[Visual rehabilitation of patients with large post-traumatic defects of the anterior eye segment through iris-lens diaphragm implantation]. / Sistema zritel'noi reabilitatsii patsientov s obshirnymi defektami struktur perednego otrezka glaznogo iabloka na osnove implantatsii iridokhrustalikovoi diafragmy.

The diversity of methodological approaches and lack of pathogenetically reasonable tactics for patients with combined ocular injuries became the basis for the development and systematization of surgical rehabilitation stages of patients, in whom post-traumatic cataract is combined with post-traumatic aniridia and corneal scarring. AIM: to construct a visual rehabilitation approach to patients with post-traumatic defects of the anterior eye segment following optical-reconstructive surgery that involved implantation of an iris-lens diaphragm (ILD). MATERIAL AND METHODS: We have analyzed 80 reconstructive cases with ILD implantation in patients with post-traumatic aniridia and corneal damage. These patients constituted the first study group (Group 1). We have also investigated 58 eyes with residual ametropy and stable visual function 1 year after ILD implantation before and after conducting a laser keratorefractive surgery. These patients were assigned to the second study group (Group 2). RESULTS: Rehabilitation approach to patients after anterior segment injuries that has been proposed allows to achieve high clinical and functional results and reduce the risk of intra- and postoperative complications. CONCLUSION: The proposed approach to patients after optical-reconstructive surgery with iris-lens diaphragm implantation followed by keratorefractive surgery is an effective method of visual rehabilitation of anterior eye segment post-traumatic defects.

Digital capture, design, and manufacturing of a facial prosthesis: Clinical report on a pediatric patient.

A digitally captured, designed, and fabricated facial prosthesis is presented as an alternative to customary maxillofacial prosthodontics fabrication techniques, where a facial moulage and patient cooperation may be difficult.

Rigid gas-permeable contact lenses for visual rehabilitation of traumatized eyes in children.

PURPOSE: The aim of this study was to investigate the usefulness and tolerance of rigid gas-permeable (RGP) contact lenses in the visual rehabilitation of children postocular trauma. METHODS: In this retrospective case series, children below 15 years of age with ocular trauma were included. The best-corrected visual acuity with RGP contact lenses was compared with that of spectacle correction. The factors affecting visual improvement were analyzed, and problems caused by contact lens use were identified. RESULTS: Twelve eyes of 12 boys were included. The mean best-corrected visual acuity was 0.81 ± 0.29 (LogMar equivalent) with spectacles and 0.47 ± 0.27 (LogMar equivalent) with contact lenses (P < 0.001). Seven of the 12 eyes achieved a >2 line increase in visual acuity with contact lens correction as compared with that using spectacle correction. The mean astigmatism in eyes that achieved this improvement in vision was 5.45 ± 1.6 diopters, whereas the mean astigmatism in the eyes that did not improve was 2.6 ± 1.2 diopters, which was statistically significant (P = 0.009). No other factors (age, corneal scar location/density, grade/zone of injury, lens status, and occlusion) seemed to affect visual improvement with contact lenses. The mean follow-up duration was about 15 months during which 91% of the patients continued their contact lens usage. CONCLUSIONS: RGP contact lenses offer a useful refractive treatment alternative in traumatized eyes of children. Eyes with high degrees of astigmatism were found to benefit the most. RGP contact lenses were found to be well tolerated in this population.

Predictive factors of open globe injury in patients requiring vitrectomy.

BACKGROUND: To determine the outcomes and predictive factors of patients with open globe injury requiring pars plana vitrectomy (PPV). METHODS: The medical records of 114 patients age 10 years or older who had undergone PPV due to ocular trauma, with at least 6 months follow up, were retrospectively reviewed. RESULTS: The mean age of the patients was 42 (SD14) years, with males accounting for 89% of the cases. Penetrating eye injury was the most common injury mechanism (43%) with most injuries occurring secondary to work related incidents (54%). After surgical interventions, 78% of the patients had visual improvement of one or more Snellen lines, while no light perception occurred in 10%. Anatomical attachment was achieved in 87% of eyes at the final follow up. Logistic regression analysis showed that the presence of a relative afferent pupillary defect (RAPD) was a significant predictive factor of visual outcome, while initial retinal detachment was a significant predictor of anatomical outcome. CONCLUSIONS: Pupillary reaction is an important presenting ocular sign in estimating the post-vitrectomy poor visual outcome for open globe injury. Vision was restored and improved in more than half of the patients in this study; however, long-term sequelae should be monitored.

[Comparative estimation of rehabilitative abilities after organ preserving operations for severe eye damages].

Postoperative analysis of rehabilitative potentialities in 59 patients operated on occasion of severe eye trauma with the use of various methods of ophthalmosurgery has been presented. It has been demonstrated that the method of organ preserving complex vitreoretinal surgery provided evading enucleation and retaining the damaged eyeball in 96.4% of cases. In 82.1% of cases it has been succeeded in retaining some vision functions and raising considerably the indices of life quality. It has been determined that properly made silicone tamponade provides the support of the necessary ophthalmotone and prevention of progressive growing of posttraumatic eyeball subatrothy--the most frequent outcome of a severe eye trauma.

[Priority trends in the sphere of eye injuries]. / Prioritetnye napravleniia v probleme glaznogo travmatizma.

Comprehensive recent research of eye traumatism is described, aspects related with changes in the trauma structure are defined and advanced methods of diagnostics as well as of therapeutic and surgical treatment in eye trauma are elucidated in the paper. It is pointed out that the above study results are valuable for rehabilitation of victims during peacetime, in emergency situations and in calamities; the contribution of civil ophthalmologic institutions to rendering a specialized medical care to victims of military conflicts is equally important. The case study comprises extensive research findings that can be used in the below cases requiring a specialized medical care: penetrating eye injuries, contusion, burn injuries of the eye, splintered trauma etc.; the current micro-surgery standards must be adhered to and the latest technologies must be used. Finally, the important role of and valuable contributions to the above research made by the Calamity Medicine Center ("Zashchita") are underlined.

Siderosis: análisis de casos clínicos / Siderosis: analysis of clinical cases

La Siderosis es una complicación tardía y muy temida de la presencia de un cuerpo extraño férrico intraocular. Su diagnóstico ensombrece el pronóstico visual, debido a los cambios irreversibles sufridos por las estructuras comprometidas. Hoy en día es cada vez menos frecuente por el diagnóstico y manejo más oportuno. Reportamos una serie de tres casos atendidos en nuestro servicio. El tiempo en que se desarrollaron los cambios varió de ocho meses a tres años. Todas las estructuras oculares fueron comprometidas. El daño retinal a nivel de los fotorreceptores fue severo con aplanamiento de las ondas de electrorretinograma. La ecografía B fue el pilar fundamental para el diagnóstico en todos los casos. En un caso se tomó una muestra de tejido iridiano durante la vitrectomía y se envió a estudio de microscopia óptica y electrónica, evidenciándose el daño por el depósito de hierro en las estructuras celulares.