Digital chromovitrectomy in the treatment of Valsalva retinopathy (clinical case)
Authors: Stebnev S.D., Stebnev V.S., Skladchikova N.I., Vashchenko T.Yu.
Organization: Samara State Medical University, Clinic "Eye Surgery"
Purpose: to present a clinical case of Valsalva retinopathy in a patient treated using a new technology "digital chromovitrectomy". The choice of the treatment method was determined by the duration of the disease, the localization of the hemorrhage, its area and depth of location relative to the structures of the vitreomacular interface. For surgical treatment, digital chromovitrectomy was used: 3D visualization (NGENUITY, Alcon) with Digitally Assisted Vitreoretinal Surgery software, the CONSTELLATION surgical system and the new UltraVit ® 25+ beveled vitractor (10000 cut/min) in combination with Triamcinolone acetonide. A rapid positive anatomical and functional result of treatment shows that modern vitrectomy provides an effective and safe treatment of Valsalva retinopathy.
Keywords: Valsalva retinopathy, Valsalva Maneuver, chromovitrectomy
Best vitelliform macular dystrophy is a rare pathology diagnosed after successful cataract surgery (clinical case)
Authors: Stebnev V.S., Stebnev S.D., Skladchikova N.I., Vashchenko T.Yu.
Organization: Clinic "Eye Surgery", Samara State Medical University
Purpose: to describe a rare pathology of the macular area — Best vitelliform macular dystrophy (BVMD), diagnosed in an adult patient after successful bilateral cataract surgery with intraocular lens implantation. The clinical examination and ОСТ examination made it possible to diagnose a homogeneous monofocal focus of yellowish color ("egg yolk") in both eyes in the projection of a rounded fovea. On ОСТ of both eyes, a smoothed foveolar contour was diagnosed, the cause of which was a projecting cone-shaped hyperreflective vitelliform material spreading from the destroyed and atrophied retinal pigment epithelium and Bruch membrane to the photoreceptor layer of the retina. The described clinical case shows that one of the rare causes of low visual acuity in an adult patient may be BVMD — a disease that requires dynamic monitoring and, first of all, ОСТ control.
Keywords: Best vitelliform macular dystrophy, cataract surgery, optical coherent tomography
Sports-related closed eye injuries (review)
Authors: Sobolev N.P., Shkandina Yu.V., Ebzeeva Z.R., Ibragimova R.R., Ragimova L.F.
Organization: A.I. Yevdokimov Moscow State University of Medicine and Dentistry, The S. Fyodorov Eye Microsurgery Federal State Institution
The proportion of sports injuries in the overall structure of eye injuries is relatively small. However, the sports eye injuries, the prevention and treatment of its consequences have a great urgency and social significance, because most of these patients are young, able-bodied and are aimed at constant physical progression. The review presents works published between 1972 and 2021, available for study in the main scientific databases: PubMed, eLibrary.ru. The literature examination focused on sports eyeball injuries. The final analysis includes 37 literary sources.
Keywords: closed injury, sports eye injury
Methods for intraocular lenses sutureless fixation (review)
Authors: Sobolev N.P., Shkandina Yu.V., Ibragimova R.R., Soboleva M.A., Ebzeeva Z.R., Ragimova L.F.
Currently, there is no single surgical treatment tactic for pathology in the ligamentous apparatus of the lens, what induced by different approaches to intraocular lenses fixation and clinical picture polymorphism. The review presents works published over the past 30 years and available for study in the main scientific databases: PubMed, eLibrary.ru. The literature review allowed a detail assessment of the advantages and disadvantages of surgical approaches to scleral sutureless fixation of intraocular implants. The final analysis includes 50 literature sources.
Keywords: extracapsular fixation, sutureless scleral fixation
Heart rate variability in patients with axial myopia
Authors: Rozanova O.I., Lodeyshchikova E.S.
Purpose: to analyze heart rate variability and parameters of autonomic regulation in patients with emmetropia and axial myopia. Material and Methods. 30 volunteers (with emmetropic and myopic refraction) aged from 23 to 30 years were examined. In addition to the standard ophthalmological examination, everyone underwent cardiointervalography (Varicard 2.51, Ramena, Russia). Results. In patients with myopia, a significant decrease in the total power of the spectrum of cardiac oscillations (p=0.034) and the activity of the parasympathetic link of the autonomic nervous system (ANS) (p=0.046) was revealed. The value of objective refraction was statistically significantly correlated with the parameters of vegetative regulation and the adaptive status of the organism. Conclusion. The general indicators of the activity of regulatory systems in patients with myopia differ from the control in terms of the total power of the spectrum of cardiac oscillations and the activity of the parasympathetic innervation link. An increase in the degree of myopia is consistent with a decrease in the total regulatory activity on the part of the ANS and an increased shift in the balance of the ANS towards the predominance of the sympathetic component.
Keywords: autonomic nervous system, heart rate variability
Effect of intraoperative panretinal laser coagulation on the morphometric parameters of the macular region in patients with diabetic retinopathy in the early follow-up period
Authors: Petrachkov D.V., Baryshev K.V., Arzukhanov D.D.
Purpose: to assess the effect of intraoperative panretinal laser coagulation on the macular region status of the retina within one month after vitreoretinal surgery. Material and Methods. 26 patients (30 eyes) were examined. The study protocol included standard ophthalmological examination methods, spectral optical coherence tomography (ОСТ) of the retina, microinvasive subtotal vitrectomy with or without intraoperative panretinal laser coagulation (PLC). The first group consisted of 16 patients (18 (60%) eyes) who underwent intraoperative PLC. The second group included 11 patients (12 (40%) eyes) who did not undergo intraoperative PLC. Results. The analysis of the results obtained during the examination of groups of patients before surgery and in the early postoperative period did not reveal a significant decrease in the central retinal thickness (CRT) and the volume of the macular region in patients of the first group. A significant decrease in these indicators was observed only in patients of the second group. Comparative analysis of the morphometric parameters of the retina between the two groups of patients did not reveal significant differences. Correlation analysis revealed a moderate relationship between the CRT, macular volume and changes in these indicators between planned visits. Conclusion. In the course of the study, was demonstrated the absence of a significant effect of intraoperative PLC on the anatomical status of the macular region.
Keywords: diabetic macular edema, diabetic retinopathy, optical coherent tomography, panretinal photocoagulation
Accelerating regeneration of eye socket bone defect by modifying xenogenic elastin biomaterial
Authors: Lebedeva A.I., Shangina O.R., Nigmatullin R.T., Gareev E.M., Kutushev R.Z.
Organization: Bashkir State Medical University of the Russian Health Care, Russian Eye and Plastic Surgery Center
Purpose: to identify the morphological aspects of the replacement of transplanted preserved and modified xenogenic elastin biomaterials in the rat eye socket defect. Material and Methods. Wistar rats were given a 7x4 mm defect in the upper wall of the eye socket. Wistar rats were treated with a 7x4 mm defect in the upper edge of the orbit. In the first experimental group (n=30), a preserved xenogenic elastin biomaterial (pXEBM) was placed in the defect zone, and in the second experimental group (n=30), a modified porous xenogenic elastin biomaterial (mXEBM) was placed. In the control group (n=30), soft tissues were sutured in layers. The tissues were excised after 1, 3, 6 and 12 months. Histological methods were used. Results. Grafts have osteoinductive, osteoconductive properties and are replaced by a full-fledged bone regenerate. After implantation, the mXEBM was replaced 2 times fasterthan the pXEBM. In the con- trol group, after 1 year, the bone defect did not spontaneously recover. Conclusion. Xenogenic biomaterials based on elastin are ultimate biomimetics. The porosity of the graft significantly accelerates the course of bone repair processes.
Keywords: regeneration, xenogenic elastin biomaterial
Quality of life comprehensive assessment for patients in surgical treatment of primary open-angle glaucoma
Heading: Тhematic supplement Article type: Short message
Authors: Kurbanov S.A., Gabdrakhmanova A.F.
Organization: Bashkir State Medical University of the Russian Health Care, City clinical hospital 10 Ufa
Purpose: to analyze the dynamics of quality of life (QoL) indicators during the primary open-angle glaucoma surgical treatment. Material and Methods. The study group consisted of 25 patients with primary open-angle glaucoma (POAG) aged 51 to 80 years. They have performed an antiglaucomatous operation — sinusotrabeculectomy. Before surgery and 1 month after, the quality of life indicators were assessed using the following questionnaires: MOS SF-36, visual analogue scale, VFQ-25, GQL-15, and hospital scale of anxiety and depression. Results. Intraocular pressure (IOP) decreased from 37.9±11.0 to 15.6±5.0 mm Hg. The analysis of the results of the SF-36 and the visual analogue scale did not reveal any changes in the dynamics (p>0.05). According to the VFQ-25 questionnaire, improvements in indicators were recorded on the following scales: "social functioning" from 75±20.0 to 83.75±17.5 points, "mental health" from 47.5±25.0 to 65±15,0 points, "role limitations" from 50.0±37.5 to 76.6±17.5 points (p<0.05). According to GQL-15, the indices before treatment were 33.6±22.0 points, 1 month after the treatment, the indices deteriorated to 38.8±23.0 points (the norm was not more than 15 points, p<0.05). According to the questionnaire of the hospital scale of anxiety and depression, clinically expressed forms of anxiety (13.0±6.0 points) and depression (12.0±3.0 points) were found, which did not change significantly overtime. Conclusion. QoL analysis during the glaucoma surgical treatment revealed no changes in parameters overtime, despite the clinical improvement in the course of the disease (decrease in IOP). Improving the quality of life of patients is considered an important component in the evaluation of glaucoma therapy, therefore, it is necessary to develop methods to improve the QoL of patients with POAG receiving surgical treatment.
Keywords: change in quality of life, primary open-angle glaucoma, sinusotrabeculectomy
Femtolaser arcuate keratotomy in the correction of corneal astigmatism during cataract surgery
Authors: Kulikova I.L., Timofeyeva N.S.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution, Chuvash postgraduate Doctors' Training Institute
Purpose: analysis of the clinical and functional results of astigmatism correction using the developed algorithm during femtolaser-assisted cataract extraction. Material and Methods. 25 patients were operated on by femtolaser-assisted cataract phacoemulsification with arcuate keratotomy according to the proposed astigmatism correction algorithm. On the 3rd day, after 3, 6 and 12 months, the indicators of uncorrected (UCVA) and maximally corrected visual acuity (MCVA), refractive and corneal astigmatism were determined. After 12 months, a graphical vector analysis was performed, efficiency, predictability and safety were evaluated. Results. 12 months after the operation, the indicators of UCVA were 0.60±0.16, MCVA0.65±0.35 (pw<0.05). The cylindrical refraction component decreased from -1.89±0.87 to -0.85±0.26 (pw<0.05). The correction efficiency within the range of >0.5 was 90%. The predictability of the cylindrical refraction component ±0.5 diopters was 68%; ±1.0 diopters was 92%. Graphic vector analysis revealed a decrease in the centroid size (0.24 ax 129° to 0.18 ax 103°). Conclusion. Correction of corneal astigmatism according to the proposed algorithm, including the calculation of parameters to the developed nomogram and compensation of cyclotorsia, allows to effectively correct astigmatism during femtolaser-assisted cataract phacoemulsification.
Keywords: femtosecond laser, cataract, astigmatism, arcuate keratotomy
Evaluation of clinical efficacy of a three-piece intraocular lens scleral fixation in patients with lens luxation into the vitreous body
Authors: Kuzmin S.V., Arkhipov E.V., Rozanova O.I.
Purpose: to analyze the results and to evaluate the clinical efficacy of a three-piece MN60AC IOL scleral fixation by the Yamane method in patients with lens luxation into the vitreous body. Material and Methods. 40 patients (40 eyes) with lens luxation into the vitreous body were examined. Mean age was 63±9 years (18-82 years). Surgical treatment with implantation and scleral fixation of a three-piece IOL using the Yamane method was performed. The IOL was calculated using the Lenstar LS 900 Haag-Streit optical biometer. The IOL position was evaluated postoperatively by ultrasound biomicroscopy and the resulting refraction. Results. In the postoperative period, there was a significant improvement in the visual acuity (p=0.001). According to the refractometry data, in the postoperative period, an increase in astigmatism was detected by an average of 1 dptrwith a change in its type. According to ultrasound biomicroscopy 85% of patients in the vertical meridian showed an IOL slope, which averaged 5.0±1.3 degrees (from 3 to 7 degrees). Conclusion. High functional results and a small number of complications prove the clinical effectiveness and safety of the three-piece IOL fixation using the Yamane method in patients with lens luxation into the vitreous cavity. For a detailed explanation of the obtained refractive results, further research is necessary with the inclusion of a larger number of patients and an increase in the follow-up period.
Keywords: intraocular lens luxation, intraocular lens scleral fixation, refraction, Yamane method