[Experimental evaluation of the efficacy of tissue-engineered constructs in the treatment of limbal stem cell deficiency]. / Eksperimental'naya otsenka effektivnosti primeneniya tkaneinzhenernoi konstruktsii v lechenii limbal'noi nedostatochnosti.

Limbal stem cell deficiency (LSCD) is one of the leading factors negatively affecting the success of keratoplasty, and its treatment remains an urgent problem in ophthalmology. With the development of regenerative medicine, one of the promising approaches is the transplantation of tissue-engineered constructs from cultured limbal stem cells (LSCs) in biopolymer carriers. PURPOSE: This study was conducted to develop an experimental model of LSCD and evaluate the effectiveness of transplantation of a tissue-engineered construct consisting of cultured cells containing a population of LSCs and a collagen carrier. MATERIAL AND METHODS: The study was performed on 12 rabbits and included several stages. At the first stage, the physiological effects of collagen matrix implantation into the limbal zone were studied. At the second stage, tissue-engineered constructs consisting of LSCs on a collagen matrix were formed and their effect on the regeneration processes in the experimental LSCD model was analyzed. The animals were divided into 2 groups: surgical treatment (transplantation of the tissue-engineered construct) was used in the experimental group, and conservative treatment was used in the control group. Slit-lamp biomicroscopy with photo-registration, fluorescein corneal staining, optical coherence tomography of the anterior segment of the eye, and impression cytology were used to assess the results. RESULTS: No side reactions were observed after implantation of the collagen matrix into the limbal zone. One month after surgical treatment of the LSCD model in the experimental group, complete epithelization with minor manifestations of epitheliopathy was observed. In the control group, erosion of the corneal epithelium was noted. The time of corneal epithelization in the experimental and control groups was 9.2±2.95 and 46.20±12.07 days, respectively (p=0.139). According to the data of impression cytology, in the experimental group there were no goblet cells in the central part of the cornea, which indicates the restoration of corneal type epithelial cells, in contrast to the control group. CONCLUSION: Transplantation of a tissue-engineered construct from cultured limbal cells on a collagen membrane should be considered as a promising method for the treatment of limbal stem cell deficiency.

[Endocapsular fixation of intraocular lens in patients with ectopia lentis and Marfan syndrome (case study)]. / Endokapsulyarnaya fiksatsiya intraokulyarnoi linzy pri ektopii khrustalika na fone sindroma Marfana (klinicheskoe nablyudenie).

Modern trends in advancement of phaco surgery techniques in patients with ectopia lentis (including patients with Marfan syndrome) are characterized by the transition from complete removal of the lens (lensectomy) to aspiration of the lens substance and attempts to preserve and reposition the capsular bag. This case study analyzes the results of surgical treatment of bilateral ectopia lentis in a 6-year-old patient with Marfan syndrome. The specifics of microinvasive phaco surgery consisted in capsular bag preservation and endocapsular fixation of the intraocular lens. The article presents the results of ophthalmological observation over a seven-year period.

[Contribution of Academician M.M. Krasnov to ophthalmological science and practice]. / Vklad akademika M.M. Krasnova v oftal'mologicheskuyu nauku i praktiku.

The scientific legacy of Professor Mikhail Mikhailovich Krasnov, Academician of the Russian Academy of Medical Sciences, is large and multifaceted. His name is associated with the whole epoch of establishment and development of new methods of diagnostics and treatment of eye diseases. The representative of the dynasty of ophthalmologists M.M. Krasnov is the author of more than 350 scientific works, 80 inventor's certificates and 40 foreign patents.

[Hybrid (femtolaser) phacoemulsification: technical aspects and functional results]. / Gibridnaya (femtolazernaya) fakoemul'sifikatsiya: tekhnologicheskie aspekty i funktsional'nye rezul'taty.

This article summarizes scientific and practical results of hybrid femtosecond laser-assisted phacoemulsification (HFE) including study of clinical and technical aspects of the intervention and evaluation of post-surgical functional state of the eye on the basis of clinical, morphological and biomechanical data. The HFE technology should be considered the method of choice for microinvasive phaco surgery, its main advantage being the possibility of controlled handling of such important surgical stages as anterior circular continuous capsulorhexis and nucleus fragmentation on a closed eyeball, which significantly reduces the risk of complications and decreases of effective ultrasound time.

[Modern achievements in the diagnosis and treatment of glaucoma]. / Sovremennye dostizheniya v diagnostike i lechenii glaukomy.

Glaucoma is one of the most difficult and significant ocular conditions. The chronic asymptomatic course of glaucoma progression leads to irreversible deterioration of visual functions. Many aspects of its pathogenesis, the features of its clinical presentation, diagnosis and treatment have been identified in recent years. The results of diagnostic methods: tonometry, perimetry, optical coherence tomography - with glaucoma do not have high specificity due to the large diversity of the population. When determining the target intraocular pressure (IOP), we look at the indicators of the choroidal blood flow and biomechanical stress of the cornea and sclera (fibrous membrane of the eye). Studying visual functions is important in the diagnosis and monitoring of glaucoma. The creation of a modern portable device based on a virtual reality helmet allows examination of patients with low central vision. Structural changes in glaucoma affect the optic disc and the inner retinal layers. The proposed classification of atypical discs allows determining the earliest characteristic changes in the neuroretinal rim for glaucoma in cases of difficult diagnosis. The complexity of the diagnosis of glaucoma is also associated with concomitant pathologies in elderly patients. In cases with comorbidity of primary glaucoma and Alzheimer's disease the structural and functional changes revealed by modern research methods for glaucoma are explained by both the process of secondary transsynaptic degeneration and the death of neurons as a result of an increased IOP. The starting treatment is and its type are fundamentally important for preserving visual functions. Drug therapy with prostaglandin analogues contributes to a significant and persistent decrease in the level of IOP, and mainly by utilizing the uveoscleral outflow pathway. Surgical treatment of glaucoma is an effective way to achieve the target IOP values. However, postoperative hypotension affects the bloodstream both in the central and peripapillary retina. Optical coherence tomography angiography helped establishe that the strongest factor that determines postoperative changes is the difference in IOP, not its absolute level.

[Hereditary ectopia lentis: diagnosis and surgical treatment]. / Nasledstvenno obuslovlennye varianty ektopii khrustalika: diagnostika i khirurgicheskoe lechenie.

This review describes hereditary diseases in which ectopia lentis may be present as one of the symptoms, considers the basic diagnostic concepts of lens disposition, and analyzes the options in surgical treatment of ectopia lentis and optical correction of aphakia.

[The impact of the position of toric intraocular lenses on the functional outcomes of phaco surgery]. / Vliyanie polozheniya toricheskikh intraokulyarnykh linz na funktsional'nye rezul'taty fakokhirurgii.

The article reviews data on the impact of the position (orientation) of toric intraocular lenses on the functional outcomes of cataract phacoemulsification surgery, discusses the algorithm of astigmatism correction with intraocular lenses including preoperative determination of the size and position of main meridians, calculation of lens parameters, marking of corneal meridians, intraoperative positioning, as well as rotation and/or repositioning of the lens when necessary.

[Long-term outcomes of bandage therapeutic-optical keratoplasty in the treatment of keratoconus]. / Otdalennye rezul'taty bandazhnoi lechebno-opticheskoi keratoplastiki pri lechenii progressiruyushchego keratokonusa.

Intrastromal keratoplasty has recently been widely used in the surgical treatment of keratoconus (KC). In 2013, a new type of interlamellar keratoplasty operation was developed - bandage therapeutic-optical keratoplasty (BTOK). PURPOSE: Evaluation of the long-term outcomes of surgical treatment of stages II and III progressive KC with BTOK technique. MATERIAL AND METHODS: The study included 107 patients (126 eyes): group 1 with stage II KC - 78 eyes, 100% of these patients were observed for 1 year, 52 eyes (66%) for 3 years, and 18 eyes (23%) for 5 years; group 2 - 48 eyes with stage III KC, with 100% of them observed for 1 year, 39 eyes (81%) for 3 years, and 12 eyes (25%) - 5 years. All patients received a customized allograft in the form of an intrastromal corneal ring segment (ICRS). RESULTS: During the first year after BTOK surgery, the uncorrected and corrected visual acuity (UCVA and CVA) in the first group increased by 0.5±0.04 (p<0.05) and 0.2±0.02 (p<0.05), respectively, in the second group - by 0.46±0.05 (p<0.05) and 0.47±0.05 (p<0.05) due to a decrease in refractive indices in the central 3.0 mm zone. In the first group, mean refraction in the central 3.0 mm zone (Km) was within 45±3.75 (p<0.05), in the second - 48.63±.2 diopters (p<0.05), while maximum refraction in the central 3.0 mm zone (Kmax) decreased from 50.02±2.20 (p<0.05) to 44.61±1.03 diopters (p<0.05) in the first group, from 58.21±3.43 (p<0.05) to 50.45±3.46 diopters (p<0.05) in the second group. The values of UCVA, CVA and refractive indices of the central corneal zone in the first and second groups did not change statistically significantly after three and five years. Minimum corneal thickness in the first group increased from 476.23±13.35 to 485.08±15.80 µm (p<0.05), in the second - from 412.73±38.63 to 422.00±42.25 µm (p<0.05). CONCLUSION: BTOK surgery can be used in patients with stages II and III KC to improve the visual functions, strengthen the ectatic cornea and stop the progression of the disease.

[Prospects for early detection of keratoconus based on systems built for computer-assisted diagnostics of structural changes in the cornea]. / Perspektivy rannego vyyavleniya keratokonusa na osnove postroeniya sistem mashinnoi diagnostiki strukturnykh izmenenii rogovitsy.

The article is devoted to the problem of diagnosing subclinical keratoconus (KK). The need to identify early signs of KK is primarily associated with the potential for the development of iatrogenic keratoectasia in cases of underdiagnosis of the disease when determining the conditions for laser keratorefractive surgery involving a decrease in the thickness of the cornea. Today generally accepted algorithms for early computer-assisted diagnosis of KK are mainly based on the analysis of various morphometric parameters of the cornea, reflecting changes in its shape and thickness induced by structural abnormalities. Direct detection of structural changes in the cornea characteristic of early KK requires the use of high-tech imaging methods that are not always applicable in everyday clinical practice. The promising approach proposed in this study is based on the fact that a digital image of a corneal «slice¼ obtained using serial analyzers such as the Scheimpflug camera widely used in clinical practice provides indirect information about the structure of the epithelial layer, the local thickening of which takes place in the initial stages KK. It is this criterion that underlies the proposed system of computer-assisted diagnosis of KK. The carried out studies have shown the high sensitivity of this algorithm, and its specificity can be increased by involving the known diagnostic indicators of KK.

[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.

[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.

[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.

[Radial keratotomy: history and current state]. / Radial'naya keratotomiya: istoriya i real'nost'.

Results of clinical use of the radial keratotomy (RK) surgery are presented in the format of a lecture and a summary. The analysis encompasses the mechanism of changes in corneal refraction, immediate intra- and postoperative complications, so-called secondary symptoms and long-term effects (addition of various pathological processes, influence of corneal changes on the results of diagnostic tests and treatment methods) of the surgery.

[Assessment of age-related changes in lens capsule biomechanics using atomic force microscopy]. / Otsenka vozrastnykh izmenenii «biomekhaniki¼ kapsuly khrustalika na osnove atomno-silovoi mikroskopii.

Studies devoted to the assessment of lens capsule biomechanics can be divided into fundamental and applied. The former are oriented towards analysis of various indicators characterizing elasticity of the capsule as a basal membrane that maintains and changes the shape of the lens, and the latter deal with widespread introduction of modern microinvasive methods of phaco surgery into clinical practice. PURPOSE: To assess age-related changes in lens capsule biomechanics based on atomic force microscopy (AFM). MATERIAL AND METHODS: The study included 50 central fragments of the anterior capsule of the human lens obtained intraoperatively during ultrasonic phacoemulsification by continuous circular capsulorhexis. The measurements were carried out in the Fast Force Volume (FFV) mode. The force curves were processed in the Nanoscope Analysis software (Bruker, USA) using the Hertz model that allows calculating the Young's modulus of the capsule sample based on the dependence of the force on the puncture depth. RESULTS: There was no statistically significant difference in the «stiffness¼ of the inner and outer surfaces before and after removal of the subcapsular epithelium (p=0.25). In all cases, the inner surface of the capsule turned out to be «harder¼ than the outer one. In this case, the ratio of Young's modulus of the inner and outer surfaces has a significant dependence on age (p<0.001). With an increase in age from 50 to 90 years, this ratio decreased from ~7 to ~1.5. This was due to a simultaneous change in Young's modulus of the opposite nature: an increase in the stiffness of the outer surface and its decrease in the inner one. CONCLUSION: It is possible to assess lens capsule biomechanics using AFM if the subcapsular epithelium is present. In this case, the objects of study are the areas of the capsule free of epithelium, and the epithelial cells themselves can be used to identify the inner surface of the capsule. Regardless of age, the stiffness of the inner surface of the anterior lens capsule significantly exceeds that of the outer surface.

Biomineralization of Trabecular Meshwork in Open-Angle Glaucoma.

A new form of open-angle glaucoma has been identified, in which calcification and silicification of the trabecular meshwork is a potentially significant component of outflow obstruction. It is noted that the mineralization of this area is promoted by various disturbances in the acid-base balance in the tissue. The role of melanosomal enzymes in the initiation of the formation of mineral calcium phosphate in trabecular tissue in open-angle glaucoma is considered.

[Strabismus and oculomotor disorders induced by injection anesthesia for cataract surgery]. / Kosoglazie i glazodvigatel'nye narusheniya, indutsirovannye in"ektsionnoi anesteziei v khirurgii katarakty.

PURPOSE: To analyze diagnostic and treatment outcomes in patients with strabismus and oculomotor disorders induced by injection anesthesia for cataract surgery. MATERIAL AND METHODS: The study included 11 patients (7 women and 4 men) aged 61 to 85 years (the mean age of 66±7.1 years) who complained of diplopia in the early post-op period after cataract phacoemulsification and elastic IOL implantation under retrobulbar anesthesia. Prior to further surgical treatment, all of the patients underwent functional multispiral computer tomography of the orbits. Prismatic spectacle correction was also used independently or in addition to surgical treatment. RESULTS: Eight out of eleven patients underwent one- or two-step surgical treatment (3 and 5 cases, respectively). In 2 patients, hypotropia did not exceed 10 prism diopters, and thus, diplopia could be compensated with prismatic spectacle correction alone. In 5 cases, binocular vision was achieved throughout the whole field of gaze. In 3 cases, surgical treatment enabled elimination of heterotropia in the primary gaze and compensation of diplopia within a radius of 40º from the center of gaze and within the entire horizontal range of eye-movement in the downward gaze. The limitation of ocular mobility decreased from 2.36 to 0.55 points leading to an associated decrease in the area of binocular diplopia - from 98% to 29%. In one case, spectacle occlusion was used. CONCLUSION: The inferior rectus restriction is the morphological substrate of anatomical and functional changes induced by retrobulbar anesthesia. As treatment options for restrictive vertical strabismus and binocular diplopia, both surgical (extraocular muscle surgery) and optical (prismatic correction, occlusion) methods should be considered.

[Results of surgical treatment of complicated uveal cataract]. / Rezul'taty khirurgicheskogo lecheniya oslozhnennoi uveal'noi katarakty.

PURPOSE: A retrospective analysis of the results of surgical treatment of complicated uveal cataracts of different origin. MATERIAL AND METHODS: The study analyzed the results of surgical treatment of uveal cataract in 30 patients (34 eyes) who were divided into three groups by uveitis etiology. The first group included 11 patients with spondyloarthritis associated with the HLA-B27 antigen; the second group included 10 patients with juvenile chronic arthritis and spondyloarthritis, negative for HLA-B27 antigen; the third group consisted of 9 patients with other systemic autoimmune diseases and uveitis of unknown etiology, also negative for the HLA-B27 antigen. The average age of the patients was 35.8±2.6; 30.8±3.8 and 34.0±2.3 years, respectively. Four patients (6 eyes) with juvenile chronic arthritis and severe ribbon-like corneal degeneration underwent standard intracapsular cataract cryoextraction with subsequent spectacle correction of aphakia. In other cases, ultrasound phacoemulsification with implantation of an intraocular lens (IOL) was used as a surgical aid. RESULTS: Regardless of the surgery technique and the cause of uveal cataract, a statistically significant decrease in the number of exacerbations per year (p<0.0001) and an increase in best corrected visual acuity (BCVA) were noted after its removal. In the long-term follow-up (2-24 months), 9 patients experienced persistent decompensation of the IOP level, which required various types of antiglaucoma surgery. CONCLUSION: Surgical treatment of uveal cataracts of various etiologies with adequate pre- and postoperative therapy provides an improvement in visual acuity and a reduction in the frequency of inflammation recurrence. Considering the high likelihood of IOP decompensation in the long-term postoperative period, IOP control should be given attention in such cases.

[Phacosurgery features in keratoconus]. / Osobennosti fakokhirurgii pri keratokonuse.

The review summarizes the results of surgical treatment of cataracts in patients with keratoconus. The major challenges of phacosurgery in keratoconus are associated with intraocular lens (IOL) power calculation, choice of the most appropriate IOL model and additional interventions required to stabilize keratectasia and reduce corneal irregularity.

[Changes in corneal nerve fibers after microinvasive cataract surgery (a preliminary report)]. / Izmeneniya nervnykh volokon rogovitsy posle mikroinvazivnoi fakokhirurgii (predvaritel'noe soobshchenie).

INTRODUCTION: Potential changes in corneal nerve fibers (CNF) induced by cataract phacoemulsification remain insufficiently studied. The need for research in this direction is dictated by a number of circumstances: introduction of corneal confocal microscopy into clinical practice, the need for phaco surgery in the presence of corneal changes of various genesis, the possible negative impact of laser radiation during hybrid (femtosecond laser-assisted) phacoemulsification. PURPOSE: To assess the changes in CNF after various methods of microinvasive cataract surgery. MATERIAL AND METHODS: The studies were conducted in patients aged 50 to 60 years who underwent standard ultrasound and hybrid phacoemulsification; the patients were respectively divided into two groups (30 surgeries each). The algorithm for assessing the state of CNF involved laser confocal microscopy using original software. To quantify the state of the nerves, two coefficients were used: CNF orientation anisotropy (KΔL) and CNF orientation symmetry (Ksym). RESULTS: Regardless of the surgery technique, tendencies were noted for the orientation anisotropy coefficient to decrease and the orientation symmetry coefficient to increase, which are conditionally comparable with previously identified age-related changes in CNF. After hybrid phacoemulsification, a decrease in the orientation anisotropy coefficient 2-2.5 months after the intervention turned out to be statistically less significant compared to the standard ultrasound technique. CONCLUSION: Further research should be aimed at analyzing the long-term results of both microinvasive phacosurgery techniques and the «classical¼ extracapsular cataract extraction, which remains the method of choice in a number of clinical situations.

[Morphological and functional condition of the macula after different types of phaco cataract surgeries]. / Morfofunktsional'noe sostoianie makuliarnoi zony setchatki posle razlichnykh metodov fakokhirurgii.

One of the directions of advancing phaco technology is related to adoption of hybrid phacoemulsification for clinical practice. Potential postsurgical changes in the macular area, when other factors are equal, can be seen as a conditional criterion for the injury rate of phaco surgeries. PURPOSE: To evaluate morphological and functional condition of the macular area after different types of phaco cataract surgeries. MATERIAL AND METHODS: Two groups were formed for comparative study in accordance with criteria for standardization and maximum mitigation of the impact of other factors on the condition of the retina - with standard ultrasound and hybrid (femtolaser-assisted) phacoemulsification (30 operations in each group). Examinations were performed initially, then 7-10 days, and 2-3 month after the surgery. Optical coherence tomography (OCT) and multifocal electroretinography (mfERG) were performed for evaluation of the morphological and functional condition of the macular area. RESULTS: There was no statistically significant dependence of linear and volumetric measures in the macular area on phaco surgery method, and the few variations were most likely related to increasing the time of ultrasound action in standard phacoemulsification. Revealed changes turned out to be significantly less marked than what is considered critical for development of macular edema. Improvement of baseline multifocal electroretinography measurements (increase of the density of retinal biopotential and decrease of latent time) just after the surgery results from the effect the lens opacification has on basic parameters, regardless of phacoemulsification technique. There were no significant differences in postsurgical measurements of multifocal electroretinography obtained in similar periods of postsurgical assessment after standard ultrasound and hybrid phacoemulsification. CONCLUSION: The results prove the safety of phaco surgery methods and the absence of negative impact of femtolaser component of hybrid phacoemulsification on structural and functional condition of central retina.