[Advanced endoscopic vacuum therapy for anastomotic leakage in the upper gastrointestinal tract]. / Usovershenstvovannaya endoskopicheskaya vakuumnaya terapiya pri nesostoyatel'nosti anastomozov verkhnikh otdelov zheludochno-kishechnogo trakta.

OBJECTIVE: To evaluate the effectiveness and clinical aspects of advanced endoscopic vacuum therapy for esophagogastric, esophagointestinal and gastrointestinal anastomotic leakage, to identify disadvantages and further possibilities for its improvement. MATERIAL AND METHODS: The study included 69 people. Esophagodudodenal anastomotic leakage was detected in 34 patients (49.27%), gastroduodenal anastomotic leakage - in 30 patients (43.48%), esophagogastric anastomotic leakage - in 4 (7.25%) patients. Advanced endoscopic vacuum therapy was used for these complications. RESULTS: Vacuum therapy in patients with esophagodudodenal anastomotic leakage led to complete healing of defect in 31 (91.18%) cases. In 4 (14.8%) cases, minor bleeding was noted during replacement of vacuum dressing. There were no other complications. Three (8.82%) patients died from secondary complications. Treatment of gastroduodenal anastomotic failure resulted complete healing of defect in 24 (80%) patients. Six (20%) patients died including 4 (66.67%) cases associated with secondary complications. Vacuum therapy for esophagogastric anastomotic leakage resulted complete healing of defect in 4 (100%) patients. CONCLUSION: Advanced endoscopic vacuum therapy is a simple, effective and safe method of therapy for esophagogastric, esophagoduodenal and gastrointestinal anastomotic leakage.

[Practical application of ophthalmic nutraceuticals in patients with dry form of age-related macular degeneration]. / Primenenie oftal'monutritsevtika pri «sukhoi¼ forme vozrastnoi makulyarnoi degeneratsii.

Development and progression of age-related macular degeneration (AMD) is associated with insufficiency of protective antioxidant systems of the body. Nutraceutical medications can positively affect the course of the disease and the visual functions of patients with AMD. PURPOSE: To conduct a placebo-controlled clinical monitoring of visual functions in patients with dry AMD while taking a drug Complex that corresponds to the AREDS 2 formula. MATERIAL AND METHODS: The study included 90 people in 3 equivalent parallel groups, two of which were represented by patients with AMD who took the Complex for 3-6 months or Placebo for 3 months. The third group included healthy subjects of the same age. In addition to standard eye examination, participants underwent evaluation of the macular pigment optical density (MPOD), spatial-frequency contrast sensitivity (CS), photostress test, and reading parameters on the Salzburg Reading Desk device. The changes of blood plasma antioxidant activity (AOA) were also evaluated in the main group. RESULTS: By day 90 of the study, patients of the main group showed statistically significant (p<0.001) growth of MPOD from 0.24±0.13 to 0.32±0.1, reduction of photostress recovery time from 68.2±17.8 to 57.3±17.5 seconds, improvement of high-spatial-frequency CS - from 25.0±8.2 to 30.6±6.8 dB, increase of near visual acuity logMAR from 0.22±0.04 to 0.19±0.03 and reading speed, and decrease of reading mistakes. Statistically significant (p<0.05) reduction of in AOA was seen during the observation period from 1.52±0.16 to 1.68±0.16. Patients of the main group who received the Complex for 180 days demonstrated additional improvements of visual functions. CONCLUSION: The drug Complex corresponding to the AREDS 2 formula contributes to a significant increase in MPOD, improvements of visual functions and overall antioxidant status of patients, which confirms the feasibility of its use in patients with dry AMD.

[Medicamental correction of pathomorphological changes of the ocular surface in patients with steroid therapy intolerance after photorefractive keratectomy]. / Medikamentoznaia korrektsiia patomorfologicheskikh izmenenii glaznoi poverkhnosti u patsientov s neperenosimost'iu steroidnoi terapii posle fotorefraktsionnoi keratéktomii.

INTRODUCTION: The problems of controlling inflammatory and proliferative response of the retina and correcting tear production in the post-operative period after photorefractive keratectomy (PRK) have not been fully solved yet. Patients intolerable to local steroids require an alternative. One drug that covers those needs is Cyclosporine 0.05%. PURPOSE: To analyze clinical effectiveness of Restasis eye drops in solving inflammatory-degenerative response and tear production insufficiency (dry eye syndrome) for post-PRK patients with steroid eye drops intolerance accompanied with increasing intraocular pressure (IOP). PATIENTS AND METHODS: Retrospective analysis of 14 myopic patients (28 eyes) was conducted; mean patient age was 25.9±6 years; myopia was (-)5.65±1.5 Diopters of spherical equivalent (SE); corneal-compensated IOP was 16.98±3.68 mm Hg before the surgery. All patients underwent excimer laser correction (PRK or Trans-PRK) with Schwind Amaris (SCHWIND eye-tech-solutions). After epithelization, all patients were prescribed 0.1% Dexamethasone solution 4 times a day (with decreasing dosing frequency) for 2 months, as well as local lubricants. The article also describes a separate clinical case of subepithelial fibroplasia that occurred post-PRK and was successfully stopped. RESULTS: All patients had transitory IOP increase caused by local steroid therapy. Mean IOP at 1-month post-op was 20.5±7 mm Hg. At that point local steroids were replaced with 'Restasis' 0.05% (Cyclosporine) eye drops prescribed 2 times per day for 2 months. As the result, IOP values decreased to 16.2±3.21 mm Hg (without any additional therapy); at 6 months mean uncorrected visual acuity reached 0.98±0.05, best corrected visual acuity achieved 1.03±0.06 and SE was 0.04±0.12 Diopters. CONCLUSION: Local Cyclosporine ('Restasis') is the method of choice for regulation of inflammatory and degenerative response and tear production insufficiency (dry eye syndrome) for post-PRK patients with intolerance to steroid eye drops.

[Algorithm for choosing parameters for relex smile surgery]. / Algoritm vybora parametrov pri operatsii ReLEx SMILE.

Presently ReLEx Smile as a method of vision correction in refractive surgery is becoming increasingly popular in Russia and abroad. PURPOSE: to develop an algorithm for planning the surgery and choosing its parameters, and to assess the efficacy, safety and predictability of the results in the 6-month follow-up period. MATERIAL AND METHODS: The study involved 80 patients (159 eyes) with myopia of various degrees with a mean age of 33±6 years (25 to 44 years old). Preoperative BCVA was 0.99±0.04 (0.8 to 1.0), spherical equivalent (SE) was -5.14±1.9 (-10.0 to -1.5). All surgeries were planned and performed according to the developed algorithm. RESULTS: Results were analyzed 6 months postop. The average SE after the surgery was -0.08 D (-0.75 to +0.5). 79.5% of patients (126 eyes) were within ±0.5 D from target refraction, 6% of patients (10 eyes) received 1-2 lines of BCVA, in 87% (138 eyes) BCVA remained unchanged, 6% of patients (10 eyes) lost 1-2 lines of BCVA. 95% of patients (151 eyes) had UCVA of 0.8 and higher 6 month after the surgery, and 79% (125 eyes) achieved 1.0 vision. No significant intraoperative and postoperative complications had occurred. CONCLUSION: ReLEx Smile is an effective, safe and predictable method of myopia correction. The newly developed algorithm reduces the risks of complications. It may be recommended for practical use by surgeons performing ReLEx Smile.

[Possibilities for early diagnosis and monitoring of age-related macular degeneration].

High prevalence of age-related macular degeneration (AMD) among older adults and treatment difficulties at later stages make early diagnosis and disease monitoring an actual problem of ophthalmology. Although methods for identification of gene-positive groups are now available, genetic studies are not sufficiently widespread in our country to ensure screening for AMD risk. In this regard there remains a need to determine the earliest objective sings of the degenerative process and progression criteria. This paper reviews anatomically oriented functional methods of retinal examination at the onset of AMD and later in the course of the disease. Analysis of collected material will provide systematic understanding of current possibilities for early diagnosis and functional monitoring of AMD patients prior to the decrease of their visual acuity.

[The role of changes in the subfractional compound of tear fluid in the assessment of damaging effect from soft contact lenses and the excimer laser ablation of the cornea].

The method of laser correlation spectroscopy (LCS) was used for the examination of the subfractional compound of tear fluid in patients who have been using soft contact lens (SCL) for a long period and before and after the excimer laser correction with transepithelial photorefractive keratectomy (Trans PRK). Based on the analysis of biological material of 141 patients aged from 18 to 33 years old, we can conclude that prolonged usage of SCL leads to catabolic processes in surface of the anterior segment of the eye and, as a result, to changes in the qualitative composition of the tear fluid. The amount of low molecular weight fractions and medium weight ingredients increases after transepithelial photorefractive keratectomy, which can characterize reparation processes after cornea ablation. Based on the results of our study we can conclude that LCS--is express analysis, with which we can diagnose and observe the initial changes in local metabolism in the anterior segment of the eye, when the objective breaches have not seen yet.

[Computer method for evaluating disorders in sense of color]. / Komp'iuternyi metod issledovaniia narushenii tsvetooshchushcheniia.

A new method for evaluating disorders in the sense of color has been developed and offered for practice. A total of 340 patients with diseases of the retina and optic nerve and 80 normal subjects were examined. The results indicate that different conditions of examination, selection of combination by the color, brightness, and deepness of the stimulus and background allow detection of decreased sensitivity of one, two, or three color perceptors (disorders in sense of color--color blindness) and permit a quantitative evaluation of functional disorders in the color channels of visual system. The new method can be used in the diagnosis of the initial pathological processes of different origin, involving the cone system at any level of visual route and associated with acquired disorders in color vision.

[A new method of assessing contrast sensitivity in patients with eye diseases]. / Novyi metod issledovaniia kontrastnoi chuvstvitel'nosti v klinike glaznykh boleznei.

A new method for examining spatial contrast sensitivity (SCS) is described, making use of the display of an IBM-compatible computer, on which sinusoidal patterns are presented: achromatic and chromatic red, green, blue against the black background at a frequency of 0.5 to 22 cycles/degree. In health similarity of curves to the achromatic and chromatic patterns was observed, with the maximal sensitivity at spatial frequencies from 2 to 8 cycles/degree and a reduction at low and high spatial frequencies. In patients with the initial open-angle glaucoma the SCS at the high spatial frequencies was reduced for all colors with "dips" at the medium spatial frequencies in response to the blue pattern. In patients with albinism the SCS to achromatic and chromatic patterns were appreciably decreased in the entire range of spatial frequencies and absent at all in the range of high spatial frequencies. The method is recommended for investigating the channels of achromatic and chromatic spatial sensitivity, detecting the contribution of color receptors to the color contrast, and for the initial diagnosis of diseases of the retina and optic nerve.

[Clinico-physiological characteristics of albinism]. / Kliniko-fiziologicheskaia kharakteristika al'binizma.

Visual functions in albinism were examined by psychophysiological and electrophysiological methods. Impaired functioning of light, brightness, and contrast channels of the visual system was revealed, as well as specific electrophysiological parameters typical of this condition: increased wave a and shortened latent periods of waves a and b on the total ERG, reduced amplitude and a shorter latent period of P-100 peak of visual evoked potential, prolonged latent periods of waves a and b of local ERG, and increased amplitude of waves a and b of L-ERG.

[Color campimetry in the diagnosis of diseases of the retina and optic nerve]. / Tsvetovaia kampimetriia v diagnostike zabolevanii setchatki i zritel'nogo nerva.

Color campimetry was realized with the use of an IBM-compatible computer display with a program permitting the registration of brightness sensitivity thresholds and the time of sensorimotor reaction to visual stimuli offered on the display in each point of the visual field. Investigation of light and color sensitivity thresholds and of the time of sensorimotor reaction to stimuli of different spectral composition in normal subjects helped study the functional topography of the retina by the time of sensorimotor reaction and by the brightness sensitivity thresholds. The methods of equalization by the brightness of the stimulus and background by means of recording the time of sensorimotor reaction was tried in experiments with different background brightness and stimulus size and in ophthalmologic examinations of patients with color abnormalities, diseases of the retina and optic nerve, with glaucoma and albinism.