[Influence of posterior capsule striae on visual acuity in the first year after implantation of different intraocular lenses]. / Vliyanie skladok zadnei kapsuly khrustalika na ostrotu zreniya v techenie pervogo goda posle implantatsii razlichnykh modelei intraokulyarnykh linz.

Posterior capsule striae are the typical consequence of phacoemulsification; the data of their influence on visual acuity is still contradictory. PURPOSE: To estimate the influence of posterior capsule striae on visual acuity within one year after implantation of three models of acrylic intraocular lenses (IOLs). MATERIAL AND METHODS: Seventy-two patients (91 eyes) were followed up for 12 months after implantation of one of models of IOLs: MIOL-2 (24 eyes, first group), SA60AT and US60MP (41 and 26 eyes, second and third groups, respectively). The condition of posterior capsule striae was evaluated using photos processed with the EPCO (Evaluation of Posterior Capsular Opacification) software. Primary and secondary striae were registered. RESULTS: Primary posterior capsule striae appeared in 33.3%, 24.4% and 38.5% of cases after surgery in the 1st, 2nd and 3rd groups, respectively (p>0.05, pairwise comparison) and disappeared during the first week after surgery. Secondary striae appeared starting with month 3 of the follow-up in 8.33%, 7.69% and 13% of cases in the 1st, 2nd and 3rd groups, respectively (p>0.05, pairwise comparison) and did not change after that. Both types of striae provided the way for ingrowth of lens epithelium and posterior capsule opacification. After summarizing the eyes from all groups, only secondary striae decreased visual acuity significantly by month 12 of the follow-up. CONCLUSION: Both primary and secondary posterior capsule striae appear with comparable frequency after implantation of MIOL-2, SA60AT and US60MP; they disappear in 50% of cases one week after surgery. Both types of striae decrease visual acuity after 12 months.

[Influence of models of hydrophobic acrylic intraocular lenses on the development of posterior lens capsule opacifications (preliminary results)]. / Vliyanie razlichnykh modelei gidrofobnoi akrilovoi intraokulyarnoi linzy na razvitie pomutnenii zadnei kapsuly khrustalika (predvaritel'nye rezul'taty).

The search for optimal design and material of the intraocular lens (IOL) that would prevent posterior capsule opacification (PCO) is still a relevant problem. PURPOSE: To compare the influence of three models of hydrophobic acrylic IOLs on the development of PCO within one year after phaco surgery. MATERIAL AND METHODS: The study included 72 patients (91 eyes) who were followed up for 12 months after implantation of one of three models of posterior chamber hydrophobic acrylic IOLs: MIOL-2 (Reper-NN, Russia, 24 eyes, 1st group), SA60AT and US60MP (Alcon, USA, 41 and 26 eyes, 2nd and 3rd groups, respectively). Posterior capsule images were taken and then processed with the EPCO 2000 (Evaluation of Posterior Capsular Opacification) software. The area of posterior capsule adjacent to the center of IOL's optic of 4.0 mm in diameter was estimated. PCO score was calculated as the weighted sum of opacification areas multiplied by the degree (from 0 to 4). RESULTS: Within 1 year of the follow-up, mean visual acuity was at least 1.0 (20/20). Significant PCO progression was observed as early as 3 months after surgery. Despite that, opacification density in all three groups at every follow-up visit did not exceed grade 2; maximal PCO score (0.0315, median) was seen 12 month after surgery in the 1st group. At the same time, differences in PCO score between the groups were not significant. Nd:YAG laser posterior capsulotomy was performed only in one patient from the 1st group 12 month after surgery. Difference in the percentage of clear posterior capsules was significant only 12 month after surgery between the 1st and 3rd groups (p=0.024). CONCLUSION: All three models of hydrophobic acrylic IOLs showed comparably high vision outcomess during 12 months of the follow-up with somewhat better PCO score and percentage of clear posterior capsules in eyes with US60MP.

[Modern view on the treatment of wet-AMD patients]. / Sovremennyi vzgliad na lechenie ékssudativnoi formy vozrastnoi makuliarnoi degeneratsii.

Age-related macular degeneration is one of the leading causes of visual deterioration in the world. There are currently about 30 million people with this pathology. The main factors stimulating the development of neovascularization and corneal edema in hypoxic patients are the production of VEGF factors - blocking them is the goal of anti-VEGF therapy. High efficacy of anti-VEGF therapy was demonstrated in pivotal Phase III trials such as MARINA, ANCHOR and VIEW 1&2 which gave basis to registration of the anti-VEGF drugs with further wide use in clinical practice. Along with that the search for a regimen that would lower the number of injections while maintaining achieved results was being conducted since the introduction of anti-VEGF drugs in the clinical practice. One of the methods allowing to lower number of injections is the fixed aflibercept regimen of 3 loading injections followed by injections with 2 months intervals, but the search did not stop with that. Currently, another regimen called 'Treat and Extend' (T&E) is seeing more use. Proactive dosage regimens such as 'Treat and Extend' are aimed at preventing the recurrence of disease activity and promoting significant improvement of visual functions, as well as maintaining the achieved treatment results while reducing the required number of injections. Based on the results of ALTAIR study assessing the efficacy of aflibercept in T&E regimen, this drug can be considered suitable for T&E regimen starting from the first year of treatment.

[Capsulotomy/capsulectomy in phacosurgery: evolution of development and up-to-date technology (communication 1)].

The review gives information on the anatomy and functions of the lenticular capsule, the evolution of development, and current techniques of capsulotomy (capsulectomy) in the surgery of cataract. It discusses the advantages and disadvantages of anterior continuous curvilinear capsulorhexis, Kloeti radiofrequency bipolar capsulotomy, vitrectorhexis, Fugo plasma blade, and other anterior lenticular capsule opening techniques.

[Capsulotomy/capsulectomy in phacosurgery: evolution and up-to-date technology (communication 2)].

The review gives information on the development, current techniques, and complications of capsulotomy (capsulectomy) in the surgery of cataract. It discusses the elaboration of the authors' low-energy femtosecond laser procedure for anterior and posterior capsulotomy.

[Femtosecond laser ablation and scanning microscopy of the internal retinal limiting membrane: an experimental study].

The investigation was undertaken to study whether femtosecond laser ablation and microscopy might be used in the internal retinal borderline membrane. Ablation of internal limiting membrane preparations removed using or not using indocyanine green was made by a low-energy femtosecond laser. Examination of the preparations by laser and electron microscopy revealed precision laser cuts of the internal retinal borderline membrane. The use of indocyanine green during laser ablation reduced laser irradiation parameters as compared to the dye not being applied. Low-energy femtosecond lasers enable precision contactless ablation of the internal borderline membrane to be carried out without collateral damage to the adjacent tissue. The parameters of laser impulses, particularly low ones used in the ablation of indocyanine green-stained preparations, prove the photosensitizing effect of the dye.

[Modern aspects of surgical treatment of branch retinal vein occlusion].

The review provides an update on the surgical management of branch retinal vein occlusion. Arteriovenous sheathotomy is shown to be the only clinically evaluated and approved technique for surgical decompression of occluded retinal vein; it is based on indirect mechanical effect of reducing external vascular compression to improve the blood flow. Despite visual improvement in some patients, capillary reperfusion was not always achieved. Results of our own experimental studies are described to substantiate the use of a low-energy near-infrared Ti:Sapphire femtosecond laser for direct non-mechanical destruction of thrombotic material to immediately restore the blood flow in retinal vein. Synchronous multiphoton femtosecond laser scanning microscopy is used to perform non-invasive three-dimensional retinal vein imaging with a submicrometer resolution during ablation. The technique allows to choose proper targets and monitor laser-assisted removal of the tissue.

[Topical aspects of etiopathogenesis, medicamentous and laser treatment of branch retinal vein occlusion].

In this review, etiopathology and non-surgical management of branch retinal vein occlusion (BRVO) are considered. To date, retinal laser photocoagulation is the only therapeutic modality proven to be efficient in the treatment of BRVO complications. Although intravitreal injections of inhibitors of the vascular endothelial growth factor and triamcinolone acetonide appear to be the most promising tools for the reduction of persistent macular edema and neovascular retinal complications, they are still prescribed for off-label applications. The use of isovolemic hemodilution and intravitreal injections of fibrinolytics is limited in patients with BRVO and does not resolve the main problem, i.e. elimination of vein occlusion. Other medicamentous modalities proposed for the management of BRVO proved inefficient. In conclusion, further studies are needed to develop new methods for the treatment of BRVO.

[Surgery for retinal internal limiting membrane (communication 1)].

The review of literature describes the structure and function of the internal limiting membrane (ILM) of the retina, shows indications for its removal, the mechanisms of action of and the efficiency of ILM peeling in various macular pathologies, as well as ILM removal techniques.

[Surgery for retinal internal limiting membrane (communication 2)].

The paper reviews specific complications of conventional peeling of the internal limiting membrane (ILM) of the retina in various macular pathologies. It also considers the promising directions of development of ILM surgery, including enzymatic lysis and femtosecond laser ablation of the ILM.