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1.
Vestn Oftalmol ; 140(1): 65-70, 2024.
Artículo en Ruso | MEDLINE | ID: mdl-38450468

RESUMEN

Prevention and treatment of anterior capsular contraction syndrome (ACCS) is a relevant problem in cataract surgery. PURPOSE: The study was performed to develop a femtosecond laser-assisted technique for anterior capsulotomy in anterior capsular contraction syndrome and assess its preliminary results in preventing the progression of pathological changes in the capsular bag. MATERIAL AND METHODS: The examination and femtosecond laser-assisted treatment without additional surgical intervention was performed in 6 patients (6 eyes) aged 69 to 73 years with anterior capsular contraction syndrome. Femtosecond laser-assisted anterior capsulotomy was performed using the VICTUS system (Technolas Perfect Vision, Germany). Capsulotomy diameter was 4.0-4.5 mm, laser radiation energy - 9000 nJ, laser exposure depth 900-1000 µm. RESULTS: The diameter of the anterior capsulotomy before treatment was 2.85 mm [2.75; 2.93]. After 1 month, the diameter of the anterior capsular opening was 2.88 mm [2.78; 2.96] (p>0.05). One year after femtosecond laser intervention, the anterior capsulotomy opening was almost the same shape and diameter - 2.84 mm [2.74; 2.94] (p>0.05). CONCLUSION: Femtosecond laser-assisted circular capsulotomy is an effective and safe method for preventing the progression of anterior capsular contraction syndrome in the absence of severe IOL decentration and for maintaining the diameter of the anterior capsular opening of at least 2.5-3.0 mm.


Asunto(s)
Extracción de Catarata , Oftalmología , Exposición a la Radiación , Humanos , Ojo , Rayos Láser
2.
Vestn Oftalmol ; 139(3): 15-22, 2023.
Artículo en Ruso | MEDLINE | ID: mdl-37379105

RESUMEN

PURPOSE: The study attempted to experimentally substantiate the possibility of using the laser activation of scleral hydropermeability (LASH) technique in glaucoma treatment by morphological evaluation of treatment outcomes. MATERIAL AND METHODS: The pulsed-periodic radiation from an Er-glass fiber laser (λ=1.56 µm) was used. The model experiment consisted of evaluating ultrafiltration of fluid through the tissues of human sclera autopsy specimen according to the original technique using neodymium chloride-based labeling agent and scanning electron microscopy. The clinical part of the study consisted of optical coherence tomography (OCT) and laser confocal microscopy of the sclera and conjunctiva (CMSC) performed in vivo immediately after laser treatment in the laser application sites in 5 patients (5 eyes) aged 57 to 68 years with uncompensated advanced (IIIb-c) stage of glaucoma who had previously underwent LASH surgery. RESULTS: Results of morphological evaluation after LASH revealed structural changes indicating increased transscleral ultrafiltration: increased intrastromal hyporeflective areas in the sclera, thinning of collagen fibers, formation of porous structures. Using an original technique involving neodymium chloride-based labeling agent and scanning electron microscopy, we were able to prove the enhancement of transscleral ultrafiltration. The results of the experiment were confirmed by in vivo OCT images of the sclera and CMSC performed in 5 patients with advanced glaucoma after LASH surgery, in which tissue decompaction in the laser-exposed areas was clearly visualized. CONCLUSION: The revealed structural changes indicate the possibility of reducing intraocular pressure after LASH by the means of forming scleral porous structures and increasing transscleral ultrafiltration. Experimentally selected optimal mode of laser exposure (0.66 W with total exposure time of 6 seconds) during LASH helps avoid gross destructive changes in the eye tissues, making the proposed intervention a sparing approach to the treatment of glaucoma.


Asunto(s)
Glaucoma , Láseres de Estado Sólido , Humanos , Esclerótica/diagnóstico por imagen , Esclerótica/cirugía , Cuerpo Ciliar/cirugía , Glaucoma/diagnóstico , Glaucoma/cirugía , Presión Intraocular , Láseres de Estado Sólido/uso terapéutico , Coagulación con Láser/métodos
3.
Vestn Oftalmol ; 139(3. Vyp. 2): 107-112, 2023.
Artículo en Ruso | MEDLINE | ID: mdl-37144376

RESUMEN

The article summarizes the experience of recent years in the development and implementation of novel original laser technologies used in surgery of the anterior segment of the eye. The presented technology of laser activation of scleral hydropermeability (LASH) in glaucoma is based on the effect of enhanced transscleral filtration and has been shown as effective and safe, which was confirmed by the results of a comprehensive clinical and experimental study. Development of another technique was associated with the need to improve the safety of laser interventions in anterior capsule contraction syndrome in pseudophakia, and resulted in a proposition to change the configuration of the anterior lens capsule incision from the usual linear-radial to T-shaped laser anterior capsulorhexis. The proposed technology of laser photomydriasis based on near-infrared radiation of the diode laser (0.810 µm) has shown its effectiveness and gentle nature (absence of atrophy of the iris stroma and post-burn pigmentation) in ectopias and pupil deformity.


Asunto(s)
Segmento Anterior del Ojo , Terapia por Láser , Humanos , Segmento Anterior del Ojo/diagnóstico por imagen , Segmento Anterior del Ojo/cirugía , Iris/cirugía , Terapia por Láser/efectos adversos , Terapia por Láser/métodos , Capsulorrexis/métodos , Seudofaquia/cirugía
4.
Vestn Oftalmol ; 139(2): 89-94, 2023.
Artículo en Ruso | MEDLINE | ID: mdl-37067937

RESUMEN

Anterior capsule contraction syndrome is a specific complication of continuous circular capsulorhexis in various phacoemulsification techniques. Surgical, laser and combined methods have been proposed for its treatment. All approaches in the treatment of anterior capsule contraction syndrome have some advantages, as well as certain problems and difficulties. This review presents the current state of this problem of cataract surgery and possible prospects for improving the treatment.


Asunto(s)
Extracción de Catarata , Terapia por Láser , Facoemulsificación , Humanos , Capsulorrexis/efectos adversos , Capsulorrexis/métodos , Facoemulsificación/efectos adversos , Implantación de Lentes Intraoculares , Terapia por Láser/métodos
5.
Vestn Oftalmol ; 139(6): 19-25, 2023.
Artículo en Ruso | MEDLINE | ID: mdl-38235626

RESUMEN

PURPOSE: This study evaluates the hypotensive effect and the outcomes of intravital morphological changes in the intervention site after laser activation of scleral hydro-permeability (LASH) by pulsed-periodic radiation from an Er-glass fiber laser (λ=1.56 µm) in patients with advanced glaucoma. MATERIAL AND METHODS: LASH surgery was performed in 19 patients (19 eyes) aged 48 to 73 years with uncompensated advanced stage (IIIb-c) glaucoma. In addition to standard methods of investigation, all patients were examined with optical coherence tomography (OCT) and laser confocal microscopy of sclera and conjunctiva (CMSC) at the laser treatment sites, and electronic tonography. RESULTS: The hypotensive effect after LASH in patients with advanced glaucoma was observed in 94.7% (n=18) of cases. The decrease in intraocular pressure (IOP) averaged 24.4% from baseline one month after intervention and 32.96% after six months of follow-up. In 15.7% (n=3) of cases, the recorded IOP decrease was insufficient as its target values were not achieved. However, in the vast majority of patients (n=16), the recorded IOP decrease corresponded to the target values and indicated compensation of the process. Results of complex morphological evaluation after LASH revealed structural changes indirectly indicating possible laser-induced influence on the processes of increased transscleral filtration and uveoscleral outflow. A high positive correlation dependence (r=0.848) was also revealed between the degree of IOP lowering and the increase in the coefficient of ease of aqueous humor outflow, attesting to the fact that IOP lowering was mainly due to the improvement of intraocular fluid outflow. CONCLUSION: The demonstrated efficacy of LASH technology indicates the possibility of its successful application as an independent method of IOP reduction in patients with advanced glaucoma.


Asunto(s)
Glaucoma , Láseres de Estado Sólido , Humanos , Esclerótica/diagnóstico por imagen , Esclerótica/cirugía , Glaucoma/diagnóstico , Glaucoma/cirugía , Presión Intraocular , Coagulación con Láser/métodos , Permeabilidad , Resultado del Tratamiento , Cuerpo Ciliar/cirugía
6.
Vestn Oftalmol ; 138(5. Vyp. 2): 266-272, 2022.
Artículo en Ruso | MEDLINE | ID: mdl-36287166

RESUMEN

Laser photodestruction (LPD) of tissues is the basis of modern laser reconstructive surgery in ophthalmology. The most common laser technologies based on LPD mechanisms include YAG laser capsulotomy (discission) (LD) of secondary cataract and YAG laser iridectomy (LIE) for glaucoma. Laser reconstructive interventions for secondary cataract, as well as LIE, have a number of advantages over traditional surgery, but at the same time are associated with the risk of complications, including in the cornea. Corneal endothelium is the most susceptible to laser damage, while Descemet's membrane and corneal stroma are injured less often. This review describes cases of iatrogenic perforation and purulent inflammation of the cornea. In the long-term, laser interventions can lead to bullous keratopathy and corneal graft rejection. At this time, the most popular and available among the methods for assessing the cornea after YAG laser interventions is the method of specular microscopy. Ultrasound biomicroscopy is used less commonly. The modern method of corneal confocal microscopy is practically not used for this purpose, and taking into account the risks of developing laser-induced injuries, it indicates its relevance and the need for further research.


Asunto(s)
Opacificación Capsular , Terapia por Láser , Láseres de Estado Sólido , Humanos , Córnea/diagnóstico por imagen , Córnea/cirugía , Terapia por Láser/efectos adversos , Endotelio Corneal
7.
Vestn Oftalmol ; 138(5): 47-56, 2022.
Artículo en Ruso | MEDLINE | ID: mdl-36288417

RESUMEN

YAG laser interventions are associated with the risk of complications, including corneal. PURPOSE: To study the mechanisms of laser destruction in exposing the posterior lens capsule (PLC) tissue to Nd:YAG laser irradiation, and to evaluate its side effects on the cornea. MATERIAL AND METHODS: The experiment involved 6 autopsy samples of human posterior lens capsule with different optical and mechanical properties, which were exposed to laser irradiation. We used the Nd:YAG ophthalmic laser LPULSA SYL-9000 Premio manufactured by «LightMed¼ (Taiwan/USA) and an experimental Nd:YAG laser system (1.064 µm). The following parameters were compared: the power of the incident radiation and radiation transmitted through the PLC, the mechanical stresses in the PLC tissue, the kinetic energy of the laser ablation products, and the pressure of gas bubbles during laser exposure in capsule samples of different densities. In the clinical part of the work, the negative effects of Nd:YAG laser on the cornea at different PLC densities were assessed using the endothelial microscope SP 3000P («Topcon¼, Japan). RESULTS: The experiment showed that in hard samples of PLC there are star-shaped point perforations with a diameter of 50±20 µm with partial rarefaction around the point defects. Damage to soft PLC samples in the form of large complete perforations was up to 200 µm in size. The temperature of laser irradiation necessary to achieve breakdown in soft PLC samples was 90 °C, in hard samples - 120 °C. The results of the experiment indicate that the final outcome - destruction of the PLC tissue - is safer to achieve not by increasing the energy, but by increasing the number of laser pulses. Clinical study results confirm a significant effect of the density of PLC on the values of laser energy and on the state of the cornea after laser intervention. CONCLUSION: The experimental data on the mechanisms of laser destruction of the lens capsule should contribute to the development of new and improvement of already known technologies aimed at reducing the risks associated with laser surgeries.


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido , Cápsula del Cristalino , Cápsula Posterior del Cristalino , Humanos , Láseres de Estado Sólido/efectos adversos , Cápsula del Cristalino/cirugía , Terapia por Láser/efectos adversos , Terapia por Láser/métodos , Córnea
8.
Vestn Oftalmol ; 137(6): 26-32, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34965064

RESUMEN

The article presents the results of ultrasound biomicroscopy (UBM) measurements of pseudophakic patients with anterior capsular contraction syndrome (CS). PURPOSE: To analyze the results of UBM in capsular CS before and after laser treatment. MATERIAL AND METHODS: The study included 42 patients with capsular CS. The HI-scan ultrasound biomicroscope (Optikon, Italy) with 35 MHz UBM probe and the LPULSA SYL-9000 Premio laser (LightMed, Taiwan-USA) were used. RESULTS: The shrinkage of the capsular bag of the lens was accompanied by a significant decrease in the diameter of the anterior capsulotomy opening, IOL decentration and its displacement towards the posterior pole of the eye, stretching or damage to the ciliary zonule, and an increase in the ciliary body thickness. In 2 cases, ruptures of the ciliary body and its separation from the place of attachment to the iris root were observed. The optimal algorithm of laser treatment was developed to minimize the risk associated with possible aggravation of the clinical manifestations of CS and possible complications during laser treatment. CONCLUSION: UBM is an effective examination method for CS, which allows assessing the state of the capsular bag of the lens and the ciliary body, evaluating the effectiveness of laser treatment and predicting the risks associated with a high probability of complications.


Asunto(s)
Cristalino , Microscopía Acústica , Cuerpo Ciliar/diagnóstico por imagen , Cuerpo Ciliar/cirugía , Humanos , Iris/diagnóstico por imagen , Rayos Láser
9.
Vestn Oftalmol ; 137(6): 82-86, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34965072

RESUMEN

Laser cyclodestructive interventions are considered the method of choice in the treatment of refractory glaucoma. However, the traumatic nature of cyclocoagulation makes it necessary to search for more gentle methods of laser treatment. One of the possible directions is the development of laser transscleral technologies that mainly affect the uveoscleral outflow. This article presents a new technique for laser activation of scleral hydropermeability (LASH) using pulse-periodic erbium glass (Er-glass) fiber-optics laser with wave length of 1.56 µm. The article describes the parameters of laser emission and the technique of LASH, and presents the mechanism of reducing intraocular pressure associated with increased transcleral drainage of intraocular fluid by forming new pores in the sclera. The effectiveness and safety of LASH is supported by a detailed example from clinical practice. This technology has proven itself as a possible alternative to the conventional contact transcleral cyclocoagulation.


Asunto(s)
Glaucoma , Láseres de Estado Sólido , Cuerpo Ciliar , Glaucoma/diagnóstico , Glaucoma/cirugía , Humanos , Presión Intraocular , Coagulación con Láser , Esclerótica/cirugía
10.
Vestn Oftalmol ; 136(6): 113-120, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33084288

RESUMEN

Nowadays glaucoma is one of the leading causes of irreversible blindness worldwide. The main goal in preservation of vision in glaucoma patients is reducing intraocular pressure (IOP), which is considered the main controlled risk factor for progression of glaucomatous optic neuropathy. The article discusses the effectiveness and safety of various transscleral laser technologies in the treatment of glaucoma. Modern transscleral laser technologies that affect the uveoscleral drainage and scleral hydro-permeability are less traumatic and more gentle making them promising in the treatment of patients with early stages of glaucoma, and not only in terminal glaucoma with pain syndrome resistant to conventional treatment ("last resort surgery").


Asunto(s)
Glaucoma , Terapia por Láser , Terapia por Luz de Baja Intensidad , Glaucoma/diagnóstico , Glaucoma/cirugía , Humanos , Presión Intraocular , Tonometría Ocular
11.
Vestn Oftalmol ; 136(5. Vyp. 2): 191-196, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33063963

RESUMEN

One of the research directions of the so-called non-motor manifestations of Parkinson's disease (PD) is associated with the assessment of structural and functional changes in the organ of vision. An assessment of the state of thin non-myelinated corneal nerve fibers (CNF) in Parkinson's disease seems to be promising considering the neurodegenerative nature of the disease, as well as the possibility of objective intravital assessment of both functional and structural changes in CNF. PURPOSE: To analyze the changes in the course and structure of corneal nerve fibers in the early stages of Parkinson's disease based on an objective algorithm of in vivo corneal confocal microscopy (CCM). MATERIAL AND METHODS: The study was conducted on a group of 16 patients aged 39 to 66 years with verified diagnosis of PD. In addition to standard neurological and ophthalmological examinations, all patients underwent IVCCM on a Heidelberg Retinal Tomograph device with special Rostock Cornea Module (HRT3 RCM), followed by processing of the obtained images using a uniquely designed analysis algorithm. RESULTS: A significant decrease in the directional anisotropy coefficient and an increase in the directional symmetry coefficient of the nerve fibers of the cornea were established (average values 3.15±1.08 and 0.92±0.04, respectively); in healthy individuals of the identical age range these indicators are 3.5±0.85 and 0.86±0.11, respectively. In addition, qualitative structural changes were noted, which consisted of an increase in the number of branches from the main nerve trunks, an increase in the tortuosity of CNF, multidirectionality, and "beaded" shape. In 9 cases, the presence of macrophages was revealed - dendritic Langerhans cells, which is an indirect sign of the inflammatory process. CONCLUSION: The preliminary nature of the results obtained in this study and the need for further research in this area are related, on the one hand, to a small sample of observations and, on the other hand, to the criterion used to assess the status of CNF based on a comparative analysis with conditionally normal indicators. In the future, in order to solve the problem of the uniqueness of changes in CNF and the possibility of using these changes as a marker for PD progression, longitudinal studies are required to reveal the presence or absence of a correlation between the stage of the disease, the results of known monitoring methods (e.g. electromyography) and quantitative indicators of the status of CNF.


Asunto(s)
Enfermedad de Parkinson , Adulto , Anciano , Anisotropía , Córnea/diagnóstico por imagen , Humanos , Microscopía Confocal , Persona de Mediana Edad , Fibras Nerviosas , Enfermedad de Parkinson/diagnóstico por imagen
12.
Vestn Oftalmol ; 136(4. Vyp. 2): 214-218, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32880142

RESUMEN

The article presents a clinical case of a functioning hyaloid artery in a 69-year-old patient. The results of OCT-angiography made it possible to detect the presence of blood flow in the projection of the persistent hyaloid artery (PHA) on the cross-section and en-face images. The vascular bed of PHA spreading along the posterior surface of the lens in the form of separate branches was visualized by slit-lamp biomicroscopy. The uniqueness of this clinical case lies in the low probability of such findings in the elderly. The presence of a developing cataract indicates the need for an individual approach in determining treatment strategies. In our opinion, the consistent use of laser coagulation technologies and laser photodestruction of PHA will minimize the risk of hemophthalmos and tractional retinal detachment during the upcoming cataract surgery.


Asunto(s)
Extracción de Catarata , Catarata , Cristalino , Vítreo Primario Hiperplásico Persistente , Desprendimiento de Retina , Adulto , Anciano , Humanos
13.
Vestn Oftalmol ; 136(4. Vyp. 2): 251-257, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32880147

RESUMEN

The review addresses the current state of atomic force microscopy (AFM) usage in ophthalmology. Briefly presented here are the history of the development of AFM, principles and modes of operation, its advantages, disadvantages, as well as a comparison with other types of microscopy. The review describes the capabilities of AFM in visualization of various structures of the eye. A significant part of the review is devoted to the study of the retina, which arouses great interest among researchers. In particular, the possibilities of AFM for visualization at the submicron level of various structures in the retina, such as the internal limiting membrane, membrane cells, Müller cells, retinal pigment epithelium in their normal state and in the presence of a pathology (age-related macular degeneration, diabetes mellitus) were reviewed. In addition, several study papers were analyzed, providing a base for the judgement of the mechanical properties of said structures. An AFM study of the visual pigment rhodopsin helped identify its dimeric structure. The stability of the rhodopsin molecule was proved to be determined by the degree of strength of its individual segments connected to each other. The AFM method is a highly accurate method that helps solve many fundamental and practical problems, particularly in ophthalmology.


Asunto(s)
Oftalmología , Retina , Microscopía de Fuerza Atómica , Rodopsina
14.
Vestn Oftalmol ; 135(5): 31-37, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31714510

RESUMEN

PURPOSE: To investigate the morphological and functional state of the outer and inner layers of the retina in patients with diabetes mellitus (DM) and nonproliferative diabetic retinopathy (NPDR), to determine the presence and nature of the relationships between structural and functional changes. MATERIAL AND METHODS: The study included 50 patients with subcompensated diabetes and NPDR and 40 people from the control group (healthy). All patients underwent OCT of the retina and optic nerve using RTVue-100 apparatus (Optovue, USA), as well as multifocal electroretinography (mfERG) and pattern electroretinography (PERG) on EP-1000 Multifocal device ('Tomey GmbH', Germany). RESULTS: When analyzing the results of OCT in patients with NPDR, a decrease in the total thickness of the retina and the thickness of its inner layers in the fovea and parafovea regions was found in comparison with the control group (p<0.001), thinning of the retinal ganglion cell (GCS) complex with increased focal losses (FLV) of up to 1.4% (Mann-Whitney test, p=0.001). In the group of patients with diabetes, there was a statistically significant decrease in the density and amplitude of P1 mfERG in all five 'rings' (Mann-Whitney test, p<0.001), increase in implicit time in the first 3 rings, decrease in P50 and N95 amplitude, increase in implicit time of N95 PERG (p=0.001) compared to the control group. CONCLUSION: The study revealed changes in the structure and functioning of the outer and inner layers of the retina in patients with NPDR, and established a reliable correlation between the morphological parameters (according to the OCT) and electrophysiological parameters (according to the mfERG and PERG data).


Asunto(s)
Retinopatía Diabética , Electrorretinografía , Humanos , Retina , Células Ganglionares de la Retina , Tomografía de Coherencia Óptica
15.
Vestn Oftalmol ; 135(5): 99-106, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31714520

RESUMEN

Small incision lenticule extraction (SMILE) keratorefractive surgery technique is a laser surgery alternative to common methods that doesn't require laser ablation of the cornea. Despite its novelty, SMILE technique has already demonstrated positive clinical results comparable to Photorefractive Keratectomy (PRK) and Laser-Assisted in Situ Keratomileusis (LASIK), which led to its widespread application in clinical practice. Compared with other keratorefractive techniques, SMILE has a number of distinct advantage including high biomechanical stability of the cornea, low risk of dry eye syndrome, absence of a corneal flap and associated complications, preservation of corneal epithelium. The article describes the most common SMILE modifications, its weak points and possible complications, as well as methods of additional correction of remaining ametropy.


Asunto(s)
Queratoplastia Penetrante , Queratectomía Fotorrefractiva , Córnea , Humanos , Queratomileusis por Láser In Situ , Láseres de Excímeros , Miopía/cirugía
16.
Vestn Oftalmol ; 135(2): 122-129, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31215543

RESUMEN

Laser surgery of the cornea, iris, angle of the anterior chamber and other parts of anterior segment of the eye sees wide application in clinical practice. The adverse effects it can cause in the anterior segment are well known and understood. At the same time, changes the treatment method can cause in the posterior segment of the eye - primarily, in macular area of the cornea, which is of great importance, have not been studied sufficiently. Purpose of the review - to consolidate previously published data on changes in the retina after laser intervention on the anterior segment of the eye.


Asunto(s)
Terapia por Láser , Retina , Segmento Anterior del Ojo , Glaucoma de Ángulo Cerrado , Humanos , Presión Intraocular , Iridectomía , Estudios Prospectivos
17.
Vestn Oftalmol ; 135(1): 53-58, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-30830075

RESUMEN

Herpesviruses involve neurotropic activity (they affect nerve cells) and have the ability to induce an immune response (a special tropism for immune tissue), which provides a valid reason for studying the possibilities of visualizing nerve fibers of the cornea and Langerhans cells (LC) in viral uveitis (with prospective applications in early diagnosis). PURPOSE: To evaluate the results of laser corneal confocal microscopy (CCM) in viral uveitis of varying localization. MATERIAL AND METHODS: The main study group included 23 patients (23 eyes) diagnosed with unilateral herpesviral uveitis (chorioretinitis), the patients' age varied from 18 to 79 years. The control group comprised 19 healthy volunteers (38 eyes) aged 20 to 75 years. In addition, the paired eyes of the main group patients were examined. In all patients, standard ophthalmologic examination was complemented with CCM performed on the HRT III device with a corneal module, followed by analysis of the course and structure of corneal nerve fibers (CNF) using copyrighted software Liner 1.2. CONCLUSION: The preliminary results achieved in this study outline the prospects for further research on the state of cornea (in particular, changes in the course and structure of CNF, and the presence of dendritiform cells of Langerhans) with laser CCM in patients with uveitis of various etiologies. These morphological changes also has potential use as diagnostic markers of inflammation of the uveal tract. The main criteria for assessing the state of cornea in viral uveitis include the following: increased tortuosity of CNF, increase in the number and size of Langerhans cells. Further research - in particular, studying the integrated use of diagnostic methods necessary for the verification of viral uveitis, as well as detailed analysis of the history and clinical picture of the disease - is required to substantiate the inclusion of laser confocal microscopy method in the algorithm for the diagnosis of viral uveitis.


Asunto(s)
Córnea , Uveítis , Adulto , Anciano , Córnea/diagnóstico por imagen , Humanos , Microscopía Confocal , Persona de Mediana Edad , Fibras Nerviosas , Estudios Prospectivos , Uveítis/diagnóstico por imagen , Uveítis/virología , Adulto Joven
18.
Vestn Oftalmol ; 134(5): 4-14, 2018.
Artículo en Ruso | MEDLINE | ID: mdl-30499533

RESUMEN

The article describes a newly developed and tested diffractive optical element (DOE) that converts non-uniform radiation of the laser output into a homogeneous ring. The Gerchberg-Saxton algorithm is shown to be well suited for achieving annular intensity distribution. Testing this ring transducer on threshold-plasticity cornea demonstrated the reversibility of axisymmetric changes in the cornea. Atomic-Force microscopy of the area of maximum stresses in the corneal periphery showed no significant changes in the structure of the cornea when irradiated in the selected mode. Measurement of Young's modulus of the corneal surface areas after their irradiation also revealed no changes in the elastic properties, while examination of the corneal structure demonstrated the absence of significant structural changes in irradiated samples compared with intact ones.


Asunto(s)
Córnea , Luz , Óptica y Fotónica , Córnea/cirugía , Humanos , Terapia por Láser , Rayos Láser
19.
Vestn Oftalmol ; 134(3): 57-64, 2018.
Artículo en Ruso | MEDLINE | ID: mdl-29953083

RESUMEN

The anterior capsular contraction syndrome (ACCS) in pseudophakic patients is known to be accompanied by postoperative opacity of anterior lens capsule (ALC) and partial or full closure of anterior capsulotomy opening. PURPOSE: To perform complex morphological assessment of ALC in patients with ACCS. MATERIAL AND METHODS: The study involved complex analysis of ALC that was removed due to ACCS in the pseudophakic eye in the setting of diabetes mellitus and past vitreoretinal surgery. The following examination methods were used: light-optical microscopy of ALC samples in the form of polychrome-colored semifine sections using optical microscope Leica DM-2500 (Germany), scanning microscopy of ALC surface with EVO LS10 (Carl Zeiss, Germany) microscope, analysis of chemical element composition and its variation of the ALC sample with energy-dispersive spectrometer Oxford X-Max50 (Oxford, UK). RESULTS: Light-optical microscopy showed altered state and plication of ALC induced by proliferation from inner surface of the fibrocellular tissue, which gradually thickens (up to 360 µm) towards center and causes reduction of anterior capsulotomy opening. Scanning electron microscopy revealed presence of tissue with uneven micro-relief and a porous three-dimensional structure uncharacteristic for capsule on the surface of ALC. Thickness of the fibrous deposition significantly exceeded the thickness of ALC. Evaluation of elemental composition of the fibrocellular tissue showed elevated concentration of sulfur and phosphorus, which indicates high activity of the regenerative process. In the observed case, the regenerative process was of substitute nature because an attempt to restore the lens was accompanied by formation of connective tissue structurally different from original. CONCLUSION: Complex assessment of an isolated ALC sample allowed revelation of the chain of pathological processes accompanying the development of ACCS.


Asunto(s)
Cápsula Anterior del Cristalino , Cristalino , Lentes , Capsulorrexis , Humanos , Complicaciones Posoperatorias
20.
Vestn Oftalmol ; 133(5): 92-97, 2017.
Artículo en Ruso | MEDLINE | ID: mdl-29165419

RESUMEN

This is a review of the literature on capsule contraction syndrome (CCS) in pseudophakic patients that involves severe fibrosis along the margin of the anterior capsule's opening and progressive contraction of the capsular bag. Possible causes of CCS and principles of its prevention and treatment have been analyzed.


Asunto(s)
Cápsula Anterior del Cristalino , Capsulorrexis/efectos adversos , Complicaciones Posoperatorias , Seudofaquia , Cápsula Anterior del Cristalino/patología , Cápsula Anterior del Cristalino/fisiopatología , Manejo de la Enfermedad , Fibrosis , Humanos , Complicaciones Posoperatorias/patología , Complicaciones Posoperatorias/fisiopatología , Seudofaquia/etiología , Seudofaquia/patología , Seudofaquia/fisiopatología
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