visualized. CONCLUSION: The revealed structural changes indicate the possibility of reducing intraocular pressure after LASH by the means of forming scleral porous structures and increasing transscleral ultrafiltration. Experimentally selected optimal mode of laser exposure (0.66 W with total exposure time of 6 seconds) during LASH helps avoid gross destructive changes in the eye tissues, making the proposed intervention a sparing approach to the treatment of glaucoma.

[Nerve fiber structure after different types of corneal transplantation]. / Struktura nervnykh volokon posle razlichnykh variantov peresadki rogovitsy.

This review presents basic information about the state of corneal nerve fibers and Langerhans cells before and after keratoplasty. Keratoplasty is a common corneal surgery that carries a risk of graft rejection. The state of corneal nerve fibers can vary after different types of keratoplasty. Corneal confocal microscopy allows in vivo evaluation of the cornea, which can help assess the condition of corneal nerve fibers, as well as reveal the presence of Langerhans cells. Further research in this direction would contribute to identifying the relationship between the state of corneal nerve fibers, the presence of Langerhans cells, and graft rejection.

[Optical coherence tomography in the diagnosis of pathologies of the horizontal portion of the lacrimal drainage system]. / Opticheskaya kogerentnaya tomografiya v diagnostike patologii gorizontal'nogo otdela slezootvodyashchikh putei.

This article reviews literature on the use of optical coherence tomography in studying the anatomical structure of the proximal lacrimal drainage system, as well as in diagnosing its pathological changes. Determining the reference values of the parameters of the lacrimal punctum and the lacrimal canaliculus remains an important issue. The review describes the advantages and disadvantages of this method, as well as the prospects for its application in clinical practice.

[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.

[Clinical and morphological characteristics of corneal epithelial dystrophy (clinical observations)]. / Kliniko-morfologicheskie kharakteristiki epitelial'noi distrofii rogovitsy (klinicheskie nablyudeniya).

This paper presents clinical observations that can be regarded as degeneration of the basement membrane of the corneal epithelium. Difficulties in identifying such forms of corneal dystrophies, on the one hand, are associated with limitation and polymorphism of the clinical picture, and, on the other hand, with insufficient information content of the basic diagnostic methods (i.e. the methods used during the initial examination). The presented clinical cases allow singling out the alarming and pathognomonic signs of the disease in the diagnostic algorithm. In the first case, attention should be paid to biomicroscopic changes in the superficial layers of the cornea and the optical defects, which can be regarded as a manifestation of an irregularity of corneal refraction. Identification of pathognomonic signs of the disease is possible on the basis of a detailed, close-to-morphological study of the structure of superficial corneal layers using confocal microscopy and optical coherence tomography. At the same time, the localization of the detected changes at the level of epithelial basement membrane and its basal sections is of crucial significance for substantiating the diagnosis. In addition, according to the literature data, recurrent erosions of the cornea of unclear etiology should be attributed to presumptive signs of degenerative changes in the basement membrane of the epithelium.

[Methods and clinical significance of the condition of corneal nerve fibers]. / Metody i klinicheskoe znachenie otsenki sostoyaniya nervnykh volokon rogovitsy.

The review provides basic information about embryology, structural features, biochemical composition, functions and classification of corneal nerve fibers, and describes anatomical, histological and functional diagnostic techniques for corneal nerves. Each method for analyzing the structure of the nerve fiber, its advantages and disadvantages are described in detail, including the history of the development of confocal microscopy (laser and light) and esthesiometry (contact and non-contact). The article also presents the criteria according to which the structure of the nerve fiber is estimated using laser confocal microscopy, and the shortcomings of these criteria. Additionally, the article reports on the futility of the use of modern esthesiometry methods.

[Confocal microscopy in the diagnosis of acanthamoeba keratitis]. / Vozmozhnosti konfokal'noi mikroskopii v diagnostike akantamebnogo keratita.

Acanthamoeba keratitis (AK) is a dangerous disease of the cornea, its prevalence has increased significantly due to widespread usage of contact lenses. The similarity of the clinical manifestations of AK to other infectious keratitis (especially herpetic keratitis) requires introduction of a rapid diagnosis method into clinical practice. PURPOSE: To evaluate the capabilities of corneal confocal microscopy (CCM) in the diagnosis of acanthamoeba keratitis. MATERIAL AND METHODS: We examined 33 patients (35 eyes) with suspected acanthamoeba keratitis using light and laser confocal microscopy of the cornea (ConfoScan and HRT devices, respectively). RESULTS: CCM was technically feasible in 23 of 35 cases (65.7%). Acanthamoeba cysts were detected in 16 cases (69.6%); trophozoites were visualized in 17.4% of cases; signs of keratoneuritis were detected in 12 eyes (52.2%); in 7 cases (30.4%), hyporeflective honeycomb-like cavities were observed in the stroma; deep stromal striae were observed in 9 cases (39.1%); activated keratocytes were detected in 11 patients (47.8%), and Langerhans cells were detected in 19 cases (82.6%). CONCLUSIONS: The main diagnostic value of confocal microscopy is the detection of direct markers of AK - cysts and trophozoites of Acanthamoeba. Both light and laser CCM techniques are suitable for the diagnosis of AK, but the resolution of laser confocal microscopy is higher. The non-invasive nature of this method and the possibility of multiple subsequent examinations make it possible to verify the diagnosis of acanthamoeba keratitis and monitor the treatment.

[State of corneal nerve fibers after laser-assisted in situ keratomileusis]. / Sostoyanie nervnykh volokon rogovitsy posle lazernogo keratomileza in situ.

PURPOSE: To assess the state of corneal nerve fibers (CNF) based on quantitative parameters after laser correction of myopia using LASIK. MATERIAL AND METHODS: The study examined 141 eyes - 80 eyes with myopia and 61 emmetropic eyes. In 47 cases a microkeratome was used to form a corneal flap, and in 33 cases a femtosecond laser was used (LASIK and FemtoLASIK, respectively). Confocal microscopy was performed before, as well as 1, 3, and 6 months after correction. Objective analysis of CNF involved automatic calculation of the anisotropy (KΔL) and symmetry (Ksym) coefficients of CNF orientation in the Liner 1.2S software. RESULTS: Lower values of KΔL were revealed in myopia as compared to emmetropia. Regardless of the method of flap formation, no CNF could be detected in the central cornea 1 month after myopia correction. In all cases after FemtoLASIK and in 2 cases after LASIK, CNF in the central cornea were first visualized after 3 months, and after 6 months CNF could be detected in all cases. At a similar observation time, CNF were visualized both after LASIK and after FemtoLASIK in the superior and inferior peripheral portions of the cornea. Analysis of long-term postoperative changes in KΔL and Ksym revealed a decrease in the former and an increase in the latter. CONCLUSION: Evaluation of the state of CNF after corneal refractive correction should take into account the initial changes in CNF in myopia that are possibly associated with an increase in axial eye length. A more dynamic restoration of innervation was noted in cases where the flap was formed with the femtosecond laser, which may be explained by the fact that the mechanism of tissue separation when using this type of coherent radiation is gentler. Considering the changes in the quantitative indicators characterizing the state of CNF, the question of «completeness¼ of the restored CNF as a result of reinnervation remains open.

[Role of ultrasound biomicroscopy in assessing the results of laser treatment in capsular contraction syndrome]. / Znachenie ul'trazvukovoi biomikroskopii v otsenke rezul'tatov lazernogo lecheniya pri kapsulyarnom kontraktsionnom sindrome.

The article presents the results of ultrasound biomicroscopy (UBM) measurements of pseudophakic patients with anterior capsular contraction syndrome (CS). PURPOSE: To analyze the results of UBM in capsular CS before and after laser treatment. MATERIAL AND METHODS: The study included 42 patients with capsular CS. The HI-scan ultrasound biomicroscope (Optikon, Italy) with 35 MHz UBM probe and the LPULSA SYL-9000 Premio laser (LightMed, Taiwan-USA) were used. RESULTS: The shrinkage of the capsular bag of the lens was accompanied by a significant decrease in the diameter of the anterior capsulotomy opening, IOL decentration and its displacement towards the posterior pole of the eye, stretching or damage to the ciliary zonule, and an increase in the ciliary body thickness. In 2 cases, ruptures of the ciliary body and its separation from the place of attachment to the iris root were observed. The optimal algorithm of laser treatment was developed to minimize the risk associated with possible aggravation of the clinical manifestations of CS and possible complications during laser treatment. CONCLUSION: UBM is an effective examination method for CS, which allows assessing the state of the capsular bag of the lens and the ciliary body, evaluating the effectiveness of laser treatment and predicting the risks associated with a high probability of complications.

[First results of clinical diagnostic analysis of post-COVID peripheral neuropathy]. / Pervye rezul'taty kliniko-diagnosticheskogo analiza postkovidnoi perifericheskoi nevropatii.

This analysis of ocular manifestations of the COVID-19 that can occur both in the acute and the post-COVID period focuses on pathological changes associated with hypercoagulation: thrombosis of the central retinal vein, occlusion of the central retinal artery, and decreased peripapillary perfusion. Potential changes in corneal nerve fibers (CNF) associated with coronavirus infection remain poorly understood. Meanwhile, previous studies have shown the possibility of using CNF as biomarkers of polyneuropathy (PNP). PURPOSE: To study clinical and diagnostic features of post-COVID PNP. MATERIAL AND METHODS: We examined 9 female patients aged 32 to 51 years who had suffered an infection caused by SARS-CoV-2 of varying severity. The patients were divided into two groups: the first consisted of 6 patients with clinical manifestations of PNP in the form of neuropathic pain, the second - 3 patients without clinical manifestations. Patients of group 1 underwent comprehensive examination including neurological examination, confocal microscopy of the cornea (in vivo CM), electroneuromyography (ENMG) of the nerves of the upper and lower extremities, quantitative sensory testing in the zone of painful sensations, while patients of group 2 only underwent in vivo CM. RESULTS: All patients of the first group, within 5-40 days after the onset of infection caused by SARS-CoV-2, exhibited symptoms of damage to various parts of the nervous system (peripheral nerves, thoracic spinal roots, trigeminal nerve). The main - and in most cases the only - symptom of the disease was neuropathic pain syndrome. In Guillain-Barré syndrome, for the first time using in vivo CM, the following changes were revealed: enlargement of in Langerhans cells, shortening of CNF and their processes, presence of neuromas. CONCLUSION: The standard neurological examination of patients with post-COVID neuropathy should be supplemented with special diagnostic methods for assessment of structural and functional state of the peripheral nerves. The in vivo CM method is capable of non-invasive assessment of changes in thin CNF and, with accumulation of empirical data, can be included in the algorithm for diagnosing post-COVID PNP.

[Experimental investigation of the safety of terahertz radiation in corneal hydration assessment]. / Eksperimental'noe obosnovanie bezopasnosti primeneniya teragertsovogo izlucheniya dlya analiza izmenenii gidratatsii rogovitsy.

Application of terahertz (THz) radiation in novel non-invasive biomedical technologies has recently received considerable attention. However, experimental data about the safety of exposure to THz radiation for biological objects (including eye structures in vivo) are limited. To our knowledge, the safety of THz reflectometry (frequency range of 0.30-0.40 THz) has not been closely examined in an animal model with subsequent morphological assessment of corneal tissues. PURPOSE: To assess the safety of pulsed THz radiation with various parameters (time, power, and frequency) for the cornea in a rabbit model. MATERIAL AND METHODS: The sample for the current study consisted of 18 Chinchilla rabbits (18 eyes). Corneal imaging and epithelial cell density before and after the exposure were evaluated using confocal laser scanning microscopy (CLSM). The histological study for objective assessment of the cornea state (day 1 and day 14) was performed after experiment termination. RESULTS: Single and multiple exposures of laser radiation at a frequency below 0.1 THz and power density below 30 nW/cm2 do not cause visible structural changes in any layers of the rabbit cornea. The results obtained in the long-term period showed insignificant reversible morphological changes only within the epithelium. CONCLUSION: The described parameters of terahertz and subterahertz radiation can be considered safe for assessing changes in corneal epithelium hydration level using non-invasive methods based on THz reflectometry.

[State of corneal nerve fibers in systemic amyloidosis]. / Sostoyanie nervnykh volokon rogovitsy pri sistemnom amiloidoze.

The term systemic amyloidosis unites a group of diseases with a single pathogenetic mechanism involving diffuse deposition of a pathological fibrillar protein (amyloid) in the intercellular space of various organs. Among the systemic forms of amyloidosis, light chain amyloidosis (AL-amyloidosis) occurs most often in clinical practice, while transthyretin amyloidosis (TTR-amyloidosis) is its most common hereditary form. Laser corneal confocal microscopy (CCM) allows for in vivo and non-invasive assessment of the state of corneal nerve fibers (CNF). PURPOSE: To assess the state of CNF in systemic amyloidosis by confocal microscopy data obtained in vivo. MATERIAL AND METHODS: The main study group included 16 patients (6 men and 10 women, mean age 60.5±11.6 years) with morphologically confirmed primary AL-amyloidosis, and 14 patients (5 men and 9 women, mean age 59.4±11.3 years) with genetically and morphologically confirmed hereditary TTR-amyloidosis. The control group included 23 healthy volunteers of the same age range without any neurological pathologies. The state of CNF was assessed by in vivo CCM data recorded on the HRT III system and its consequently processing using authors' self-developed program Liner 1.2. The criteria for neuropathy intensity was the degree of CNF tortuosity characterized by coefficients of anisotropy (KΔL) and symmetry (Ksym) of CNF orientation. RESULTS: According to the NIS scale, the manifestations of neuropathy in the subgroup of patients with TTR-amyloidosis were significantly more pronounced compared to AL-amyloidosis patients. The severity of clinical manifestations of neuropathy did not depend on the duration of TTR-amyloidosis and AL-amyloidosis (Spearman R rs=0.21, p=0.58 and rs= -0.49, p=0.055, respectively). Changes in the quantitative indicators (a decrease in the anisotropy coefficient and an increase in the symmetry coefficient of the fibers orientation) confirm increased tortuosity of CNF in systemic amyloidosis. CONCLUSION: The clinical picture of systemic amyloidosis is characterized by polymorphism of neurological manifestations that include various symptoms of damage to the peripheral somatic and autonomic nervous system. In vivo CCM can be used to reveal qualitative and quantitative changes in CNF in patients with systemic amyloidosis. However, statistical unreliability of the identified quantitative changes allows considering the state of CNF in amyloidosis only as a component of the disease monitoring algorithm, but not as a biomarker of the disease.

The Role of Polymorphic Markers rs1478604, rs2292305, and rs2228262 in THBS1 Gene in the Development of Autoimmune Dry Eye Syndrome.

An association of polymorphic marker rs2228262 in the THBS1 gene with the risk of developing dry eye in Sjögren syndrome was revealed. Confocal microscopy data suggest that this polymorphic marker is responsible for the high probability of corneal nerve fiber lesion in Sjögren syndrome even in the absence of clinical and functional signs of dry eye syndrome. A significant correlation was established between polymorphic markers rs1478604, rs2228262 in THBS1 gene and the coefficients of anisotropy and orientation symmetry of corneal nerve fibers. These results allow considering these polymorphic markers as a genetic factor of predisposition to dry eye syndrome in patients with Sjögren syndrome.

[Indications for retinal laser coagulation in the treatment of retinoschisis and rhegmatogenous retinal detachment]. / Pokazaniya k primeneniyu lazernoi koagulyatsii setchatki v lechenii retinoshizisa i regmatogennoi otsloiki setchatki.

PURPOSE: To determine the indications and assess the effectiveness of laser coagulation of the retina (RLC) after different types of surgeries for retinal detachment (RD), except vitrectomy. MATERIAL AND METHODS: The study included 160 patients (165 eyes) with various types of retinal detachment and retinoschisis who remained under observation for 11 years. RESULTS: In case of retinal tear with a slight local RD (less than one quadrant), we recommend the use of RLC as monotherapy. Such patients are indicated to undergo regular examinations (1 month, 3 months, 6 months, 1 year). Due to risk of tractional defects of the retina in the lower quadrants during the introduction of gas-air mixture into the vitreous cavity, in the presence of retinal pathology it is recommended to perform RLC before the pneumatic retinopexy stage. In large retinal tears, despite their upper localization, pneumatic retinopexy is not indicated due to the possibility of gas spilling over the edges of the tear under the retina, leading to an increase in the initial size of the tear and spread of RD. We noted the effectiveness of RLC monotherapy for retinal detachment of various localization. After sealing the sclera, retinal laser coagulation on the shaft along the seal is necessary to limit the tear along the edge, since over time the seal may shift causing a relapse of RD. CONCLUSION: The study has confirmed the effectiveness of laser coagulation of the retina as an independent method for the treatment of retinoschisis and retinal tears with local detachment.

[Changes in corneal nerves fibers in the early stages of Parkinson's disease according to in vivo confocal microscopy (preliminary report)]. / Izmeneniya nervnykh volokon rogovitsy na rannikh stadiyakh bolezni Parkinsona po dannym lazernoi konfokal'noi mikroskopii (predvaritel'noe soobshchenie).

One of the research directions of the so-called non-motor manifestations of Parkinson's disease (PD) is associated with the assessment of structural and functional changes in the organ of vision. An assessment of the state of thin non-myelinated corneal nerve fibers (CNF) in Parkinson's disease seems to be promising considering the neurodegenerative nature of the disease, as well as the possibility of objective intravital assessment of both functional and structural changes in CNF. PURPOSE: To analyze the changes in the course and structure of corneal nerve fibers in the early stages of Parkinson's disease based on an objective algorithm of in vivo corneal confocal microscopy (CCM). MATERIAL AND METHODS: The study was conducted on a group of 16 patients aged 39 to 66 years with verified diagnosis of PD. In addition to standard neurological and ophthalmological examinations, all patients underwent IVCCM on a Heidelberg Retinal Tomograph device with special Rostock Cornea Module (HRT3 RCM), followed by processing of the obtained images using a uniquely designed analysis algorithm. RESULTS: A significant decrease in the directional anisotropy coefficient and an increase in the directional symmetry coefficient of the nerve fibers of the cornea were established (average values 3.15±1.08 and 0.92±0.04, respectively); in healthy individuals of the identical age range these indicators are 3.5±0.85 and 0.86±0.11, respectively. In addition, qualitative structural changes were noted, which consisted of an increase in the number of branches from the main nerve trunks, an increase in the tortuosity of CNF, multidirectionality, and "beaded" shape. In 9 cases, the presence of macrophages was revealed - dendritic Langerhans cells, which is an indirect sign of the inflammatory process. CONCLUSION: The preliminary nature of the results obtained in this study and the need for further research in this area are related, on the one hand, to a small sample of observations and, on the other hand, to the criterion used to assess the status of CNF based on a comparative analysis with conditionally normal indicators. In the future, in order to solve the problem of the uniqueness of changes in CNF and the possibility of using these changes as a marker for PD progression, longitudinal studies are required to reveal the presence or absence of a correlation between the stage of the disease, the results of known monitoring methods (e.g. electromyography) and quantitative indicators of the status of CNF.

[The effects of corneal collagen cross-linking on the corneal structure in keratoconus]. / Vliyanie krosslinkinga rogovichnogo kollagena na strukturu rogovitsy pri keratokonuse.

The article reviews the key information regarding morphological changes in keratoconic corneas and dramatic alterations of the corneal tissue induced by corneal cross-linking according to data obtained with in vivo corneal confocal microscopy, presents basic information on keratoconus visualization techniques widely used for diagnosis, monitoring of ectasia, as well as efficacy assessment of its treatment, and lists basic principles of corneal cross-linking procedure and confocal microscopy with consideration of morphology specifics of keratoconic corneas. The article also discusses prospective benefits of further research and longitudinal studies aimed to define the origin of keratoconus and to develop advanced corneal cross-linking protocols.

[Phacosurgery effects on the condition of corneal nerve fibers]. / Vliyanie fakokhirurgii na sostoyanie nervnykh volokon rogovitsy.

The question of potential changes in the nerve fibers of the cornea induced by phacosurgery remains poorly investigated. This is a review of results of many individual studies aimed at assessing the condition of corneal nerve fibers following different techniques of cataract removal. The authors substantiate the necessity for structural analysis of fiber changes based on in vivo confocal microscopy of the cornea. Functional assessment of corneal sensitivity (esthesiometry) does not allow objective conclusions, for several reasons. Further studies on corneal nerve changes after phacosurgery could be directed at improving software products for objective quantitative assessment of corneal nerve fibers and analyzing long-term results of various phacosurgery techniques.