Search

The paper presents the results of a long-term (up to 2-year) clinical monitoring of 30 patients operated on for leukomas of various etiology, who were a high risk group and received the oral cyclosporine HEXAL postoperatively. Three types of the course of a postoperative period were identified. These included: an absolutely favorable course in 33.3% of cases (Group 1), a relatively favorable one in 30% (Group 2), and an absolutely unfavorable course in 36.7% (Group 3). The studies demonstrated that cyclosporine diminished the degree of an inflammatory reaction and promotes its rapid relief and better functional results in the late postoperative period. Transparent and semi-transparent engraftment could be achieved in 63.3% of cases. The causes of poor outcomes (in 36.7%) may be the inadequate doses of the cyclosporine and the time of its administration (unsteady-state blood cyclosporine concentrations (TO), the inadequate efficiency or initial inefficiency of immunosuppressive therapy.

The paper presents the results of a long-term (up to 2-year) clinical and immunological monitoring of 25 patients operated on for leukomas of various etiology, who were a high risk group. The objective of the study was to clarify the causes of the inefficiency of treatment with cyclosporine (Cs) and to develop specific indications for its usage. The autoimmune reactions against the cornea (a cellular response) were studied. The levels of cytokines (interferon (IFN)-gamma, IFN-alpha, interleukin (IL)-1beta, IL-2, IL-4, IL-8, and IL-10) and the markers of herpesvirus activation (IgM antibodies) were defined. Retrospectively, the patients were divided into groups according to the pattern of a postoperative period and to the type of immunograms: moderately reactive (n = 6 (24%)), hyperreactive (n = 6 (24%)), and areactive (n = 13 (52%)). The findings suggest that the inefficiency of treatment using the Cs dosage regimens may be due to the wide variability and specific features of immunological responsiveness in particularly critically ill patients. In the authors' opinion, areactive patients (most of them were the post-burnt) need the most careful approach. Overall, the findings suggest that it is necessary to strictly select a Cs dosage regimen on an individual basis and to correct it during clinical and immunological monitoring.

The paper analyzed the immediate and late results (the state of intraocular pressure and visual functions) of combined surgery for cataract and glaucoma, by using the developed instrument. Eighteen patients (19 eyes) aged 54 to 92 years who had open-angle glaucoma or phacotopic glaucoma (dislocation of the lens to the vitreous body) and cataract underwent combined surgery involving extraction of cataract, its phacoemulsification with intraocular lens (IOL) implantation through the scleral tunnel, and sinus trabeculectomy (STE) performed with a perforator, the instrument developed by the authors. The findings confirm the efficiency of the combined surgery (STE) with cataract extraction through variously extended scleral tunnels in patients with open-angle glaucoma, normalizing intraocular pressure and improving visual functions by one-stage surgery. Combined surgery for cataract extraction with IOL implantation through the scleral tunnel and STE, which is performed with the instrument proposed by the authors, has been put into practice.

The paper presents the results of studying involutional changes in the accommodative apparatus of the eye in presbyopia by ultrasound biometry and biomicroscopy. Persons aged 40-70 years who had presbyopia and emmetropic refraction and without concomitant eye disease were examined. In addition to routine studies, all the examinees underwent ultrasound biomicroscopy and ultrasound biometry. The age-related lenticular enlargement was established to be accompanied by a considerable reduction in the orbicular space of the posterior chamber of the eye to the extent of its transformation to a slotted space. The presbyopic patients were found to have a significantly diminished tone in the middle and posterior portions of the lenticular ligamentous apparatus to the extent of its sag, with the altered direction of their passage between the crystalline lenticular equator and the ciliary body crown, i. e. from meridional to radial. The revealed significant age-related topographic and anatomic changes in the orbicular portion of the posterior chamber of eye and in ligamentous tone, which are associated with the involutional increase in the size of the crystalline lens point to the great importance of decreasing the working accommodation distance in the development of presbyopia.

The paper describes the stages of development of unique tests for strict threshold estimation of the color power of each retinal color (red, green, and blue) perception under the direction of Ye. N. Yustova. These threshold tables are shown to be more informative in the diagnosis of both congenital and acquired color visual disorders than all other existing appliances intended for either evaluation of color anomaly or detection of chromaticity (rather than color as an item of three components!). Due to their high informative value and, at the same time, easiness-to-use, and cheapness, the tables developed by Yustova et al. should be an obligatory attribute of an ophthalmologist's work place. For this, they should be reissued, by taking into account comments on the first edition, which are mentioned in the paper.

The paper provides the results of limbic transplantations in 21 patients with varying postburn leukomas. Autolimbic (n = 6; 28.6%) and limbic (n = 15; 71.4%) transplantation was performed 34.27 +/- 13 months after injury. Limbic transplantation with removal of the fibrovascular pannus resulted in improved visual acuity in all cases with the relatively transparent corneal stroma (Group 1; n = 10). In some cases, limbic transplantation could circumvent the problems associated with corneal graft epithelization after further corneal transplantations in Group 2 patients (n = 8) with turbid corneal stroma. In Group 3, surgery was made to prevent corneal changes occurring when the bulbar conjunctiva was removed during plastic repair of mucosal fornices from the lip. Postoperative recurrent corneal conjunctivization and epithelial erosion were observed only in 4 patients. The findings are of value in defining the site and indications for limbic transplantations in the surgical rehabilitation of patients who have experienced severe eye burns.

The paper presents the results of three-dimensional combined tear ultrasound analysis in various diseases accompanied by the dry eye syndrome. Sixty-five patients with clinical manifestations of the dry eye syndrome were examined. Of them, there were 20 patients with Sjogren's syndrome and disease, 25 with dry eye syndrome of unknown genesis, 5 with lachrymal gland tumorous lesion, 5 with cystic lacrimal gland changes (dacryops), and 10 persons above 65 years of age (a risk group). In each of the study group the study determined the mean sizes of a ultrasound section of the lacrimal gland, its mean volume, and densitometric indices, such as density and vasculogenicity index, as well as the mean values of hemodynamic parameters in the lacrimal artery. The characteristic echographic signs of lacrimal gland structural changes and vascularization are described in Sjogren's disease and syndrome, dry eye syndrome of unknown genesis, dacryops, neoplastic processes involving the lacrimal gland. The proposed algorithm of lacrimal gland ultrasound study can enhance the accuracy and validity of results of the differential diagnosis of various lacrimal gland diseases with the clinical manifestations of the dry eye syndrome. The findings may be further used for the monitoring and detection of three-dimensional and structural changes in the lacrimal gland, which result from various pathological processes with the clinical manifestations of the dry eye syndrome.

The paper presents the differential diagnostic signs of choroidal tumors, which are revealed by spatial ultrasound analysis of their angioarchitectonics. An algorithm of a study of the angioarchitectonics of choroidal tumors has been developed on the basis of the current ultrasound technologies that can combine B- and 3D-mode grey scale with energy and color Doppler mapping. Fifty-six patients (58 eyes) with various choroidal neoplasms, including 42 patients with choroidal melanomas, 6 with circumscribed choroidal hemangiomas, and 8 (10 eyes) with metastatic choroidal lesion, were examined. Analysis of the results of the study revealed the specific echographic features of each type of a tumor. The proposed procedure of ultrasound analysis makes it possible to expand the spectrum of the analyzed parameters of the angioarchitectonics, to locate spatially, and to trace the association of the neoplasmic vascular bed with the extraocular circulatory system, which is of great importance in choosing an adequate treatment option.

The paper deals with noninvasive YAG-laser surgery that is used in the treatment of hemophthalmia, particularly hemophthalmia of posttraumatic genesis. A Visulas YAG laser unit ("Karl Zeiss") was used for YAG laser radiation. Its energy parameters were 0.8 to 9.2 mJ; 2-10 impulses; 1-30 laser treatment sessions. YAG-laser radiation affected the altered part of vitreous body: from fresh blood to the emergence of hemophthalmia as adhesions and conglomerates. YAG-laser applied to pathological vitreous body changes in hemophthalmia is effective and causes their elimination with subsequent lysis. YAG-laser vitreolysis is the operation of choice in traumatic hemophthalmia and may be used not only as an independent surgical technique, but also an additional one in the surgical and medical treatment of hemophthalmia. YAG-laser application to the vitreous body reduces the time of treatment for traumatic hemophthalmia.

The paper describes a procedure for intraoperative diagnosis of Zinn's zonula defects in intraocular lens (IOL) implantation. Studies were made during treatment of 14 patients (14 eyes) with complicated cataract, in whom intraoperative endoscopic diagnosis of dislocation of the lens was made. The diagnosis of third-degree lenticular subluxation was verified in 9 patients; in 5 patients who were biomicroscopically diagnosed as having second-degree lenticular subluxation, its third-degree was revealed by intraoperative endoscopy. The paper provides strong evidence that the use of endoscopes in the surgery of the anterior ocular portion facilitates the diagnosis of lenticular ligamentous apparatus disturbances in the miotic rigid pupil, altered anterior segment due to injuries to the organ of vision, aids in defining the surgical treatment policy, the choice of a method for lenticular removal, and the type of an implanted IOL.

The paper gives the results of a follow-up of the clinical course and visual outcomes of penetrating keratoplasty (PK) in combination of corneal epithelial stem cell grafting (limbic transplantation (LT)) in 10 patients (10 eyes) in end-stage burn disease. For LT, autologous limbic grafts were used in 5 cases and allogenic ones were applied in 5 more cases. Visual outcomes were assessed in the periods of 2 months to 4 years and 3 months. A rather high visual acuity was obtained in the patients who had undergone PK in combination with autologous LT. The majority of patients with allogenic LT were observed to have a recurrence of keratoleukoma and less significant functional outcomes. Possible tissue incompatibility, followed by lysis of allogenic limbic grafts, and inadequate ocular surface moistening are considered to be main causes of recurrent corneal conjunctivalization. PK in combination with LT substantially increases the possibility of visual rehabilitation in patients with postburn total corneal leukomas. The use of autologous limbic grafts for these purposes is more effective as compared with that of allogenic ones.

The paper presents the comparative data of retinal tomography in the presence of choroidal neovascularization. In all patients, life-time morphometry of a 6x6-mm central retinal area (at 20 degrees from the point of fixation) was made on a retinal thickness analyzer (Talia, Israel). During the study, the authors analyzed the most significant indices: mean retinal posterior pole thickness; mean retinal paracentral region thickness; mean retinal central region thickness; mean neuroepithelial thickness above the subretinal neovascular membrane (SNM). Statistical analysis showed that the increase in neuroepithelial thickness was directly related to that in the intensity of SNM fluorescence. The mean neuroepithelial thickness above SNM, intra- and subretinal hemorrhages, intraretinal microcysts in patients with age-related macular degeneration and the presence and extent of thinning and fibrotic area permitted evaluation of the magnitude of activity and presumptively the duration of choroidal neovascularization.

The paper gives the results of electroretinographic and psychophysical studies in hypertensive patients with first-, second-, and third-degree blood pressure (BP) elevation. The most characteristic functional symptoms of hypertensive retinopathy were defined at different stages of its development. There may be impaired retinal bioelectrical activity and diminished contrast and color sensitivity both in the presence and absence of ophthalmoscopically visible changes. Based on the findings, the authors have developed a functional classification of hypertensive retinopathy in relation to the degree of BP elevation.

The paper provides the data of a 2-year monitoring of ocular refraction in 327 consecutive 10-14-year-old schoolchildren (654 eyes) unrandomized under natural conditions and cycloplegia. The authors studied whether there was an association of refraction and its changes with absolute and relative accommodation, habitual accommodation tonicity, the length of the anteroposterior optic axis, and the presence of pseudomyopathy and astigmatism. Over 2 years, myopia occurred in 15.4% of the eyes, its degree increased from -0.88 (-1.37/-0.50) to -1.25 (-2.31/-0.62) diopters. Criteria for myopia prediction were identified. These included a relative accommodation reserve of less than 2.5 diopters, an anteroposterior optic axis length of more than 24.33 mm, a habitual accommodation tonicity of less than + 0.41 diopters, the presence of pseudomyopia (77.8% of cases), reversed astigmatism and underlying emmetropia. A mathematical model was constructed for prediction of myopia, the proportion of its correct prediction being 90.4%, which makes it possible to recommend for clinical application.

The paper presents an algorithm of ultrasound spatial analysis of the unaltered lacrimal gland. The algorithm has been used to define its shape, size, density, structural features and the pattern of blood supply, as well as the anatomic and topographic position in the orbit. The study was conducted in the B- and 3D-modes of color and energy Doppler mapping on both sides. The procedure was based on the clinical examination of 40 healthy individuals aged 20 to 75 years who had no systemic vascular and lymphoid tissue lesions or functional impairments of the lacrimal gland itself. The study defined the mean values of the ultrasound section of the lacrimal gland: 1-1.8 and 0.5-0.8 cm for vertical and horizontal ones, respectively; the mean volume of the lacrimal gland of 0.66 to 1 cm(3) and the densitometric parameters (density and vasculogenicity index); three types of structural manifestations of the unaltered lacrimal gland were identified. The proposed algorithm of ultrasound study of the lacrimal gland may enhance the accuracy and validity of results in the differential diagnosis of various orbital diseases.

The paper presents the results of a computed tomographic study of extraocular muscles (EOM) in 75 patients (131 orbits) without orbital pathology and different forms of endocrine ophthalmopathology. It also gives data on changes in EOM density and structure. The outline of the muscles has been studied at different stages of edematous exophthalmos and endocrine myopathy. The obtained quantitative results of EOM changes allow one to make a differential diagnosis of different forms of endocrine ophthalmopathy and to plan treatment of these patients.

The paper presents the results of an investigation of the effect of the nootropic agents pantogam and nooclerine on visual functions in patients with primary open-angle glaucoma. These agents have been found to have a beneficial effect on the functional activity of the retina and optic nerve, light sensitivity, hemo- and hydrodynamics of the eye.

The paper deals with the basic pathogenetic aspects of development of orbital hernias--the factors of a tarsoorbital fascial change in the presence of the hereditary syndrome of connective tissue hyperplasticity and elevated intraorbital pressure, which affects the volume of orbital fat. The possibilities of a differential diagnosis of orbital hernias and eyelid edemas are considered. There is a biomechanical association of orbital hernias with acquired age-related enophthalmos. The examples of impairments in the tolerance of the optic nerve and in the development of optic neuropathy in enophthalmos are considered. The fact that there may be tarsoorbital fascial lesions, followed by the development of orbital hernias after parabulbar injections is indicated. The author proposes an operation dealing with the reposition of orbital hernias instead of their resection during blepharoplastic interventions.

The effect of steady-state nystagmus suppression has been found upon periodic light exposure of the eye. The paper describes the exposure facility and procedure based on the changes in the amplitude and frequency of light pulse until there is a response of a patient's nystagmus parameters that are continuously monitored by video-assisted computer system. After periodic light exposures, there was a persistent suppression of nystagmus and a steady-state increase in visual acuity by an average of 0.1.

The paper presents two classifications of the dry eye syndrome: the Madrid and Russian classifications. The creation of its classification is required for the elaboration of treatment policy for this category of patients. The classifications are based on the scientific data on the epidemiology, etiology, and pathogenesis of the dry eye syndrome. Each classification identifies different forms of the dry eye. The classifications virtually published at the same time do not greatly differ from each other and they reflect the current approach to systematizing different forms of the dry eye. The paper analyzes the Madrid versus Russian classifications.

The paper presents preliminary results of deep layer keratoplasty first performed in Russian ophthalmology. It describes its surgical techniques. Deep layer posterior keratoplasty was made in 3 patients with epithelial-and-endothelial dystrophy of the cornea. The operation was simultaneously made with ultrasound cataract phacoemulsification and intraocular lens (IOL) implantation artificial in one case. In the early postoperative period, the fixed position of a transparent keratograft was achieved and the epithelial layer also recovered without signs of bullous keratopathy. The immediate results of posterior keratoplasty inspire optimism. Deep layer keratoplasty is technically more difficult than penetrating keratoplasty, more painstaking and more prolonged. At the same time it has no shortcomings typical of penetrating keratoplasty. The procedure of deep layer keratoplasty requires further long-term study, simplification of surgical techniques, detection of possible complications, and modes of their correction.

The paper presents the results of studies made in patients with different stages of primary open-angle glaucoma, by using oscillatory potentials (OP). A significant inverse relationship was established between the OP index and the intraocular pressure; the OPI index was decreased in progressive glaucoma. The findings suggest that neuronal relationships are impaired in the proximal retina in glaucoma due to its ischemic processes.

There have been recent data on an important role of the rennin-angiotensin system (RAS) and its major effector--angiotensin-converting enzyme (ACE) in the pathogenesis of diabetes mellitus and its complications. The treatment for diabetes mellitus with ACE inhibitors (ACEI) has received wide recognition. By lowering blood pressure, ACEI improves endothelial function, positively affect carbohydrate metabolism, and exerts a nephroprotective effect. However, the role of ACEI in the treatment of diabetic retinopathy (DR) remains to be studied. This paper presents the results of a comprehensive clinicofunctional study of 36 patients with preproliferative DR before and after treatment with the ACEI perindopril. The agent has been found to have a positive effect on visual functions, retinal electrogenesis, and the state of the blood-retinal barrier.

This paper deals with refractive disorders in cataract surgery. The authors have studied the efficiency of eximer laser correction (LASIK) of astigmatism on pseudophakic eyes and proposed their own modification of the technology "Pre-flap" that provides the most advantageous conditions for laser correction. In addition, preflapping permits correction of astigmatism in the immediate period after cataract extraction, thus reducing the time of the patients' rehabilitation. Clinical and functional studies have provided evidence for the proposed procedure.

The paper describes the methods and results of multimodality treatment for progressive myopia in children and adolescents, by applying acupuncture, massage, and manual therapy. Thirty-three patients aged 7 to 17 years who had progressive myopia of 0.5 to 10.8 diopters were treated by an original procedure as repeated courses. Their follow-up lasted 2 years. A beneficial therapeutic effect as increases in uncorrected and subcorrected visual acuity, ocular accommodation reserves, and myopia regression rates was observed in 64% of the patients. Two-year myopia stabilization was achieved in 45% of cases. There were neither complications nor side effects. The possible mechanism of the remedial effect of the procedure is discussed in the paper.

This study was undertaken to detect and study the distribution, localization, and morphological features of the histamine-positive structures of the lens in intact animals. The paper presents a detailed account of fluorescent and morphological differences between the nuclei of different portions of the lens.

The paper compares the efficiency of infrasound and ultrasound phonophoreses. The efficiency was evaluated on the basis of the rate of radiotracers within the eye after infrasound or ultrasound exposure of the eyeball. The exposure was made after preliminary putting the radiotracer-impregnated application into the bulbar conjunctiva of an animal. Radioactivity was recorded on a Siemens gamma camera in its lifetime. The time course of changes in the radioactivities measured 10, 30, and 60 minutes after termination of exposures strongly suggests its stable increase in the eye exposed to infrasound. At the same time 10 minutes after ultrasound exposure, the increased concentration of a radiotracer in the eye was less than that after infrasound exposure and then it progressively decreased. Thus, having a significant phoretic activity, infrasound, as ultrasound, creates more favorable conditions for long drug storage in the eye.

The paper lays down the basic principles of ophthalmoplastic treatment on the basis of an analysis of the results of treatment and follow-ups of 2300 patients aged 6 months to 18 years who have abnormalities of the orbit and appendages of the eye. Emphasis is laid on the preference of methods for plastic repair, using local tissues, and free autologous grafting of the skin and mucosa. A soft material that is to be easy grown through, such as Carbotextim-carbonic felt, is recommended when contour plastic repair of the orbit is required. For hanging, a mersilene mesh should be employed in case of blepharoptosis. To achieve the better cosmetic results, it is better to operate at the age of more than 4 years; however, treatment should be initiated at the age of 1 year when there are available functional indications (symblepharon, ablepharia, or cryptophthalmus).

This paper presents the outcomes of 230 primary, advanced, and secondary implants of polytetrafluoroethylene orbital inserts manufactured by the closed joint stock company "Nauchno-Proizvodstvennyi Kompleks (Scientific-and-Production Complex) "Ekoflon" (Saint Petersburg). The duration of a follow-up was 6-36 months (mean 15.9 +/- 037 months). The accumulated experience suggests that polytetrafluoroethylene orbital inserts are noted for their biocompatibility, easiness of manual treatment, and simplicity of implantation. Thus, porous polytetrafluoroethylene orbital inserts are promising medical articles designed for the prevention and treatment of the anophthalmic syndrome.

The development of the programs analyzing the image of the fundus of the eye has aroused considerable interest in computer-aided diagnostic tools. At present the majority of such programs is based mainly on the analysis of information of the brightness and color of an image. The paper proposes a procedure for correcting the color images of the fundus of the eye, by lowering the impact of color differences caused by external causes, such as the spectrum of a light source, the spectral characteristics of ocular optical medium transmission, and those of a photo receiver. The procedure for correcting the color retinal images is to standardize the color of an image and makes it possible to use information on color with more confidence to recognize diseases of the eye grounds and the natural course of a pathological process.

The paper considers the armament development ultimately resulting in the predominance of using minor blasting assemblies and accordingly to a drastic prevalence (as high as 80%) of mine explosion injuries among other battle injuries to the eye. The particular severity of these injuries requires their efficient subdivision into types and severity, which is alleviated by the introduction of a new classification of mechanical injuries into the eyeball. It is obligatory for each ophthalmologist to know this classification. It is the ophthalomologist who may be the first specialist to start rendering an aid to the victim. In terms of the highest level of development of modern ophthalmological diagnosis and intraocular eye surgery, delivery of a patient to a specialized eye traumatological center where he/she will be given a comprehensive aid, including an intraocular one, in 3-7 days rather than the promptest surgical debridement (generally as just wound closure) is a master link in obviating the losses associated with eye injury. There is evidence that the same interregional centers as the army centers that have operated in Kabul and Rostov-on-Don should be set up preferably on the basis of multidisciplinary hospitals in the civil health care system. They could become an original testing area for researches of explosive injuries to the eye and a source of materials for making the centralized national register of eye injury.

The paper discusses the problems of abnormalities of the oculomotor apparatus and binocular vision, considers the topical aspects of the pathogenesis and treatment of amblyopia, gives data on the new methods of recording the binocular movements of the eye, and provides evidence for the tactics and stage sequence of surgical treatment for concomitant oculomotor disturbances.

The paper analyzes the topical problems of injuries to the organ of vision. It mentions the basic trends in the pattern of ocular traumatism. The ways of further studies of a number of issues of eye traumatology are defined. The significance of basic studies in solving the problems of eye traumatology is shown.

The paper generalizes the present-day principles of prevention of progressive and complicated myopia. The risk factors of complications and disability due to congenital and acquired myopia are defined. Methods of spectacle, contact, and surgical correction in congenital myopia are discussed. There is evidence for the importance of studies dealing with the etiological factors and pathogenetic mechanisms in determining the ways of preventing myopia. Recommendations are given for the prevention of disabling forms of myopia.

The paper covers the issues of blindness and disability associated with pathology of the organ of vision. It lists the principal causes of blindness in the developed and developing countries. Basic tendencies in solving the problems of blindness and weak sight are defined. The issues of disability due to pathology of the organ of vision and the ways of its reduction are discussed.

The present paper generalizes the tactical principles of the examination and treatment of patients with orbital fractures. The clinical signs of a fracture are evaluated, with emphasis laid on the significant and insignificant symptoms. Routine X-ray study is regarded as an inadequate diagnostic technique, computed tomography is presented as a basic procedure for detecting and detailing the specific features of the fracture. The cases (n = 161) are divided into 5 groups according to the types of fracture. The treatment sequence is defined, by taking into account the severity of injury. The time of reparative operations (early or late) is recommended in terms of the risk for ocular dysfunction. The principles of reparative and compensatory surgical techniques for different types of injuries, mainly by applying bony autografts and Carbotextim, are given.

The paper presents summarized data on the current approaches to correcting and diagnosing refractive disorders (primary and secondary ametropias, aberrations, and impaired accommodation).

The paper describes the current types of electroretinography, the origin of electric retinal activity and its role in the diagnosis, differential diagnosis, and monitoring of retinal diseases of various origin. It presents the electroretinographic symptoms typical of pathology of the retinal cone and rod system in some hereditary diseases whose genes have been mapped and cloned to date and whose pathogenesis specified. The current concepts of retinal remodeling in its dystrophic changes are produced and emphasis is laid on the necessity of using the progress of vision biology and physiology in ophthalmological practice.

The paper analyzes complications due to 500 orbital plastic repairs for traumatic deformities. Biomaterials (cadaveric cartilage/bone, allograft for orbital wall plastic repair, or xenopericardium) were applied in all cases. The lost orbital volume was also compensated for by Carbotextim-M. Damage to the inferior oblique muscle was the severest intraoperative complication. The bulk of complications in the early postoperative period were transient and implant displacement in the late periods required its position correction only in 4% of cases. The implant displacement-associated risk factors were as follows: male sex, childhood, application of a solid material (cartilage, bone), and its attachment failure. Purulent processes were local and encountered in 2% of cases. The low incidence of severe complications, as well as permanently high functional and cosmetic outcomes (during as long as 98.2 months) suggest that biografting of the lower orbital wall is effective.

The paper details the currently available psychophysical and objective diagnostic methods. Among the recently used improvements, there is enhancement of the capacities of a perimetric analysis, an objective control of fixations during multifocal electroretinography, confocal ophthalmoscopy of the retina, and its enhancement coherent optical tomography. Study of local visual activity, quantitative analysis of metamorphopsias, autofluorescence analysis of retinal pigment, and evoked visual multifocal potentials are regarded as innovations. Future developments of methods for functional studies of the organ of vision may follow several directions: improvement of available methods, development and application of new different methods, and estimation of the advantages of different studies.

The paper presents the comparative results of clinical and immunological studies dealing with the use of the physiological reparation regulators (the human amniotic membrane and systemic enzyme therapy) and the antimetabolite 5-fluorouracil (5-FU) to prevent excessive ocular tissue scarring. The clinical observations have demonstrated the high efficiency of the proposed methods for the physiological regulation of reparative processes as compared with the use of 5-FU, which manifested as a more marked normalization ofophthalmotonus and fewer numbers of postoperative complications. The investigation of the study of proliferation-activating cytokine (TGF-beta1) and antiprolerative cytokine (IFN-gamma) has demonstrated the immunomodulating properties of the physiological reparation regulators used in the present study.

The paper gives the preliminary results of an analysis of the metric characteristics of images in 40 patients with the anomalous outline of the lid slit of varying genesis, by applying an original computer program. The program is based on the principle of automatically finding the line of the true symmetry of the face, its paired fixed points, and the orientation of an image. Computer-aided estimation of the shape and width of the lid slit, the parameters of the lids along the conventional lines shows that the measurements are of high accuracy (0.1 mm for linear values and 0.1 for angular values). The paper analyzes the effect of modified resection of the superior tarsal muscle. In a patient with aponeurotic ptosis, the uplift of the upper lid was 4.1 mm (1.9 mm higher than that obtained by a pharmacological test). In the author's opinion, the proposed procedure makes it possible to solve the problems associated with the processing, storage, and transmission of images and with the assessment of relationships of the structures of the appendage of the eye.

The paper analyzes the diagnostic value of computed tomography (CT) in posttraumatic lesion of the eye socket, ball, and appendage and identifies the basic groups of patients in whom CT is an essential study. In 2004, the Department of Traumatology, Reconstructive Surgery, and Eye Prosthesis, Helmholtz Research Institute of Eye Diseases, performed CT in 323 patients (18.2% of the inpatients and 3.4% of the outpatients). Analyzing all CT images identified the basic groups of patients in whom this study was essential. The CT scans characterizing examples from each group of patients are given. The studies could extend indications in patients with posttraumatic lesion of the eye and orbital area for CT. The latter is an important and essential study in patients with traumatic pathology of the eye with multiple and hard-to-reach foreign bodies and with trauma of the soft and osseous structures of the orbit, which makes it possible to determine not only the possibility, but also pattern and scope of a surgical intervention and to assess its long-term result.

The paper deals with the analysis of the outcome of severe eye contusion in scleral ruptures that are subject to none or inadequate debridement. In 2004, a group of 85 patients undergone enucleation due to severe posttraumatic changes was examined to analyze the outcomes of misdiagnosis of ruptures of the scleral capsule of the eye in its contusions and penetrating wounds. Examination of the eyeball after its removal revealed different defects of the optic scleral capsule in 6 (8.2%) cases of the 85 patients undergone enucleation. Each case pointing to the undiagnosed pathology of the eye during primary debridement and surgical treatment of these patients or to the partial debridement of scleral wounds is noteworthy. It should be noted that a primary care involving debridement was delivered to virtually all patients in different ophthalmological facilities. The paper gives a detailed account of each case, by describing its history data, the state of the eye, the performed studies and operation, and presents photos demonstrating each case. In eye contusion, it is necessary to adequately evaluate its severity and to reveal the whole complex of injuries and also to pay attention to the quality of debridement of wounds since adequate containment of a wound of the eye and adaptation of its edges can preserve the eye as an organ in most given cases.

Solid-phase enzyme immunoassay was used to study the serum levels of the antiendoxin IgA, IgM, IgG antibodies and total immunoglobulins of classes A, M, and G in 62 patients (122 eyes) with type 2 diabetes mellitus at different stages of diabetic retinopathy. Patients with diabetic retinopathy concurrent with type 2 diabetes mellitus were found to have a significant imbalance of antiendotoxin immunity. The highest level of anti-lipopolysaccharide (LPS)-IgA was detected in patients with nonproliferative diabetic retinopathy that exhibited macular edema, single or multiple aneurysms, hemorrhages, portions of solid lipid exudate and preproliferative diabetic retinopathy, in addition to vascular changes. Much lower levels of anti-LPS-IgA were found in nonproliferative retinopathy in which only retinal vascular changes and in proliferative diabetic retinopathy were noted. The patients with proliferative diabetic retinopathy complicated by neovascular glaucoma were ascertained to have the lowest levels of antiendotoxin antibodies of all the classes. As compared with the control group, the patients of all groups had the decreased levels of anti-LPS-IgM. The paper presents the results of a correlation analysis of the relationship of the parameters of antiendotoxin immunity to the levels of total immunoglobulins.

The present paper presents the results of a study of hemodynamic features in 83 patients with intraocular tumors (74 uveal melanomas and 9 solitary choroidal hemangiomas), by applying high-frequency duplex scanning with color Doppler coding and Doppler spectral analysis of flows. The tumors in question are shown to differ in the qualitative and quantitative indicators of blood flow, which can be successfully used in the complex differential diagnosis and in the adjustment of management policy in the patients of this category.

The present paper deals with the study of the efficiency of oral use of the antioxidative drug Immugen (a complex of alpha-tocopherol, oubichinone, selenium aspartate, methionine, and soyabean phospholipids) on a rabbit model of severe alkaline-induced corneal burn. The investigations have indicated that addition of Immugen to the rabbit feed exerts a significant positive effect on the parameters of the local antioxidative system of the eye and causes an increase in the activity of superoxide dismutase and catalase, and, on day 14, in antioxidative activity. The early experimental periods were marked by a slight rise in the frequency of deep corneal ulcerations. Moreover, the long-term clinical effect of use of Immugen appears as a significant increase in the area of the transparency-preserving affected cornea. The findings suggest that the antioxidants can show their optimal effect in the complex therapy for burn processes, including the use of proteinase inhibitors.

The paper evaluates the clinical effectiveness of Vitrum Vision ("Unifarm") that contains a complex of carotenoids, vitamins, and trace elements, which is adapted to ocular tissue metabolic features, in the tired eye syndrome and senile macular degeneration. The use of Vitrum Vision in patients with the tired eye syndrome improved the basic parameters of photosensitivity and increased the reserve of relative accommodation and in those with myopia enhanced uncorrectable visual acuity, ameliorated the magnitude of subjective visual and ocular symptoms, and increased the duration of a visual load until sensations of eye tiredness appeared. The administration of the drug in all clinical forms of senile macular degeneration increased visual acuity, improved the basic parameters of photosensitivity, enhanced the functional activity of neurons in the central portions of the retina (as shown by electrophysiological studies) while that in the subretinal neovascular membrane diminished retinal edema, improved the patients' general condition, far vision, and increased comfort on reading.

The paper presents the results of surgical treatment in 12 (12 eyes) infants aged 3 to 11 months who had different forms of unilateral congenital cataract. The surgical techniques involved the following stages: formation of a sclerocorneal tunnel cut, 3.5 mm in width, anterior continuous circular capsulotomy (anterior capsular rhexis), aspiration-irrigation techniques for removal lens masses, implantation of a flexible intraocular lens (IOL) into the capsular sac, graded opening of the posterior capsule with anterior vitrectomy in some infants. The authors could achieve symmetrical capsular rhexis in 75% and intracapsular IOL fixation in all the cases. During 3-month-to-2-year follow-ups after surgery, IOL held its position in the capsular sac; IOL dislocation and lenticular body capture were not observed in any case.

The paper outlines the clinical and morphological picture of 6 sympathizing eyes enucleated in 1996 to 2003 after vitrectomy and other endovitreal interventions into early injured or operated eyes. Resurgery was attempted early after wounds or a primary operation on the average following 20 days. Sympathetic ophthalmia (SO) generally occurred in the posterior uveal tract as panuveitis or posterior uveitis and diagnosed in the late periods. Specific granulomatous inflammation in the uveal tract was observed in all eyes and the morphological feature of sympathizing eyes was the spread of an inflammatory process to the retina with the development of the latter's epithelioid-cell granulomas and adhesive chorioretinitis. The authors also discuss the possibility of additional antigenic stimulation accompanied by a progressive autoimmune process in the eye and by the generalization of a granulomatous inflammation, as well as the role of retinal minor lesions in this process as a source of additional autoantigens during repeated vitreoretinal operations. The latter, as the authors believe, are a risk factor of SO. In this connection, when repeated vutreoretinal interventions should be made in the presence of an uncompleted wound process in the eye and when they should be conducted under the conditions of active immunosuppressive therapy gain in great importance.