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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 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.

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 presents an analysis of traumas of the orbit combined with craniocerebral trauma in children made according to data obtained at the eye microsurgery department, Morozov's Pediatric City Clinical Hospital. Fractures of the lower orbit wall account for around 70% of all orbit fractures; clinical signs of fractures of the lower orbit wall are defined; computer tomography is shown to be the most informative diagnostic tool. The paper contains indications for plasty of the lower orbit wall. Materials used in orbitoplasty are comparatively analyzed. The use of demineralized osseous implants is preferential.

The paper presents a complete clinical, instrumental, histopathological, immunohistochemical, cytological, and molecular-genetic testing of intraocular schwannoma in a 13-year-old girl.

The paper presents the results of studying the effect of 10% perfluorane (PF) emulsion intravenously injected 1-2 days before surgical treatment for rhegmatogenous retinal detachment on the levels of the cytokines IL-1beta, TNF-alpha, IL-6, and IL-4 in the serum and subretinal fluid of patients. PF infusion was found to exert an immunomodulatory effect that favored a short-term increase in the serum level of proinflammatory cytokines (IL- 1beta and IL-6) at week 1 and TNF-alpha on day 1) with their gradual normalization. The subretinal fluid showed recovery of the mechanisms for local immunological reactions; eye inflammation reduced due to the decreased production of proinflammatory cytokines and simultaneously the elevated level of the anti-inflammatory cytokine IL-4.

The paper analyzes outpatient cards of 415 patients who underwent enucleation for uveal melanoma (UM) in 1962-2008 and who have been registered in the Moscow City Ophthalmology Center since 1990. The patients' mean age was 58.94 +/-1.29 years. During the follow-up, 56 patients died 5.24 +/- 1.84 years postoperatively. The distribution of UM by the histological types was as follows: spindle cell (n = 275; 66.27%); mixed cell (n = 100; 24.09%), and epithelioid cell (n = 26; 6.27%) UM. Eleven (2.65%) patients were diagnosed as having necrotic melanoma. Poor (preequatorial and juxtapapillary) position was observed in 35.4% of the patients. Mortality in patients with UM after enucleation was 14.44% with a life expectancy of 5.24 +/- 1.84 years. The findings make it possible to recommend that an enucleation procedure should be developed, by concurrently forming a locomotor stump, which promotes the improvement of the results of individual cosmetic prosthetics in patients with UM that is not to undergo organ-saving treatment.

The current methods widely used in ophthalmology to examine patients to diagnose the dry eye syndrome and to trace the course of a process are invasive. Both the Norn test using stains and the Schirmer test with the filter paper strips being inserted are stimuli that affect the rate of tear generation, which misrepresents the data obtainable. The developed procedures for examining the eye in polarized light permit one to considerably reduce the invasiveness of patient examination. The study indicated the high efficiency and diagnostic value of the proposed procedures in the examination of patients with the dry eye syndrome. Polarization filters available in the standard kit of up-to-date slit lamps make it possible to use the proposed procedures without any modification of ophthalmological equipment in wide clinical practice.

The paper presents the results of practical application of a new screening method for determining tolerant intraocular pressure (TIOP) on a Blood Flow Analyzer (Paradigm, USA). Studies were conducted on 331 eyes (205 subjects). Group 1 consisted of 80 patients (126 eyes) without glaucoma being found, with intraocular pressure (IOP) in the average normal range, but with a TIOP excess of 1-8 mm Hg (a risk group); Group 2 included 15 subjects (20 eyes) without glaucoma with normal IOP in whom TIOP exceeded the existing IOP by 1-7 mm Hg; Group 3 comprised 110 patients (185 eyes) with Stage I-III primary open-angle glaucoma (POAG) with compensated IOP. Morphofunctional studies revealed glaucoma in 95 (75%) eyes in the risk group: Stages II and I in 61 and 30%, respectively; and advanced glaucoma in 9%. At the same time, there was a close correlation of the probable detection of glaucoma with the existing degree of a TIOP excess. No cases of glaucoma were observed in Group 2. The determination of TIOP and morphofunctional changes over time in Group 3 revealed a stable glaucomatous process in 99% of cases in which IOP was lower than or equal to TIOP, as well as progressive glaucomatous neuropathy in 91% in which compensated LOP exceeded TIOP. The results of the study in Group 3 suggest that the index TIOP may be used as a guide of IOP in the treatment and monitoring of POAG. The presented data indicate that the determination of the level of TIOP is a required element of both standard ophthalmological examination and monitoring of glaucoma.

The outcomes of keratitis in lagophthalmos occurring due to various causes despite therapeutic measures are generally poor. The influence of factors, such as drying of the cornea, impairment of its trophism, and infection, leads to the development of rough leukomas, and occasionally to eye death due to occurring endophthalmitis. The paper describes a clinical case of deep trophic central corneal ulcer on the single seeing eye with lagophthalmos, as well as ulcer treatment by the authors' procedure, by simultaneously affecting both elements of the pathology (lagophthalmos and trophic ulcerative keratitis of central localization) and creating an artificial pupil. This allows one to increase visual acuity, to cure keratitis, and to close a palpebral fissure.

The paper analyzes recent literature and the authors' experience in treating choroidal melanoma with transpupillary thermotherapy. Analysis of the results of treatment in 30 patients shows the efficiency of the technique only the tumor is less than 2 mm thick. When the latter is larger, transpupillary thermotherapy may be used only in combination with brachytherapy. Risk factors worsening the efficiency of thermotherapy are defined. These include tumors that are more than 2 mm thick or slightly pigmented, and the presence of a subretinal exudate. The frequency and severity of complications were estimated after transpupillary thermotherapy. The occurrence of complications and their pattern depend on the baseline sizes of choroidal melanoma, the number of performed sessions, and previous treatment (local tumor resolution). Comparison of the data available in the literature and the authors' experience made it possible to define clear indications for transpupillary thermotherapy in order to treat choroidal melanomas and to identify factors promoting the prevention of possible complications.

The paper deals with the diagnosis of optic nerve atrophy caused by temporal giant-cell arteritis (Horton's disease) and shows how difficult to make a differential diagnosis between glaucoma and other non-eye diseases that also induce optic nerve atrophy. It describes a clinical case that illustrates the difficulties in diagnosing optic nerve involvement in Horton's disease.

The paper gives the results of comparative assessment of ophthalmoergonomic indicators of the visual system in patients with high-grade myopia after contact correction and within 12 months after phacitic intraocular lens (IOL) implantation. A considerable increase in the level of visual analyzer performance was achieved after surgical correction. The found positive changes in visual analyzer performance after phacitic intraocular lens versus contact correction are explainable in the context of physiological optics by the formation of the optimal ocular cornea--phacitic IOL--lens system that ensures great functional reserves for visual perception as a whole as compared with the optical contact lens--cornea--lens system.

The paper describes a simplified calculation procedure for the volume of the osseous orbit. The use of correction factors allowed the authors to show the appropriateness of calculation of the volume of the osseous orbit from 4-6 fragments instead of 45-55 ones, as had been accepted. The presented volume characteristics of the orbit may be used in the differential diagnosis of false and true exophthalmos and in the planning of orbital operations.

The paper gives data of computed tomography in 100 patients (148 orbits) with edematous exophthalmos (lipogenic and mixed types). There is a relationship of the higher degree of exophthalmos to the increased orbital soft tissue contents. A procedure is described for the individual calculation of the amount of removed orbital fat during compressive operations, which considers both the individual features of the anatomic structure and existing exophthalmos.

The study was undertaken to develop an efficient system for prevention and treatment of ophthalmological complications at spontaneous delivery in parturients with peripheral vitreochorioretinal dystrophies and retinal dystrophic detachment. The paper considers the results of a 2-year follow-up of 188 women during pregnancy and puerperal period. No visual changes were revealed in all the cases after both spontaneous delivery and cesarean section (if there are obstetric indications). The findings suggest that timely detection and treatment of menacing types of peripheral vitreochorioretinal dystrophies and retinal detachment considerably reduce the rates of surgical delivery as shown by ophthalmological indications.

The paper gives the results of electroretinography (ERG) in 38 patients (73 eyes) with type 2 diabetes mellitus at different stages of diabetic retinopathy (including in diabetic macular edema). The reductions in the macular ERG (M-ERG) amplitude parameters and in the retinal density of bioelectrical activity and the decreased amplitude and longer latency of multifocal ERG (mfERG) N1 and P1 components evidence the involvement of the retinal macular region into the pathological process and the magnitude of these changes depends on the presence of imaged macular edema. Despite the certain limitations of mfERG, assessment of the topography of retinal bioelectrical activity in the central field of vision is an important supplement to M-ERG results and may be a prognostic criterion for the development of a pathological process and its extent.

The possibilities of using infrared teleradiothermometry in the differential diagnosis of inflammatory and dystrophic diseases in the eyeball have been studied. The paper presents the physical bases of the technique, the procedure of measurements, and data on superficial eye temperature in health and in some pathological processes.

The paper deals with the examination of computed tomograms of 72 patients (90 orbits), including 29 males (36 orbits) and 43 females (54 orbits), who had no any orbital pathology. The patients' age ranged from 34 to 65 years. Data on the volume of the bony orbit and its soft tissue contents are given. The dimensions of the transversal opening to the orbit and its depth are shown. The volumes of all the ocular muscles (extraocular muscles, the elevator muscle of the upper eyelid), optic nerve, eyeball, and ocular fat are separately calculated. These indices may be used for both the differential diagnosis of true exophthalmos and pseudoexophthalmos and the planning of any orbital surgery.

The paper analyzes the diagnostic capacities of two studies (the routine Schirmer test and lacrimal meniscus biometry). It indicates the basic limitations of the Schirmer test and describes a procedure for lacrimal meniscus biometry. Based on the results of studying the lacrimal meniscus in healthy individuals from a control group, the authors revealed a relationship of the height of the lacrimal meniscus to the area and horizontal size of the palpebral fissure. Comparison of the results of studies of basal lacrimal secretion in the presence of dry keratoconjunctivitis and dry eye syndrome in the study patients with hypolacrimation defined the latter as mild, moderate, and severe. There was discordance between the values in 33.85% of cases. The Schirmer test has not shown to be the method of choice in examining basal lacrimal production; erroneous results may be obtained in a third of patients. Lacrimal meniscus biometry makes it possible to identify the degree of significant hypolacrimation more exactly and to minimize the indices of preserved basal secretion.

The paper specifies indications and success criteria for photodynamic therapy with visudine for classical macular choroidal neovascularization. Three major clinical types of a response to treatment are presented. These include: 1) complete regression of the subretinal neovascular membrane (SNM) with retinal edema resolution; 2) partial regression of SNM with its shift to inactive status that is attended by a significant reduction in pathological transudation from the newly formed vessels; 3) partial regression with the preserved high transudating activity of SNM. There was stabilization of lesion extents and visual functions in types 1 and 2 responses to therapy and a continued SNM growth and progressive visual worsening in type 3 response.

Macular drusen are known to be a major risk factor of age-related macular degeneration (ARMD) of the retina. The use of laser coagulation of macular drusen to prevent the progression of a dystrophic process remains to be disputable question so far. This paper presents the clinical and functional results of laser coagulation of macular drusen in 30 patients with bilateral retinal ARMD. The routine ophthalmological study, photorecording, fluorescence angiography of the fundus of the eye, optic coherent tomography, and electrophysiological studies indicated macular drusen regression, increased visual acuity, and better electrophysiological parameters. Choriodal neovascularization and exudative complications did not develop in both the early and late follow-up periods.

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 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 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 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 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 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 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 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 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 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.

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 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 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.

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 analyzes the results of removal of epibulbar tumor and nontumor masses, by using the radiowave surgical technique. The authors used two basic modes: fulguration and completely rectified and/ or completely filtered wave. Postoperative healing was aseptic and areactive. The duration of reparation depended on the working conditions, the volume of excised tissues, and the individual pattern of reparative processes. No intraoperative and postoperative complications were found. There were no cases of relapses and on-going growth during 9-12-month follow-ups. The authors have concluded that a radiowave knife may be used in surgery for epibulbar tumor and nontumor masses.

Presented in the paper are data of a comparative analysis of efficiency of different methods of administration of drugs in neuritis and partial atrophy of the optic nerve. New techniques of application and fixation of irrigation systems in the retrobulbar and Tenon's space are described. Experimental and clinical data proving advantages of the new method of administration of drugs by an automatic pulse doser in the treatment of inflammatory diseases of the optic nerve are represented. The use of such intensive intermittent technique of administration of drugs in Tenon's space performed at the preliminary stage before electrostimulation of the optic nerve made the procedure by far more effective and ensured better treatment results.

Described in the paper are comparative descriptions of the efficiency of epibulbar and retrobulbar anesthesia made through evaluating the sensation of pain experienced by patients in cataract phacoemulsification and IOL implantation. The patients (1046 subjects, aged 28 to 89) were shared between 2 groups; they received an identical premedication by midazolam, peroral administration, 3.75 mg in 1 h before surgery. Epibulbar anesthesia with 1% proximetacaine hydrochloride, administered via instillator, was used in Group 1 (524 patients). Analgesia with 2% lidocaine hydrochloride solution (injections, 1:1) was made in Group 2 (522 patients). The subjective pain sensations experienced by patients during subsequent surgical stages were evaluated by an international 6-point scale. The pain sensations were found to vary from 0 to 4 points (mean point value--2.25) in Group 1. The most severe pain was experienced by the patients during the introduction of the phacoemulsificator tip into the anterior chamber of the eye (mean pain value--1.75 points) as well as during IOL implantation (mean pain value--1.25). The instillator-based analgesia does not normally provoke any complications and is well tolerated by patients; it can be recommended for cataract phacoemulsification.

Described in the paper is an efficiency study of using, postoperatively, the low-intensity helium-neon laser (LIHNL) in patients with obstruction of the lacrimal tracts. Eighty patients were examined after endonasal dacryocystorhinostomy. They were shared between 2 groups with respect to a postoperative course: group 1--experimental, 40 patients, and group 2--control, 40 patients. The experimental patients received, apart from the traditional postoperative therapy, a course of LIHNL therapy. The controls received only the traditional postoperative treatment. The efficiency of postoperative treatment was evaluated by clinical, instrumental and laboratory examination methods. The study denoted that the use of LIHNL in the early postoperative period after endonasal dacryocystorhinostomy had a pronounced anti-inflammatory effect, speeded up the wound healing, prevented the growth of granulation tissues and the merging of the shaped lacrimal-sac fistula with the nasal cavity. LIHNL contributed to a complete recovery of the functional activity of the nasal mucous tunic. Thus, the LIHNL therapy essentially facilitates the postoperative management of patients, cuts the rehabilitation period and enhances the treatment results.

The so-called nonpenetrating surgeries have been, during the recent years, used on an expanding basis in patients with open-angle glaucoma. The paper focuses on their evolution from sinusotomy, suggested by M.M. Krasnov in 1962, to different variations of temporal-canal-stomy. Efficiency of the penetrating and nonpenetrating surgeries is comparatively analyzed; their possible action mechanisms are elucidated.

Described in the paper are the results of ophthalmologic, ultrasound and radiological examinations of 3 girls with the Aicardi syndrome. It was for the first time, that an expansion of the optic-nerve disk excavation was described in patients with the above syndrome; such expansion was conditioned by trans-synaptic neuron degeneration induced by lesions to optic radiation in view of prenatal of encephaloplastic processes. The changing brain white substance as projected by optic radiation was detected in all children by computer and magnetic resonance tomography. Besides, other anomalies of the optic nerve (bindweed syndrome, coloboma) and of the retina are elucidated. Finally, the pathogenesis and differential diagnostics of the Aicardi syndrome are under discussion.

Described in the paper are the results of observations of the autogenous and allogenic limb transplantation (LT) made in 4 patients at exacerbation of severe and extra severe burns of the eyes and made in 8 patients in the remote period after severe chemical burns (4 months and more after trauma). A total vascularized corneal leukoma shaped up in 3 patients with LT made at exacerbation; an intense corneal opacification was observed in 1 more such patient. As for the patients, who were operated on in the remote period, better corneal properties and significantly improved visual acuity were registered in them. Relapsing corneal conjunctivalization were observed only in 3 cases of allogenic LT. Thus, LT was proven to be an effective tool in the remote visual rehabilitation of patients with severe eye burns, whereas, the procedure made at exacerbation and in cases of acute and extra acute burns with extensive lesions in the conjunctiva is low effective or a failure.

The purpose of the case study, as described in the paper, was to evaluate the cell loss in the corneal posterior epithelium (CPE) after laser cataract extraction (LCE) by means of a new laser unit designed on the basis of ND:YAG laser with a wave length of 1.44 microns. The conditions of 59 eyes with high (degrees 3-4) and extra high (degree 5) lens density were analyzed preoperatively and 3 months after LCE. Group 1 comprised 51 surgical cases, which were ideal in the technical respect; Group 2 comprised 8 surgical cases involving an intraoperative short-time lifting of the fragmentized lens mass into the eye anterior chamber during aspiration. The method of contactless endothelial biomicroscopy ("SP-1000" unit, "Topcon Co.", Japan) was made use of. According to the obtained results, it can be stated: the CPE cell loss made 1-9% (4.69 +/- 0.7%) and 1-18% (9.4 +/- 8.4%) in Groups 1 and 2, respectively. The total energy exposition level to laser radiation is the most significant factor affecting the CPE cell loss. The pulse energy radiation level did not affect the CPE cell loss. The corneal posterior surface was subject to a highly adverse impact in the fragmentation of brown cataracts. Finally, the results are indicative of an insignificant surgical trauma in LCE.

The use of a metallic suture in eye microsurgery is described in the paper. The metallic suture made from a 0.05-0.05 mm vanadic stainless steel wire (corresponding to 8:0) was applied in 1202 cataract extractions, penetrating injuries, antiglaucomatous surgeries and in removal of pterygium at the medical-and-sanitary facility of steel works in the town of Bokaro (India). The observation period ranged, on the average, from 3 months to 3 years. There were no complications during the procedure of applying the suture. However, it caused a minor response in the ocular tissues during the early postoperative period. Small bullae were observed in the corneal surface near the suture in 7 cases (0.58%), which disappeared spontaneously in 3-4 days. Irritations inflicted by the suture ends were registered in 2.58% of cases (31 patients). The mean postoperative astigmatism was, 3 months after surgery, 1.65 diopters. The sutures were removed in 132 cases (10.98%), including in 16 patients with irritation, and in 116 patients for the purpose of correcting a high astigmatism. The share of patients with a visual acuity of 0.5 and higher was, in one week, 43.59% and went up, one month later, to 78.20%. The suture was well tolerated by patients, it was quickly covered by the corneal epithelium, there was no rejection and it can be easily manufactured. The suture is sterilized by routine techniques without need for any extra treatment before use; it is a reactive, biologically inactive, efficient, convenient and causes minimal operative and postoperative complications.

Data about the dynamic changes in the peripheral blood cellular composition, a correlation between the quantities of circulating polinuclei and mononuclei of the blood and the activity of myeloperoxidase in granulocytes of Turkmen children, aged 4 to 16, with penetrating ocular injuries are presented in the paper with regard for age and ecological peculiarities of the region of residence.

The paper is devoted to the actual problem of ophthalmology--removal of cysts and retinal detachments caused by cystoid retinal lesions. 3 stages of treatment are identified: stage 1 used YAG-laser dissection of the external wall of the retinal cyst with drainage of its contents. Stage 2 involved extrascleral filling reinforced by argon coagulation of the zone of the emptied cyst or by endolaser coagulation. Laser intervention was performed by the laser combine "Visulas-YAG II" produced by the firm "Karl Zeiss" (Germany) and fitted up by endolaser output. Coagulation energy was 0.2-0.7 W, the power of YAG-laser was 0.1-5.7 mJ with impulses of 120. Almost in all of the cases laser action was realized during one session. The laser's action was associated with hemorrhage in 11 cases (57.9%), and within 1 year of observations 2 relapses were noted (10.5%). YAG perforation of the external wall of a retinal cyst brings on its drainage and evacuation that is a perspective factor in subsequent surgical interventions during operations for retinal detachment due to cystoid degeneration.

In this summing-up paper the authors discuss the results of surgical prevention and correction of progressive myopia carried out at Department of Ophthalmic Diseases of Russian University of Peoples' Friendship during two recent decades. Remote results of bandaging scleroplastic and reduced chondroplastic operations recommend scleroplastic interventions for prevention of myopia progress. Combined scleroplasty and cataract extraction stabilized the elongation of the antero-posterior axis of the eye and essentially improved visual acuity of 18-20 diopters. New variants of interlamellar operations are presented: tunnel-circular and fragmented circular, which are protected by patents of the Russian Federation. These operations are recommended for patients with stable myopia of 8-15 diopters after scleroplasty. Their advantage is low traumatism, absence of deep incisions on the cornea, wide optic center, possibility of regulating the refraction effect by replacing the implants or their complete removal without serious consequences for the cornea.