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Blepharoptosis is an abnormally low position of the upper eyelid in relation to the eyeball due to its omission. The method of surgical treatment of blepharoptosis depends on the function of the levator.The aim. To analyze the results of surgical treatment of partial blepharoptosis of various etiology by the dosed muscle-conjunctival resection of the upper eyelid cartilage.Material and methods. We operated 78 patients (82 eyes) with blepharoptosis, among them with congenital blepharoptosis – 34 people (36 eyes), with acquired – 44 (46 eyes). The patients’ age was from 6 to 82 years.Inclusion criteria: the function of the upper eyelid levator – more than 5 mm, the width of the palpebral fissure – 3 mm or more.The patients underwent a dosed muscle-conjunctival resection of the upper eyelid cartilage in the period from 2018 to 2021. The follow-up period ranged from 2 months to 2 years.Results. Elimination of blepharoptosis was achieved in all patients. With congenital blepharoptosis, a good result was obtained in 33 people (91.7 %), satisfactory – in three patients (8.3 %), which was associated with the asymmetry of the palpebral fissure, for the correction of which these patients underwent additional intervention. In patients with acquired ptosis of the upper eyelid, a good result was achieved in 91.3 % of cases (42 eyes). One patient underwent repeated surgery due to hypocorrection and asymmetry of the palpebral fissure width after the first surgery.In all patients, the result remained stable throughout the observation period.Conclusion. The use of the method of dosed muscle-conjunctival resection of the upper eyelid cartilage in patients with partial ptosis of the upper eyelid and intact levator function made it possible to obtain a good cosmetic and functional result: with congenital blepharoptosis – in 91.7 % of cases, acquired ptosis of the upper eyelid – in 91.3 % patients.

In recent years, ophthalmologists have paid great attention to keratoconus, as the disease is socially significant and affects the young working-age population. According to the literature and in clinical practice, it was found that patients with keratoconus have similar character traits, which are manifested to a greater or lesser extent in each patient. According to a number of authors, these patients have less adaptability, passive aggression, and paranoia. In addition, there is a tendency to disorganization of thinking, substance abuse and anxiety. The article considers clinical cases of Association of keratoconus with mental disorders and diseases such as schizophrenia, obsessive-compulsive disorder, Tourette’s syndrome. Examples of the occurrence of the disease after mechanical damage to the eyeball are given. This paper also describes changes in the quality of life of patients with this pathology, identified using different questionnaire options. The use of 18 different, most frequently used questionnaires to determine the impact of keratoconus on the patient’s quality of life is considered: specialized for keratoconus, General for eye pathology, and General medical for assessing mental functions. Using a specialized questionnaire for keratoconus, changes in the quality of life were evaluated in the following categories: visual acuity assessment, problems with near or far vision, restrictions on social interaction due to low vision, restriction of physical activity, dependence on others due to eye problems, deterioration of mental health associated with changes in the visual organ, driving problems, restrictions on visual fields, color perception and eye pain. General ophthalmological questionnaires were also used, in particular, to assess dry eye syndrome, visual impairment, contact lens use and their impact on quality of life, etc. In patients with keratoconus, other questionnaires were also used, for example, to assess the indicator of the state anxiety scale, selfassessment of depression. This article discusses the advantages and disadvantages of the questionnaires, their applicability directly to patients with keratoconus.

Purpose. To evaluate the clinical and functional results of a combined intervention - one-stage cataract phacoemulsification and a newly developed version of partially fistulizing antiglaucoma surgery (PFS) of patients with primary open-angle glaucoma (POAG) as compared with those of phacoemulsification in combination with penetrating and non-penetrating antiglaucoma intervention.Material and methods. 61 patients (65 eyes) with a combination of incomplete complicated cataract and previously unoperated stages I–III POAG. were divided into 3 groups: group 1 (control, 17 patients, 17 eyes) with ultrasonic cataract phacoemulsification (PEC) and non-penetrating deep sclerectomy (NPDS); 2 group 2 (control, 25 patients, 28 eyes patients with PEC and trabeculectomy (TE); group 3 (main, 19 patients, 20 eyes) with PEC and the newly developed PFS.Results. The best long-term results, with approximately equal hypotensive parameters were achieved with combined operations, which included PEC with TE (the absolute effect achieved in 65% of cases) and PFS (in 60%). However, the number of early postoperative complications after PFS turned out to be almost 2 times as small as after a simultaneous intervention with penetrating TE, and was wholly comparable with that after NPDS (15 and 11.8%). At the same time, the best visual results over the relevant period were observed in the main (0.78 ± 0.06) group and the control group 1 (0.64± 0.05).Conclusion. Combined simultaneous intervention, including cataract phacoemulsification with the newly developed partially fistulizing antiglaucoma surgery, is an effective way to improve visual acuity, normalize intraocular pressure and stabilize glaucomatous optic neuropathy, as well as to reduce the drug load on the patient.

The density of macular pigment in the central retina is the total concentration of lutein, zeaxanthin and meso-zeaxanthin. Normally, the average value of the optical density of macular pigment can vary significantly as it depends on the person's lifestyle, the total amount of pigment in the body, nutrition, gender, age, as well as concomitant diseases such as diabetes, obesity, arterial hypertension. Differences in the level of optical density of macular pigment between different countries were revealed and it was showed that this parameter drops in cases of retinal pathology, cataract, glaucoma, myopia, macular degeneration, or diabetic macular edema. The level of macular pigment may be considered as a significant diagnostic criterion in many ophthalmic pathologies, so any changes of this parameter require attentive consideration.

The article presents an overview of modern publications on epidemiology, risk factors, and the main links of the etiology and pathogenesis of age-related macular degeneration (AMD). The nonexudative or “dry” form of age-related macular degeneration is a multifactorial progressive pathological process caused by hereditary predisposition, general and local disorders of lipid metabolism, negative changes in the blood supply to the eye, age-related destruction of the Bruch’s membrane and retinal pigment epithelium, the appearance of signs of local and systemic inflammation, the development of oxidative stress with the impact of toxic lipoperoxidation products on the structures of the posterior segment of the eye. Recent studies have discovered new ways of retinal pigment epithelial cell death in response to oxidative stress in AMD, in particular necroptosis, which, in addition to classical apoptosis, is considered the main mechanism of this process. It is noted that the development of AMD may be associated with an age-related decrease in the level of estrogen in women. The analysis of the data on the etiopathogenesis of age-related macular degeneration presented in the modern literature indicates the need for further research and generalization of local and general pathological processes developing in the dynamics of retinal visual function disorders by specialists of various scientific disciplines.

Background. Pterygium is ubiquitous and multifactorial; today, information on the prevalence of pterygium, risk factors, the relationship of its development with concomitant pathology and the type of life activity of patients in various regions of Russia is limited. All of the above led to the conduct of this epidemiological study in the Republic of Bashkortostan.The aim of the study: to study the prevalence of pterygium, as well as to identify the relationship of risk factors for its development with the type of life activity and concomitant diseases in the urban and rural population of the Republic of Bashkortostan.Methods. On the basis of the Ufa Research Institute of Eye Diseases, within the framework of the Ural Eye and Medical Study (UEMS) research project, a population study of people living in urban and rural regions of the Republic of Bashkortostan was carried out. The study involved 5899 people, including men – 43.7 % (2585 people), women – 56.3 % (3314 people), urban residents made 42.3 % (2491 people), rural – 57.7 % (3408 people).Results. As a result of our study, pterygium was diagnosed in 138 people (204 eyes – 2.3 %) (95% CI: 2.0–2.7 %). One-way analysis showed a higher prevalence of pterygium associated (p˂0.10) with a number of systemic and ophthalmic parameters. However, according to the results of multivariate analysis, it was revealed that the prevalence of pterygium was significantly associated with older age (p = 0.006), rural area of residence (p = 0.001) and low educational level (p = 0.03).Conclusion. The prevalence of pterygium in Republic of Bashkortostan according to the UEMS study was 2.3 %, or 23 people per 1000 population among people over 40 years old. The nature of the settlement influences the prevalence of pterygium in the Republic of Bashkortostan. Pterygium was more common among older people among all respondents who took part in the study. In the study, pterygium was not a biomarker of general somatic diseases.

Keratoconus is a progressive bilateral corneal ectasia, accompanied by loss of vision due to high irregular astigmatism, which is the leading indication for corneal transplantation. The review presents a variety of surgical corneal transplantation techniques for keratoconus available today and discussed their advantages and disadvantages.

Keratoconus (KC) is a progressive degenerative corneal disease, leads to the aberration of biomechanical and optical properties and thinning of the cornea, causes astigmatism and decreases visual acuity.Materials and methods. 33 patients (35 eyes) with stages II–III of non-progressive keratoconus and concomitant cataracts of various stages of maturity were operated on. The average age of the patients was 46.5 ± 2.7 (41–63) years old. The operations were performed according to our proposed two-stage method of treating ametropia in patients with KC and cataracts (Patent of the Russian Federation No. 2748634 of 28.05.2021). The first stage was the implantation of FERRARA intrastromal corneal ring segments (ICRS) with thickness from 150 to 350 μm. To correct residual refractive error in 5–7 months after stage 1, patients underwent stage 2: cloudy lens was removed and replaced with toric posterior chamber intraocular lens (TIOL) – AcrySof IQ Toric (Alcon, USA), T-fl ex Toric RayOne (Rayner, UK).Results and discussion. After stage 1 of the operation (ICRS implantation), the uncorrected visual acuity (NCVA) was 0.2 ± 0.03, the best corrected visual acuity (BCVA) was 0.4 ± 0.02. In 1 month after stage 2 (phacoemulsifi cation + TIOL) NCVA was 0.64 ± 0.11 and BCVA was 0.74 ± 0.12. During the entire follow-up period after the surgery visual functions, refraction, and rotational stability of TIOL were stable.Conclusions. Conducting a two-stage surgical intervention in patients with keratoconus and cataracts allows to stop the progression of the disease and effectively correct the ametropia concomitant with keratoconus.

Objectives: to evaluate the effectiveness of photosensitizer solutions in the experiment in different modifications of standard UV corneal crosslinking. Materials and Methods. Experiments were performed on 32 enucleated porcine eyes ex vivo and 12 rabbits (24 eyes) in vivo, divided into 4 groups depending on instillations of the photosensitizer solutions: Dextralink, Ribolink, Hypolink and Riboflavin. Evaluation of corneal saturation was performed using two modifications of standard UV CXL: in the first case, instillation of the photosensitizer solution was performed during the entire crosslinking procedure (30 min - saturation and 30 min - ultraviolet irradiation); in the second case, instillations lasted only for the first 30 minutes, the precorneal riboflavin film was removed, and instillation of solution was not performed. Results and Discussion. Instillation of photosensitizer solutions within 60 minutes showed that Dextralink significantly reduced the thickness of the cornea by about 24 % ex vivo and 21 % in vivo, while Hypolink, on the contrary, caused its increase by 9 % ex vivo and 23 % in vivo, respectively. The use of Ribolink and Riboflavin did not change the linear parameters of the cornea during the entire follow-up period. The results of the 2nd series of studies showed that effects of solutions on the cornea during their instillation for 30 minutes were generally preserved during the entire observation period up to 60 minutes. In the group where Dextralink and Hypolink solutions were used, there was a slight tendency to normalization of the initial parameters of the cornea. Conclusion. Safe and effective implementation of UV crosslinking of the cornea is possible on the basis of a rational approach to the performing the stages of stroma saturation with photosensitizer solutions, depending on the initial state of the cornea: Dextralink is recommended for a thickness of more than 450 m, Ribolink - at 400-450 m, Hypolink - from 350 to 400 m. Halting of instillations on the saturated stroma during UV irradiation is advisable to be accompanied by intraoperative control of its thickness. When performing a standard crosslinking technique, where instillations of photosensitizer accompany the stage of UV irradiation of the cornea, it is necessary to take into account the presence of a precorneal film that can absorb some of the radiation energy. The peculiarity of this crosslinking technique can be considered as a potential way to protect intraocular tissues from excessive exposure to UV radiation.

Purpose. To conduct a comparative analysis of the effectiveness of intravitreal injection of dexamethasone-containing implant and aflibercept in macular edema in patients with diabetes mellitus. Material and methods. The study involved 80 patients (80 eyes) with macular edema. The group 1 included 38 patients (38 eyes) who underwent a single intravitreal injection of dexamethasone-containing biodegradable implant «Ozurdex» in a dose of 0.7 mg according to the standard technique. In the group 2, 42 patients (42 eyes) received 5 loading doses of aflibercept with an interval of one month. All patients underwent monthly spectral optical coherence tomography (OCT) of the macular area, as well as visometry and tonometry during the observation period. Results. One month after intravitreal injection of the studied drugs in both groups, no inflammatory reactions were detected in any case. According to OCT data, cystic edema of the macular area with a tendency to decrease the thickness in the fovea was preserved. After treatment with aflibercept, the average retinal thickness in the macula was 186.4±15.1 µm, and visual acuity averaged 0.48±0.05 in 85.7% of patients. During therapy with intravitreal injection of Ozurdex, an increase in visual acuity was noted in 89.4% of patients. Conclusion. This study found that intravitreal pharmacotherapy with an angiogenesis blocker and a dexamethasone implant in patients with diabetic macular edema are comparable in its effectiveness – 85.7 and 89.4% respectively. If systematic anti-angiogenesis therapy is not possible for a number of reasons, it is advisable to use a prolonged dexamethasone implant. Key words: macular edema, intravitreal pharmacotherapy, angiogenesis inhibitor, implant with dexamethasone.

Purpose. Studying the prevalence and functional results of cataract surgery and factors that negatively affect postoperative visual functions in the population of the Republic of Bashkortostan. Material and methods. The study was carried out on the basis of a pilot descriptive population study – Ural Eye and Medical Study (UEMS), conducted on the basis of the Ufa Research Institute of Eye Diseases. This analysis included 5 885 people aged 40 and over with data on performing cataract surgery. Poor visual outcome after cataract surgery was defined with uncorrected visual acuity below 0.3. Statistical data analysis was performed using the IBM SPSS Statistics application package. Results. The prevalence of cataract surgery was 6.1% (95% confidence interval (95% CI) 5.5–6.8%). A higher frequency of operations was associated with the age factor (odds ratio – OR 1.13, 95% CI 1.11–1.15%, p

Purpose. To assess an association of markers near the COL5A1 gene and in its intron with keratoconus. To study the relationship between the presence of marker alleles and the level of expression of the COL5A1 gene in the cornea of patients with keratoconus. Material and methods. The study included 70 patients diagnosed with keratoconus, and 100 participants of the control group. All participants were genotyped for two markers associated with keratoconus: rs1536482 and rs7044529. The diagnostic indicators were calculated to assess a possibility of application of these markers as a keratoconus classifiers. In patients with keratoconus who underwent keratoplasty, corneal samples (n=9) were collected to isolate the RNA. The COL5A1 gene expression level was compared between the group of patient corneal samples with at least one marker allele (rs1536482 +) and the group of samples without marker alleles (rs1536482-) using real-time PCR coupled with reverse transcription. Results. A significant difference of the rs1536482 marker allele occurrence was found between the group of keratoconus patients and the control group (p=0.0004, Fisher test). At least one marker allele rs1536482 was found in 67.1% of patients (marker sensitivity) with keratoconus and in 46% of control group participants. Thus, the specificity of the marker is low (0.54). The odds ratio was 2.4, and the risk ratio was 1.69. Gene expression analysis in the keratoconus patients’ cornea did not reveal an association of the COL5A1 gene expression level with the genotype (p=0.9, Mann-Whitney test). Conclusion . In this study, an association of rs1536482 with keratoconus was identified in a cohort of patients from Russia. However, due to the low specificity of this marker, it cannot be used as a keratoconus classifier. The presence of a marker allele is not associated with the COL5A1 gene expression level.

This review presents the characteristics and results of clinical studies of patients with age-related macular degeneration implanted with the developed for this purpose first macular IOL – intraocular macular telescope (IMT). This lens was designed specifically for patients with the most severe or terminal form of age-related macular degeneration and is designed for monocular implantation to provide central vision while maintaining peripheral vision of the paired eye, which is important for maintaining the balance and orientation of patients. This device allows patients to see both in dynamic and static situations in the near, intermediate and far ranges. The disadvantages of this lens are a decrease in the visual field and depth of focus (which excludes its bilateral implantation), the need for a large (10–12 mm) incision for implantation, which can cause an increase in corneal astigmatism and the risk of complications, in particular, the pupillary block with an increase in intraocular pressure. There are also difficulties in the study of the fundus after its implantation to assess the small changes in the macula or to identify possible postoperative complications after cataract surgery (macular oedema, etc.). Also after the implantation of this lens, there is need for special programs of visual rehabilitation. The patient’s commitment to the rehabilitation measures for the adaptation of the central visual field of the operated eye with the peripheral vision of the second eye is crucial for success of the IMT macular telescope implantation procedure.

Aim. To study of the prevalence of diabetes and diabetic retinopathy in the Republic of Bashkortostan among people over 40 years of age, depending on the stage of the disease, gender and the nature of the settlement of the respondents. Materials and methods. A population-based study “Ural Eye and Medical Study” on the basis of the Ufa Research Institute of Eye Diseases covered 5899 people, of whom 2581 (43.7 %) were men, 3318 (52.3 %) were women. There were 2501 (42.3 %) urban residents, 3398 (59.7 %) rural residents. Statistical data analysis was performed using the IBM SPSS Statistic application package.Results. According to the study, diabetes was observed in 687 people, among them – 221 (32.2 %) men, 466 (67.8 %) women; urban residents – 378 (55.0 %) people, rural – 309 (45.0 %) people. The prevalence of diabetes is 11.6 %. Diabetic retinopathy was observed in 102 people (27 men – 26.5 %, and 75 women – 73.5 %), urban residents – 60 (58.8 %), rural – 42 (41.2 %). The prevalence of diabetic retinopathy among the entire study population was 2.1 %, or 14.8 % in the diabetic population. Conclusions. The prevalence of diabetes in the Republic of Bashkortostan according to the results of the Ural Eye and Medical Study was 11.6 % among people over 40 years old. The prevalence of diabetic retinopathy in the general population of the republic was 2.1 %, and in the population with diabetes it was 14.8 %, which is, in general, less than the global average.

Currently, the treatment of neovascular age-related macular degeneration (AMD) includes: intravitreal injections (bevacizumab, ranibizumab, aflibercept, pegaptanib, etc.), photodynamic therapy, surgical treatment (subretinal surgery, recombinant tissue plasminogen activator + gas, macula translocation) and etc. Rehabilitation of these patients is carried out using special optical tools (glasses, magnifying lenses, loupes, electronic devices). Classic external devices for the correction of very poor eyesight are not convenient to use: they are often lost or forgotten at home, not adapted for constant wear, people are embarrassed to use them in public places. This review presents the characteristics and clinical results of the implantation of two intraocular lenses, the Lipschitz Macular Implant (LMI-SI) and the Scharioth Macula lenses, in patients with age-related macular degeneration (AMD). These IOL can be implanted during standard phacoemulsification with the implantation of usual posterior chamber IOL or years after the cataract extraction, which makes them unique among other lenses that are implanted only during the cataract extraction procedure. The Lipschitz Macular Implant (Israel, 2013) is a rigid IOL made of polymethyl methacrylate (PMMA), implanted in a capsular bag, it requires an incision up to 6 mm. A positive feature of the Scharioth Macula lens (1stQ GmbH, Germany, 2017) is the smallest incision needed for implantation — no more than 3 mm. This lens consists of a biocompatible hydrophilic acryl with a UV filter, the peripheral zone of the lens is optically neutral, the square design excludes its free rotation. Also, this lens can be used as therapy for progressive macular dystrophy of various etiologies. The additional macular IOLs do not affect peripheral vision, reduce binocularity when reading, and require complex visual rehabilitation.

Purpose: To assess the topographic location of the demarcation line in in different areas of the cornea after standard corneal crosslinking.Patients and methods. 12 patients (15 eyes) with keratoconus of stages 1–2 of Amsler-Kruimerich classification were observed. UV cross-linking was performed in all patients according to the standard Dresden protocol with 0.1% aqueous solution of riboflavin. The patients underwent optical coherence tomography of the anterior segment of the eye on “DRI OCT Triton” (“Topcon”, Japan) in different areas of the cornea to assess the location of the demarcation line. Results. Demarcation line was revealed in1 month after standard corneal cross-linking in most cases (87%). Biomicroscopy showed that DL limited the anterior and middlelaers of the stroma from the posterior one. The stromal demarcation line depth according to OCT averaged 305.73 ± 41.08 μm (range of 282–345 μm) at the center, nasally — 215.16 ± 35.5 μm (range of 160–289 μm) and temporally 205,23 ± 32.81 μm (range of 190–276 μm). A significant difference in the depth of DL localization in the central zone of the cornea and a 6 mm zone (p < 0.001) was noted. Conclusion. The corneal stromal (обычно) demarcation line is one of the indicators of the depth of photochemical process of corneal cross-linking. Optimal timing of detection of DL following corneal collagen crosslinking is 2 weeks — 3 months. The depth of DL in the corneal studied areas is different; it is deeper in the central zone than in the peripheral ones.

Aim. The objective of the present study was the comparative evaluation of the morphological characteristics of the reaction of the ocular tissues following experimental scleroplasty with the application of the xenografts from UV-irradiated and non-irradiated pericardium. Materials and methods. To elucidate the morphological characteristics of the reaction of the eye tissues to experimental scleroplasty, we used histological sections of the 16 eyes of 8 rabbits. The animals were allocated to two groups. Those in group 1 underwent sclera-strengthening operations as described by Khatminsky with the use of UV cross-linked xenotransplants from the pericardium. Part of them was preliminarily subjected either to UV-irradiation at a wavelength of 370 nm and an irradiation power of 5 mW/cm2 for 20 minutes or to the treatment with a 0.5% aqueous solution of riboflavin during 30 minutes (the right eyes from 4 animals). The remaining rabbits comprised group 2 and were operated using the same procedure with the application of the xenotransplants from the non-irradiated pericardium. The left eyes of all the animals remained intact and serves as the controls. The enucleated eyes were subjected to the microscopic and histological examination within 2 weeks (two rabbits from each group) and 1 month after surgery. Results. The morphological study of the enucleated eyes obtained within 2 weeks after the surgical intervention gave evidence of only the mild aseptic inflammatory reaction in the form of a lean rim composed from lymphocyte-like cells buried deep in the sclera close to the transplants from the UV-irradiated pericardium. The histological studies carried out within 1 month after the operation have demonstrated the signs of formation of a connective tissue capsule. The sections through the sclera of the enucleated eyes with the use of the biological materials from the non-irradiated pericardium obtained 2 weeks after the operation at the borderline with the transplants exhibited the clearly visualized signs of aseptic inflammation with massive lympho-macrophage infiltration and the presence of a large amount of fibroblasts. Only isolated areas of the granulation tissue were identified within 1 month after the intervention. Conclusion. The histological study of the enucleated rabbit eyes conducted within 2 weeks after experimental scleroplasty has demonstrated the less pronounced reaction of the ocular tissues to the introduction of the UV-irradiated xenografts in comparison with that of the non-irradiated ones. One month after the surgical intervention with the application of the xenotransplants from the UV cross-linked pericardium, the histological signs of the formation of the capsules from the connective tissue were well apparent in the association with the mild inflammatory reaction of the ocular tissues. The animals operated with the use of the non-irradiated biological materials from the pericardium experienced massive inflammatory lympho-macrophage infiltration and exhibited only isolated areas of the developing granulation tissue.

Diabetes mellitus (DM) is the most common endocrine disease, and therefore a pressing medical and social problem. In many cases, ocular manifestations of DM are considered the particular cause of patients' disability. The review presents an analysis of morphological, experimental and clinical studies of the cornea in patients with diabetes mellitus - full articles, reviews and monographs of Russian and foreign authors, mostly those published in the recent years. Among the considered topics are modern methods of examining conjunctiva and cornea, clinical and morphological changes in these tissues, and the early diabetic changes in all their structural layers. The review also describes the importance of diabetes-related changes in the conjunctival vessels and corneal nerve fibers and shows the correlation between the densities of corneal nerve fibers and epidermal nerve fibers.Сахарный диабет (СД) - самое распространенное из эндокринных заболеваний, поэтому является приоритетной медико-социальной проблемой. Часто при диабете именно глазные проявления в первую очередь приводят к инвалидизации больных. В обзоре представлен анализ морфологических, экспериментальных и клинических исследований конъюнктивы и роговицы у пациентов с СД - оригинальные статьи, обзоры и монографии отечественных и зарубежных авторов преимущественно последних лет. Рассмотрены современные методы исследований конъюнктивы и роговицы при СД. Обсуждены клинико-морфологические изменения этих тканей, описаны ранние диабетические изменения их структурных слоев. Представлена важная роль изменений сосудов конъюнктивы и нервных волокон роговицы (НВР) при диабете, показана корреляция между плотностью (НВР) и эпидермальных нервных волокон.

Purpose: to analyze the effectiveness of Ex-Press drainage device implantation for refractory glaucoma of different origin for 3 years. Patients and methods : The study consisted of 82 patients (86 eyes) with refractory glaucoma aged 26–86 years (67.37±0.53). Pre-operative IOP level averaged 37.8±1.04 mm Hg. Ex-Press drainage device implantation was rated according to the following criteria: IOP, time course of visual functions, the need for additional drug therapy and reoperation, the presence of intraoperative and postoperative complications. Examination of the patients was carried out from 1 to 8 days after the surgery and within 1, 3, 6, 12, 24 and 36 months. Results: According to our research results relative hypotensive effect equaled 74.4% (64/86) within a year after the surgery; 67.4% (58/86) — within 2 years; 65.1% (56/86) — after 3 years of follow-up period. The maximum decrease in IOP by 61.6% was observed immediately after the surgery. There was no effect of surgical treatment within3 years in 34.9% (30/86). Complications were observed in 23.2% (20/86) of cases: choroidal detachment — 12.8% (11/86), hyphema — 3.5% (3/86), eruption and dislocation — 3.5% (3 / 86), delayed expulsive hemorrhage — 2.3% (2/86), cyst of filtering bleb — 1.2% (1/86). Conclusion . Fistulizing operations with implantation of Ex-Press drainage device for refractory glaucoma provide normalization of IOP in 65.1% of cases (including 15.1% on the background of additional drug therapy) at follow-up period up to 3 years.

Down syndrome is one the most widespread forms of genomic pathology accompanied by mental retardation and impairment of cognitive functions. One of the commonest eye diseases in the patients with Down syndrome is corneal ectasia that occurs 10 times more frequently in the children with Down syndrome than in the general population. Objective. Of the present study was the comparative analysis of the biometric parameters of the cornea and the clinical manifestations of keratoconus in the patients presenting with Down syndrome. Materials and methods. We undertook the comprehensive analysis of the biometric parameters of the cornea in 54 patients (108 eyes) with Down syndrome who made up the main study group. The control group was comprised of 62 practically healthy children (124 eyes). Results. The patients presenting with Down syndrome were found to have a higher refractive power of the cornea, a more pronounced elevation of the posterior corneal surface and its irregular patterns, a smaller corneal thickness, and lower degree of corneal hysteresis in comparison with the control children. The verified diagnosis of keratoconus was established in 11 patients of the main group. Conclusion. The present study has revealed keratoconus in 11 (20.4%) children presenting with Down syndrome which suggests a higher prevalence of this pathology in our study group in comparison with its mean prevalence reported thus far for the general population. The early subclinical forms of ceratoconus are known to more frequently occur in the children aged from 12 to 18 years, with the incidence of its later stages being especially high in the group of the patients between 19 and 38 years of age. This discrepancy is supposed to be attributable to the progression of the clinical symptoms of the eye disease with age and its late diagnostics. The deviation of corneal biometric characteristics from the respective normal values documented in 79.6% of the patients included in the present study should be regarded as reflecting the objective situation. It is concluded that the patients presenting with Down syndrome should be referred to the group at enhanced risk of development of keratoconus and undergo the regular ophthalmological examination.

Surgical results of 76 patients (76 eyes) aged 25-79 years with secondary refractory glaucoma were analyzed. The best hypotensive effect and visual functions integrity were achieved with Ahmed valve implantation (86.7% and 83.3% of cases respectively); after conventional fistulizing surgery the hypotensive effect was observed in 45.5%, noncompromised vision--in 54.5% of cases. Tunnel trabeculectomy with iridocycloretraction led to normalization of intraocular pressure and stabilization of visual functions in 81.3% and 68.8% of cases respectively and thus can be considered as an alternative to fistulizing surgery in patients with secondary refractory glaucoma. Uveal glaucoma is a relative contraindication to Ahmed valve implantation, while neovascular glaucoma is that to tunnel trabeculectomy with iridocycloretraction.

Antivasoproliferative therapy is a pathogenetic treatment for diabetic macular edema. The objective of the study was to investigate the effect of ranibizumab on foveolar parameters in spongiform macular edema. A total of 37 patients (38 eyes) with spongiform macular edema were assessed and given antivasoproliferative therapy with ranibizumab. Optical coherence tomography showed a reduction of the total retinal thickness by 44 microm (from 306 +/- 77 microm to 262 +/- 30 microm, p0.05). The pigment epithelium thickness within the central area changed from 21 +/- 4 microm to 40 +/- 9 microm. The maximum decrease of the outer nuclear layer thickness was noted in 400 +/- 100 microm from foveola and averaged from 72 +/- 19 microm to 29 +/- 6 microm with its gradual increase to the periphery to 100 +/- 8 microm.

Neovascular glaucoma (NVG) is one of the most severe form of refractory glaucoma. Vascular endothelial growth factor (VEGF) is one of the strongest promoters of angiogenesis and was found to be the main neovascularization regulator. The use of anti-VEGF-agents is a rational option because in the majority of cases it allows to reach disappearance or reduction of neovascularization, that significantly reduces the risk of complications in following surgery or laser treatment of NVG.

Methods of conservative treatment of amblyopia are presented in the review. The paper includes information about pleoptics, physiotherapy, pharmacotherapy and examples of combined treatment of the amblyopic eye. Analysis of literature shows that this problem is an issue of concern and further research is needed.

As new technics in vitreoretinal surgery develop performance of miniinvasive procedures has become possible in children with ocular diseases associated with cataract (persistent hyperplastic primary vitreous, retinal detachment, vitreous synechia), retinopathy of prematurity, retinoblastoma, retinal detachment of different ethiology as well as for prevention of proliferative syndrome. Analysis of endovitreous surgical procedures in children allows to estimate advantages and falls of each technique, helps to find new techniques aimed to improve functional outcome and decrease unfavorable results of vitreoretinal surgery.

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 impact of long personal computer use on the development of spasm of accommodation and myopia was studied in adults. The majority of the examined bank employees were found to have symptoms of computer visual syndrome; myopia developing in adulthood (the maximum age being 32 years) was detected in 33.74% of cases. Complex treatment, including instrumental and drug therapies, for spasm of accommodation and myopia was performed in 97 patients. Increased visual acuity and accommodation extent, reduced refraction, and eliminated discomfort are indicative of the efficiency of the treatment performed. At the same time due to its unstable therapeutic effect, the development of efficient technological and medical measures to prevent spasm of accommodation and myopia remains urgent.

An immunological study was performed in 71 children aged 6-15 years old. Twenty seven of these 71 patients have undergone surgery for congenital cataract, 23 - for traumatic cataract aspiration-irrigation with a posterior chamber intraocular lens implantation and 21 - for secondary intraocular lens implantation. The number of peripheral blood active T lymphocytes, CD4(+), CD8(+), HLA DR(+) lymphocytes and antibody response to lens (alpha-crystalline) and retina (S-antigen) proteins were determined. Tissue specific antibodies were revealed in cases of both increased and decreased T-cellular immunity parameters. Sensibilization to S-antigen at the background of HLA DR(+) lymphocytes increase and a decrease in other parameters of immunity that may be regarded as the autoimmune status was the most unfavorable prognostic sign. In these cases even after atraumatic surgery the risk of postoperative inflammation was rather high with development of chronicity.