[Transepithelial corneal collagen crosslinking in patients with progressive keratoconus]. / Transépitelial'nyi krosslinking rogovichnogo kollagena pri progressiruiushchem keratokonuse.

PURPOSE: To assess the effectiveness of transepithelial collagen crosslinking (CXL) in patients with keratoconus. MATERIAL AND METHODS: The study involved 44 patients (44 eyes) with stage I-II progressive keratoconus. Patients were divided into two groups. The 1st group included 22 patients that had underwent transepithelial CXL. The 2nd group included 22 patients that had underwent traditional CXL. RESULTS AND DISCUSSION: All patients of the group 2 all patients had corneal syndrome, which lasted 2-4 days. In the 1st group, 98% of the patients did not have corneal syndrome and their visual acuity (VA) was same as preoperative on the next day after the surgery. In the 2nd group, the mean level of postoperative pain was 1.7 times higher than in group 1 (p<0.05). Six months after the treatment, uncorrected VA (UCVA) in the 1st group has increased by 52%, the best corrected VA (BCVA) - by 17%, in the 2nd group UCVA increased by 53%, BCVA - by 20% (p<0.05). The demarcation line in the 2nd group was 2.2 times deeper than in the 1st group (p<0.05). Six months after the treatment in the 1st group mean K1, K2 and Km decreased by 1.5%, 2.3% and 1.7% respectively (p>0.05); in the 2nd group - by 3.6%, 3.9% and 4.1% (p<0.05) compared with the data before the surgery. One year after the treatment, mean Kmax in the 1st group decreased by 2.1%, in the 2nd group - by 3.9%. Differences with preoperative values were statistically significant only in the 2nd group. CONCLUSION: Transepitelial CXL is a safe procedure well tolerated by patients and leading to a rapid restoration of visual function. Transepithelial CXL proved to have reduced effectiveness in inducing improvement in keratometric values, its effect on visual acuity was likely to be similar to that of epithelium-off CXL.

[Results of macular zone assessment with optical coherent tomography in patients with anterior endogenous uveitis].

45 patients (50 eyes) with anterior endogenous uveitis of various ethiology were included into the study. Examination included traditional ophthalmologic evaluation, laboratory testing and Optical Coherent Tomography (Stratus OCT 3000 "Carl Zeiss Meditec"). Retinal foveola thickness was showed to be 194-350 microm in 38 eyes (76%) compared with control group (everage value 172+21 microm). The average central macular thickness in examined group was 222+26 microm, it is more than in control group by 50 microm (p < 0.05). These results allow us to suggest that the majority of patients with anterior eye inflammation have inflammatory changes in posterior segment.

[Impaired antiendotoxin immunity in patients with diabetic retinopathy and type 2 diabetes mellitus].

Solid-phase enzyme immunoassay was used to study the serum levels of the antiendoxin IgA, IgM, IgG antibodies and total immunoglobulins of classes A, M, and G in 62 patients (122 eyes) with type 2 diabetes mellitus at different stages of diabetic retinopathy. Patients with diabetic retinopathy concurrent with type 2 diabetes mellitus were found to have a significant imbalance of antiendotoxin immunity. The highest level of anti-lipopolysaccharide (LPS)-IgA was detected in patients with nonproliferative diabetic retinopathy that exhibited macular edema, single or multiple aneurysms, hemorrhages, portions of solid lipid exudate and preproliferative diabetic retinopathy, in addition to vascular changes. Much lower levels of anti-LPS-IgA were found in nonproliferative retinopathy in which only retinal vascular changes and in proliferative diabetic retinopathy were noted. The patients with proliferative diabetic retinopathy complicated by neovascular glaucoma were ascertained to have the lowest levels of antiendotoxin antibodies of all the classes. As compared with the control group, the patients of all groups had the decreased levels of anti-LPS-IgM. The paper presents the results of a correlation analysis of the relationship of the parameters of antiendotoxin immunity to the levels of total immunoglobulins.