[Prevention of intraoperative miosis in femtosecond laser-assisted phaco surgery]. / Preduprezhdenie intraoperatsionnogo mioza v fakokhirurgii c primeneniem femtosekundnogo lazera.

INTRODUCTION: Prevention of intraoperative miosis in hybrid (femtosecond laser-assisted) phacoemulsification is a relevant problem of cataract surgery. PURPOSE: Development and clinical study of an effective method for preventing intraoperative miosis in hybrid (femtosecond laser-assisted) phacoemulsification. MATERIAL AND METHODS: Hybrid phacoemulsification was performed in 300 patients (300 eyes). The first group (100 eyes) 3 days prior to the surgery was prescribed instillations of 0.1% indomethacin 3 times a day and 3 times in 2 hours before surgery at 30 minute intervals. The second group (100 eyes) 3 days prior to the surgery was prescribed instillations of 0.1% indomethacin 3 times a day, 3 times in 2 hours before the surgery at 30 minute intervals, and 1 hour before the surgery an additional intramuscular injection of diclofenac. The third group (control, 100 eyes) 2 hours before the operation was prescribed instillations of 0.1% indomethacin, 3 times at 30 minute intervals. The diameter of the pupil was evaluated before the beginning of femtosecond laser stage and before the opening of anterior chamber during the second stage of the operation. RESULTS: When the interval between the femtosecond laser stage and emulsification of the nucleus fragments was maintained at less than 15 minutes, pronounced decrease of the pupil (more than 2 mm) was noted in 8.2% of cases in the first group, 6.7% in the second group and 14.1% in third (control) group; mean values of pupil narrowing were 0.68±0.27 mm in the 1st group, 0.63±0.25 mm in the 2nd group, and 0.93±0.39 mm (p<0.05) in the third group. CONCLUSION: The clinical study showed high efficiency of the proposed methods for prevention of intraoperative miosis in hybrid (femtosecond laser-assisted) phaco surgery. An important factor affecting intraoperative narrowing of the pupil is the time interval between the femtolaser stage of the operation and emulsification of the nucleus fragments, which should not exceed 15 minutes.

[Surgical technique of retropupillary iris-claw fixated IOL reimplantation]. / Khirurgicheskaia tekhnika reimplantatsii intraokuliarnoi linzy s retropupilliarnoi fiksatsiei.

Prevention and treatment of cataract surgery complications in patients with lens subluxation remains one of the current problems of phaco surgeries. PURPOSE: To develop and to test the surgical technique for reimplantation of in-the-bag dislocated intraocular lenses (IOL) or sulcus-fixated IOL. MATERIAL AND METHODS: Surgical outcomes of 150 patients (150 eyes) with in-the-bag IOL dislocation (122 eyes) or sulcus fixated IOL dislocation (28 eyes) were analyzed. The follow-up period lasted 1-3 years. RESULTS: In all cases the dislocated IOL was removed and retropupillary iris-claw 'Artisan' IOL implantation was performed. After the IOL exchange, visual acuity improved in all patients, while the fixation of retropupillary IOL remained stable. CONCLUSION: This surgical technique of dislocated IOL exchange coupled with retropupillary implantation of 'Artisan' IOL provides reliable anatomic and functional results.

[Results of secondary retropupillary-fixated intraocular lens implantation]. / Rezul'taty reimplantatsii intraokuliarnoi linzy s retropupilliarnoi fiksatsiei.

Surgical treatment of intraocular lens (IOL) with late dislocation remains one of the current problems of ophthalmology. PURPOSE: To evaluate specific morphofunctional changes in the eye after dislocated IOL exchange with retropupillary-fixated iris-claw IOL. MATERIAL AND METHODS: Surgical outcomes of 150 patients (150 eyes) with in-the-bag IOL dislocation (122 eyes) or sulcus-fixated IOL dislocation (28 eyes) were analyzed. The follow-up period was 1-3 years. RESULTS: Increase in visual acuity and stable retropupillary fixation of the IOL was observed in all cases after reimplantation. Mean endothelial cell loss after 3 months was 6.9±1.3% in the group with preoperative density of >1200 cells/mm2 and 12.3±2.7% in the group with preoperative density of <1200 cells/mm2. There was no significant increase in intraocular pressure after IOL reimplantation. The incidence of clinical cystoid macular edema with decreased visual acuity was 4.7%, which is significantly more frequent than in patients after uncomplicated phacoemulsification with in-the-bag IOL implantation. CONCLUSION: Retropupillary implantation of iris-claw IOL provides stable fixation, good functional outcomes with low complication rates and is suitable for reimplantation in eyes without adequate capsular support.

[A new method of macrofragmentation of dense nuclei by using loop fragmentizer]. / Novyi metod makrofragmentatsii plotnykh khrustalikovykh iader s pomoshch'iu petlevogo fragmentatora.

The study results showed a principle possibility to fragmentize the most dense lens nuclei by means of a nylon cutting loop. The safety and efficiency of applying a loop fragmentizer in phacoemulsification of high-density cataract were equally demonstrated. The method advantages are conditioned by that a preliminary splitting of the nucleus into fragments without trenches being shaped cuts essentially the total capacity and duration of ultrasound impact, thus, the irrigation time and the needed volume of balance salt solution also decrease intraoperatively: it, naturally, diminishes the generally-known traumatic aftermaths of surgical intervention.

[Phacoemulsification of cataract in patients with high myopia]. / Fakoemul'sifikatsiia katarakty u patsientov s vysokoi stepen'iu miopii.

We conducted a study for the purpose of developing a phacoemulsification technique for patients with high myopia optimized for the specificity of myopic eye. The study involved 124 (165 eyes) patients with high myopia and cataract. The lens density in operated patients was of degrees II-IV according to Buratto. The anterior-posterior axis of the eyeball ranged from 26.5 to 34.00 mm. the patients were shared between the experimental (92 eyes) and control (73 eyes) groups with respect to a used surgical technique. A modified procedure was applied in the experimental groups and the basic technique was used in the control group. The time of lens extraction, the volume of used irrigation liquid and the frequency rate of intra- and postoperative complications were the criteria in efficiency evaluation. The study showed the modified surgical procedure of phacoemulsification to ensure a better visualization, to reduce the load on the lens ligamentous apparatus and to facilitate, as much as possible, manipulations made on the lens nucleus of myopic eye; it also cuts the time of cataract lens extraction, which ensures a less volume of used irrigation liquid.

Biochemical and immunochemical analysis of gangliosides of human small cell lung carcinoma: production of monoclonal antibodies against a unique marker of small cell lung carcinoma, ganglioside Fuc GM1.

Immunization of mice with a pure preparation of the ganglioside adsorbed on Salmonella typhimurium and hybridization of splenocytes with myeloma P3-X63-Ag 8.653 have resulted in hybridomas producing monoclonal antibodies against ganglioside Fuc GM1, a marker of human small cell lung carcinoma. Characterization of four hybridomal clones and data on the antigenic specificity of the monoclonal antibodies are given. All four monoclonal antibodies reacted only with Fuc GM1 in an enzyme-linked immunosorbent assay. In radioimmunodetection of the antigen on thin-layer plates, two of the four monoclonal antibodies gave cross-reactions with Fuc GD1b. The obtained monoclonal antibodies have revealed the presence of Fuc GM1 in all seven cases of small cell lung carcinoma we have studied and the absence of Fuc GM1 in the normal human lung tissue and in lung adenocarcinomas.