[Surgical management of infectious keratitis]. / Khirurgicheskie metody lecheniya infektsionnykh keratitov.

Infectious keratitis is one of the most common causes of blindness worldwide. Despite the existence of a wide arsenal of quite effective antimicrobial drugs, some forms of bacterial and viral keratitis are resistant. Advanced acanthamoeba and mycotic lesions of the cornea, as well as mixed forms of infection usually do not respond well to conservative treatment. In the absence of positive dynamics from the applied etiotropic therapy with observed further progression of the microbial process, there is a risk of corneal perforation and spread of infection to the sclera or deep ocular structures with a high probability of irreversible functional disorders or anatomical death of the eye. In such cases, a timely transition to surgical treatment is necessary in order to maintain structural integrity of the eyeball. For this purpose, corneal crosslinking, microdiathermocoagulation, tissue adhesive, autoconjunctival plasty, amniotic membrane, corneoscleral flap coating, various combinations of these methods, as well as therapeutic keratoplasty are used most often in clinical practice. The choice depends on the etiology, size and depth of the lesion, its localization, prognosis of visual outcomes, somatic status of the patient. Therapeutic keratoplasty is the most radical and effective method of surgical intervention that allows eradication of the infectious focus and best possible restoration of the structural integrity of the eyeball. However, in some cases due to inaccessibility of donor material or high risks of the surgery and non-transparent graft engraftment, it is advised to use alternative surgical approaches, and keratoplasty, if necessary, should be carried out for optical purposes at a further, "quiet" period.

[Modern biotechnological treatment methods of persistent corneal epithelial defects]. / Biotekhnologicheskie metody lecheniya persistiruyushchikh epitelial'nykh defektov rogovitsy.

The article reviews modern methods of treatment of persistent corneal epithelial defects and considers the factors involved in the development of this pathology, including the limbal stem cell deficiency, which is likely to play the main role. The most promising treatment methods are described, particularly the use of blood derivatives and cell therapy.

[Ipsilateral automated anterior lamellar rotational autokeratoplasty in the treatment of superficial central stromal opacity]. / Ipsilateral'naia avtomatizirovannaia peredniaia posloinaia rotatsionnaia autokeratoplastika v lechenii poverkhnostnogo stromal'nogo tsentral'nogo pomutneniia.

Corneal opacity is one of the main causes of monocular blindness in the world. Various modifications of keratoplasty are considered radical, effective - and in some cases the only - way of visual rehabilitation of this category of patients. The article describes a case of using the original surgical method of ipsilateral automated anterior lamellar rotational autokeratoplasty. Application of the described surgical technique made it possible to preserve the advantages of the known methods of ipsilateral rotational penetrating autokeratoplasty (IRA) and to level out their main disadvantages. In addition, the use of anterior lamellar rotational autokeratoplasty allowed the endothelial layer of the cornea to remain intact; its decompensation is one of the main reasons for unsatisfactory outcomes of penetrating keratoplasty. The use of a microkeratome device and the formation of an interface between the layers of its own tissues made it possible to achieve clinically insignificant violation of light scattering in this zone. With the right choice of a patient with shallow local central corneal opacity and careful planning of the original method, ipsilateral lamellar rotational automated autokeratoplasty can be an alternative to both standard penetrating and lamellar allokeratoplasty.

[Ophthalmic Rosacea: etiopathogenesis and modern treatment methods]. / Oftal'morozatsea: étiopatogenez i sovremennye metody lecheniia.

Rosacea is a multifactorial chronic inflammatory disease with various clinical manifestations. Primarily it is seen as a dermatological condition, but it's not uncommon for it to develop ophthalmological implications affecting eyelids, cornea and conjunctiva. The article describes main aspects of its etiopathogenesis, variations in its clinical course and treatment approaches. There is currently no universal treatment strategy for the disease due to its varying clinical manifestation, particularly of its ophthalmological form, differing severity of the pathological process, lack of knowledge about its etiology and pathogenesis. Leading role in its pathological process belongs to disturbance of regulatory mechanisms of the vascular, immune and nervous systems. Additionally, higher levels of metalloproteinases and vascular endothelial growth factor (VEGF) can be observed. Possible influence of a range of micro-organisms also hasn't been excluded. Basic therapy involves both systemic and topical drugs. The first include tetracycline antibiotics. A new direction in Rosacea treatment that aims at structural and functional restoration of vascular endothelium, improvement of microcirculation and recovery of rheological properties of blood is angioprotector therapy, in particular with Calcium Dobesilate (Doxi-Hem). Aside from systemic drugs, the ophthalmological forms of Rosacea are treated topically with anti-inflammatory preparations, immunosuppressants and artificial tears that are chosen depending on the symptoms' severity. In cases with heavy corneal damage, various types of keratoplasty can be performed. Collaboration between ophthalmology and dermatology specialists is necessary in order to choose adequate strategy for Rosacea treatment.