Search

The paper presents the results of studying morphological changes in keratoconus by life-time confocal microscopy. A total of 50 patients (100 eyes) with grades 1-to-4 keratoconus were examined. The most pronounced changes were found in the corneal areas involved in an ectatic process. Four grades of epitheliopathy were conventionally identified in relation to the desquamation of superficial epitheliocytes, the change of their shape, impaired adhesion with the underlying layers, and transparency disorders. The indirect signs of altered Bowman's membrane were revealed. In early keratocons, the stroma showed hyperreflectivity of anterior layers, higher activated keratocytes, their changed shape and spatial orientation. The emergence of microstrium in the posterior stromal layers with their gradual spread to the midstroma and anterior stroma, abnormal transparency, and scarring were typical of the progress of the disease. There were processes of homogenization and fibrotization of stromal structure and fewer keratocytes. There might be changes in Descemet's membrane (undulating folds) and posterior epithelium (polymegatism, polymorphism, enlarged intercellular spaces, and cell apoptosis). Thus, confocal microscopy reveals certain regularities of a pathological process in keratoconus at different stages of the disease.

The paper gives the results of surgical treatment in 30 children (30 eyes) aged 2 months to 5 years who had primary persistent hyperplastic vitreous body. A study group (with intraocular lens (IOL) implantation) comprised 12 children (12 eyes). At surgery, the age of 8 babies was 4 to 12 months and that of 4 children was 13 to 36 months). Postoperative follow-ups lasted 6 to 40 months. Flexible lenses were implanted. A control group consisted of 18 children (18 eyes) operated on at the age of 2 months to 5 years (without IOL implantation). Despite severe retinal and optic nerve changes that are the ground to avoid surgical treatment, the authors' findings provide evidence that early primary IOL implantation in children with the primary persistent hyperplastic vitreous body yields satisfactory functional results.

The paper provides the results of a 15-year following-up of 91 patients with exposed orbital implants made from synthetic and biological materials. Surgery was made in the patients treated at different health care facilities. The authors analyze the causes of implant exposure in different periods. Early after surgery the most common causes of implant exposure are surgical equipment failure (inadequate implant coating with adjacent tissues), a too large implant arching the tissues, and mismatch of an artificial eye. In the late period, the more common cause is secondary infection or the toxic properties ofa material itself, which cause a persistent chronic inflammatory reaction. Moreover, the authors consider the mechanism of implant exposure and rejection depending on the material of an implant. The paper describes medical and surgical treatments in patients of this group.

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 presents data on demodicosis-induced blepharoconjunctivitis complicated by the dry eye, such as predictors, etiology, and pathogenesis of this disease. It gives a concise outline of the life history of mites and their species parasitizing on the human skin cycle and an extended treatment regimen for blepharoconjunctivitis complicated by the dry eye. The time course of changes in the pathological signs of blepharitis is shown when the latter is treated using the given regimen and the treatment is discontinued. The authors provide the data of Schirmer's test and Norn's test, which have been used to support the results of the present investigation. The mechanism of action of the drugs considered in the paper on the eyelids is outlined. There is a tendency for demodicosis-induced blepharoconjunctivitis to be completely eliminated and the signs of the dry eye to be compensated when meticulously chosen therapy, including hygienic measures, is performed.

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 shows the capacity of fluorescence diagnosis (FD) in patients with subretinal neovascular membranes. Photosens was used as a photosensitizer (PS) (NIOPIK) in FD. The agent was intravenously injected in a dose of 0.05 mg/kg. To study the kinetics of tissue PS distribution, the authors employed a procedure of local fluorescence spectroscopy using a LESA-01-Biospek spectrometer, which was improved when applying the procedure for visual assessment of a visual fluorescence image. It was ascertained that the results of photodynamic therapy (PDT) should be compulsorily taken into account in processing its parameters. In some cases, PDT may be recommended on days 3, 5, and 7 after administration of an agent. By taking into account the pharmacodynamics of Photosens, 0.5 mg/kg, all patients should keep the light regime for 3 months.

The paper considers the results of studies into an accommodative response in 75 patients with aphakia and pseudophakia following 3 months of cataract surgery. In pseudophakia, there is no objective recording of changes in both refraction and accommodation on producing an accommodative stimulus of varying size and at varying rates. Nevertheless, astigmatism subgroup patients could read, by using the capacities of the ocular focal region.

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.

The paper presents the results of studying the photofungicidal activity of a photosens (octacationic phthalocyanine) in the in vitro and in vivo systems. Cultured Candida guilliermondii were employed in in vitro investigations. The single combined action of octacationic phthalocyanine at a concentration of up to 1 microM and laser irradiation at a wavelength of 675 nm were established to allow the high activation (up to 100%) of yeast fungi to be achieved in the in vitro system. In vivo investigations were performed on 14 rabbits (28 eyes) with induced keratomycosis. In the first series, fluorescent diagnosis of photosens accumulation in the pathological corneal areas was made in 9 (18 eyes). Based on the data obtained in the second series of experiments, the authors examined the feasibilities of photodynamic therapy for corneal mycotic lesions with the above photosensitizer in 5 rabbits (10 eyes).

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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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.

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 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.

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 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.

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 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).

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 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 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 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 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 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 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.