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Purpose. To analyze the corneal indices obtained during examination with the Corvis® ST device of myopic patients — candidates for laser refractive surgery with dry eye syndrome (DES), before and after its treatment.Patients and methods. Study group I consisted of 88 patients with mild to moderate dry eye syndrome according to the classification of the International Seminar on Dry Eye Syndrome (TFOS DEWS II Definition and Classification Report), group II — 88 patients with no signs of corneal-conjunctival xerosis with complex myopic astigmatism at the age of 18 to 45 years (29.01 ± 7.68). The study of biomechanical parameters of the patients’ cornea was carried out using Corvis® ST (Oculus, Germany).Results. During the initial examination, six out of ten biomechanical indicators (DAM, A1T, A1V, A2T, A1L, SP_A1) in patients of study group I were significantly different (p < 0.05) from the indicators of study group II, the rest (A2V, A2L, HC_time, PD) were comparable (p > 0.05). Complex indices CBI, BAD_D in patients with DES were also statistically significantly (p < 0.05) different from those of patients without signs of DES and did not change after treatment for DES (p > 0.05). During the initial examination of patients in group I, 37 patients (42 %) had TBI in the range of 0.5–0.9. Against the background of conservative treatment of dry eye syndrome, the number of such patients decreased to 20 (22 %), and with a TBI level of up to 0.3 it increased to 30 (34 %).Conclusion. The values of corneal biomechanical parameters determined during examination on Corvis® ST in patients with dry eye syndrome are different from those of patients without symptoms of corneal-conjunctival xerosis. Improving the condition of the ocular surface against the background of drug correction of dry eye syndrome and, as a result, improving the TBI index, provides a better selection of patients for laser refractive surgery and the choice of method for its implementation. The influence of asymptomatic dry eye syndrome in a significant number of patients on the value of corneal parameters studied on Corvis® ST determines the need for preventive diagnosis of dry eye disease in the general algorithm for examining all patients before refractive surgery.

Purpose: to evaluate the effectiveness and safety of complex therapy in patients with demodex blepharitis and dry eye. Methods. 25 patients with mixed demodex blepharitis and dry eye (50 eyes; 10 men, 15 women; 61.9 ± 5.6 years) were examined before and after treatment with 0.5 % levofloxacin instillation (5 times a day, 5 days); sulfur and metronidazole gel applications (Blefarogel-forte) as part of therapeutic eyelid hygiene (Blepharogel-cleansing, Blepharolotion; starting from day 6, 2 times a day, 45 days); 0.24 % sodium hyaluronate instillation (3 times a day). Therapy effectiveness criteria were as follows: D. folliculorum mite population reduction; positive dynamics of blepharitis objective signs and meibomian gland dysfunction severity (MGD-S, points). Therapy safety criteria included the absence of negative dynamics of OSDI, tear film breakup time (TBUT, s), inferior tear meniscus height (ITMH, µm) and xerosis index (XI, points). Results. As a result of the therapy, statistically significant changes were noted, including mite population reduction (from 9.23 ± 0.81 to 3.54 ± 0.80 imagos); eyelid margins edema intensity decrease (from 3.18 ± 0.39 to 1.30 ± 0.45 points) and hyperemia decrease (from 2.90 ± 0.29 to 0.9 ± 0.3 points); MGD-S decrease (from 2.1 ± 0.3 to 0.95 ± 0.21 points); OSDI decrease (from 43.23 ± 4.70 to 25.10 ± 2.65 points); TBUT increase (from 4.05 ± 0.50 to 5.55 ± 0.50 s); XI decrease (from 5.36 ± 0.49 to 4.04 ± 0.60 points). Conclusion. The treatment of demodex blepharitis and dry eye treatment, including sulfur and metronidazole gel applications, therapeutic eyelid hygiene and 0.5 % levofloxacin and 0.24 % sodium hyaluronate instillation demonstrated a high efficiency and a good safety profile.

Purpose: to evaluate the ocular surface changes (OSC) in seasonal and chronic allergic blepharoconjunctivitis (ABC) under dry eye (DE) conditions and to consider therapeutic possibilities.Materials and methods. 60 patients with seasonal ABC and mild DE syndrome (group 1) and 50 patients with chronic ABC and moderate DE syndrome (group 2) were tested for lipid deficiency (LD; negative lipid-interference test), aqua-deficiency (AD; inferior tear meniscus height < 250 fim), and mucose deficiency (Bijsterveld`s xerosis index > 3 scores; XI, scores), Ocular surface disease index (OSDI), tear film break-up time (TBUT, seconds), meibomian gland dysfunction (MGD) according to Korb, taking into account the proportion of MGD (%) and its severity (MGDS, scores), and the “lid-wiper” symptom (LWS, scores) Statistics: M ± s; Mann — Whitney U-test; differences were statistically significant at p < 0.05.Results. LD was diagnosed in 65% of the 1st group patients (OSDI 32.3 ± 4.2, TBUT 6.5 ± 0.6, TMH 363.4 ± 43.96, XI 2.1 ± 0.4, MGDproportion — 41.02 %, LWS 1.1 ± 0.2). LD and MD were detected in 35 % of 1st group patients (OSDI 41.3 ± 5.7, TBUT 5.7 ± 0.5, TMH 332.9 ± 29.9, XI 4.2 ± 0.7, MGD proportion — 61.9 %, LWS 1.24 ± 0.4). The differences in OSDI, TBUT and XI values between DE patients with LD and DE patients with LD and MD were statistically significant. LD and AD were diagnosed in 48 % of 2nd group (OSDI 48.5 ± 6.4, TBUT 5.5 ± 0.6, TMH 192.3 ± 20.8, XI 2.5 ± 0.5, MGDS 1.8 ± 0.4, LWS 1.9 ± 0.3). LD, AD and MD were detected in 52 % of the 2nd group patients (OSDI 57.5 ± 5.8, TBUT 4.6 ± 0.6, TMH 177.7 ± 16.9, XI 5.5 ± 0.6, MGD-S 2.2 ± 0.4, LWS 2.3 ± 0.4). The differences in OSDI, TBUT and XI values between DE patients with LD-AD combination and DE patients with LD-AD-MD were statistically significant.Conclusion. OSC included lipid deficiency (65 %) and lipid-mucose deficiency (35 %) in S-ABC patients; OSC were represented by lipid-aqua-deficiency (48 %) and lipid-aqua-mucose-deficiency (52 %) in C-ABC patients. In our opinion, the diagnostics of these clinical variants of OSP diagnosis, opens up opportunities for differentiated tear replacement therapy. MGD was diagnosed in one half of S-ABC patients and in all C-ABC patients, which we believe determines another possible therapy direction — eyelid therapeutic hygiene aimed at MGD relieving and lipid deficiency compensation.

Purpose: to conduct a prospective study of the results of surgical treatment of patients with pigment dispersion syndrome and complex myopic astigmatism. Materials and methods. As a result of a comprehensive examination of 10453 adult primary patients with complex myopic astigmatism, the diagnosis of pigment dispersion syndrome was made in 99 patients (0.94 %). The study group consisted of 22 people, 9 men and 13 women, with an average age of 29.4 ± 9.8. In the case of iridosonular contact, according to ultrasound biomicroscopy, laser basal iridectomy was performed at the first stage. In the case of normal intraocular pressure indicators, laser correction of myopia was made in patients of the study group within 6 months after laser basal iridectomy. Results. During biomicroscopy, a Krukenberg spindle was observed in 34 eyes (77.2 %), exogenous pigment was detected in 20 eyes (45.4 %) on the iris and lens, and sectoral illumination of the iris was detected in 5 (11.4 %). After laser basal iridectomy on 24 eyes (54.5 %) in all the studied meridians, we noted a tendency to deepen the posterior chamber, but the increase was statistically significant only at 12 hours (P < 0.05). The achieved decrease in the angle of the anterior chamber was statistically significant (P < 0.05) in the meridians of 3, 9 and 12 hours and ranged from 3.56 to 8.53 degrees in different meridians. Laser correction of complex myopic astigmatism was performed in 11 patients (22 eyes) using ReLEx® SMILE technology and 10 (20 eyes) patients using FemtoLASIK technology. At the end of the observation period after correction, refraction within ±0.5 dptr of the planned one was achieved in 88.1 % of cases (37 eyes), ±1.0 dptr — in 100 % of cases. The efficiency coefficient was 88.46 %, the safety coefficient was 92.8 %. Postoperative values of corneal-compensated IOP were comparable with preoperative indicators (P > 0.05). Conclusions. The analysis of the of surgical treatment results in the patients with pigment dispersion syndrome and myopia showed the absence of negative dynamics in the course, as well as high efficiency, safety and stability of the results achieved after laser correction. The applied algorithm for the management of patients with combined pathology with pigment dispersion syndrome and myopia is pathogenetically justified, safe, promotes the preservation of visual functions of patients and improves their quality of life.

Professor Stanislav Vladimirovich Ochapovsky (1878-1945)—Doctor of Medical Science, Honored Scientist of the Russian Soviet Federative Socialist Republic—was a Soviet ophthalmologist, public figure, local historian, and honorary citizen of the Caucasus, Uchkulan, and Beslan. He organized the fight against trachoma in the North Caucasus, founded the school of Kuban ophthalmology, and laid the groundwork for regional medicine and ophthalmology.

Purpose: to evaluate the effectiveness of approaches to tear substitution in dry eye syndrome (DES) patients before cataract phacoemulsification (CPE). Material and methods. 60 DES and cataract patients who received preoperative therapy — tear substitute instillations (4 times a day, 1 month), were examined before CPE. They were divided into 2 groups each of which was subdivided into two subgroups. Group 1 included 30 mild DES patients with lipid deficiency who had a negative lipid interference test, meibomian gland dysfunction (MGD), and aqua deficiency absence (Schirmer-1 test > 15 mm). The subgroup 1.1 (15 patients) received 0.18 % sodium hyaluronate (SH) instillations (Gilan comfort), while the other subgroup 1.2 received “fat-water” type emulsion instillations. Group 2 consisted of 30 moderate DES patients with lipid-aqua deficiency, who also had negative lipid interference test, MGD, and aqua deficiency presence. Subgroup 2.1 (15 patients) received 0.3 % sodium hyaluronate (SH) instillations (Gilan ultra comfort), while subgroup 2.2 patients received “fat-water” type emulsion instillations. We evaluated: the OSDI points, and tear break-up time (TBUT). Results. As a result of therapy, a positive effect of the therapy on OSDI and TBUT was observed in all subgroups. In group 1 , OSDI decrease and TBUT increase were more pronounced in subgroup 1.1 patients, however, this difference between subgroups was not statistically significant. In group 2, OSDI decrease and TBUT increase were more pronounced and statistically significant in subgroup 2.1 patients. Conclusion. In patients with mild DES and lipid deficiency, 0.18 % SH (Gilan comfort) demonstrated a positive effect on OSDI and TBUT comparable to the “fat-water” type emulsion. In moderate DES patients with lipid-aqua deficiency, 0.3 % SH (Gilan ultra comfort) demonstrated a statistically significant and more pronounced positive effect on OSDI and TBUT than the “fat-water” type emulsion.

Introduction. Artificial Intelligence is new theoretical approaches, methods, technologies and applied systems for modeling and extending human intelligence. In ophthalmology, artificial intelligence is one of the tools that help improve the efficiency of the treatment process through more accurate diagnostics, search for new biomarkers of diseases, automation of decision-making processes and assistance in other aspects of the physician’s daily activities. The purpose of this review is to describe the currently available developments for the diagnosis and surgery of keratoconus in the field of artificial intelligence. Material and methods. Databases that were used for literature search included: Google and Google Scholar, PubMed, Embase, MEDLINE and Web of Science. Results. As a result of a search across all selected databases, as well as a selection of relevant studies, 75 articles were analyzed. Most of the studies that were selected for full-text analysis were the development of diagnostic algorithms. The most common classical machine learning methods were support vector machines method and random forest method. The most commonly used type of neural network is the convolutional neural network. 4 studies out of 75 reported the creation of a graphical interface for using the developed algorithm in a clinical environment.Conclusion. The accuracy of the algorithms that were obtained in the analyzed researches was basically more than 90%. It indicates the ability of machine learning models to solve complex clinical problems

Purpose. To assess the results of penetrating keratoplasty and identify the risk factors for the graft disease (GD) development. Material and methods. Data of 582 patients after corneal transplantation performed in the period since 2011 to 2019 for keratoconus (41%), as well for corneal leucorrhoea and dystrophies (59%), aggravated by concomitant pathology, the so-called high-risk keratoplasty (HRK) were analyzed in a retrospective cohort study. We estimated the functional results and incidence of GD. The calculation of the t-criterion; cross-tabulation method; Kaplan–Meier survival analysis and multivariate analysis were applied.Results. As a result of penetrating keratoplasty, the BCVA (best corrected visual acuity) in patients with keratoconus increased by 20%; in patients with HRK – by 8%. In the general group the graft survival rate was 72%, while the 8-year successful graft engraftment in patients with keratoconus comprised 91%, with HRK – 60%. A significant relationship of the GD development with preoperative diagnosis and rekeratoplasty was determined. The risk of GD incidence was minimal in patients under 30 years of age and maximum in patients aged from 50 to 70 years. Survival rates for corneal transplants were better in men than in women.Conclusion. Penetrating keratoplasty in patients with keratoconus provides a good functional result with a minimal risk of GD development. With penetrating keratoplasty in high-risk patients, the effectiveness of surgical interventions is significantly lower (by ~30%).

Purpose: to evaluate the effectiveness of plasmapheresis as a method for preventing and treating the graft rejection reaction in corneal transplantation.Patients and methods. The study involved patients with surgical pathology of the cornea, who underwent a prophylactic course of plasmapheresis procedures and underwent penetrating keratoplasty (Main group); and patients with surgical pathology of the cornea who underwent penetrating keratoplasty, but did not undergo plasmapheresis (Comparison group), whose data were analyzed retrospectively. The control group consisted of conditionally healthy individuals of both genders. Subgroups of patients with high and low risk keratoplasty were also identified within the Main group and the Comparison group.Results. Patients with keratoplasty who received a course of therapeutic plasmapheresis in the perioperative period demonstrated a statistically significant increase in the number of cases of a decrease in the level of C-reactive protein and a statistically significant decrease in the median values of the mean stimulated cytochemical index and the mobilization coefficient. Depending on the risk group for keratoplasty, the patients showed different dynamics of the levels of the studied interleukins after the course of plasmapheresis and keratoplasty. In patients of the Comparison group who did not receive a course of plasmapheresis in the preoperative period, over a period of 1.3 years, 22 cases (24 %) developed graft disease, while patients of both subgroups of the Main group who received a course of therapeutic plasmapheresis in the preoperative period, didn’t demonstrate any cases of graft disease. In patients of the Comparison group (in total for two subgroups), the maximum number of cases of graft disease (n = 24) was observed in the first 500 days after surgery. At the same time, the patients of the Main group who underwent plasmapheresis had the best graft survival rates: during the observation period, there were no cases of graft disease (in both subgroups).Conclusion: the obtained data indicate the ability of plasmapheresis, performed in the perioperative period, to prevent the development of graft disease in patients with keratoplasty.

Detachment of the pigment epithelium is the separation of the basement membrane of the retinal pigment epithelium from the inner collagen layer of Bruch’s membrane, which occurs in 80 % of cases in patients with neovascular age-related macular degeneration. The outcome of anti-VEGF therapy for pigment epithelial detachment may be adherence of the pigment epithelium, the formation of pigment epithelium tear, or preservation of the detachment. The pigment epithelium tear of 3–4th degrees can lead to a sharp decrease in visual acuity.Most retrospective studies confi rm the absence of a proven correlation between anatomical and functional outcomes in the treatment of pigment epithelial detachment in cases of maintaining the integrity of the pigment epithelium monolayer, and therefore the main attention of researchers is focused on studying the morphological features of pigment epithelial detachment during therapy with angiogenesis inhibitors. Modern technologies of spectral optical coherence tomography make it possible to evaluate detailed quantitative parameters of pigment epithelium detachment, such as height, width, maximum linear diameter, area, volume and refl ectivity within the detachment.Groups of Russian and foreign authors identify various biomarkers recorded on optical coherence tomography images. Dynamic registration of such biomarkers expands the ability of clinicians to predict morphological changes in pigment epithelial detachment during anti-VEGF therapy, as well as to optimize treatment regimens to prevent complications in the form of pigment epithelium tear leading to a decrease in visual acuity.Modern methods of deep machine learning and the use of neural networks allow achieving higher accuracy in diff erentiating the types of retinal fluids and automating the quantitative determination of fl uid under the pigment epithelium. These technologies allow achieving a high level of compliance with manual expert assessment and increasing the accuracy and speed of predicting morphological results of treatment of pigment epithelium detachments.

Background. In the available literature, there are isolated publications devoted to the topic of the possible effect of laser correction by the Femto LASIK method on the myopic eye choroid. In this connection, in our opinion, the relevance of continuing research in this direction remains.The aim of this study was to examine the volume of the retina in the macular zone, the thickness of the choroid and the ciliary body using optical coherence tomography on myopic eyes after femtosecond-assisted laser in situ keratomileusis in the short term.Material and methods. 30 patients (30 right eyes) aged 20 to 35 years, suffering from mild and moderate myopia, but without pathological changes in the retina according to OCT, made up the study group. All patients underwent myopia correction using the Femto LASIK method. Before the operation, after 4 hours and the next day, they underwent the examination of the retinal volume in the macular zone, the choroidal and the ciliary body thickness using OCTResults. The analysis of the obtained results of the studied parameters showed that the ciliary body thickness and the retinal volume in the macular zone did not undergo statistically signifi cant changes and remained within the preoperative values (p > 0.05). We observed a tendency to an increase in the thickness of the choroid 4 hours after the operation, but the carried out statistical analysis did not confi rm the reliability of its changes (p > 0.05). On the next day, the choroidal thickness indices practically recovered to the preoperative level (p > 0.05).Conclusion. A study of the retinal volume in the macular zone, the thickness of the choroid and ciliary body using OCT in myopic eyes in the short term after Femto LASIK showed the absence of statistically signifi cant changes in the studied parameters, which indirectly indicates the safety of this method of laser correction for the posterior segment of the eye.

Purpose. Analysis A-VEGF therapy for wet form age-related macular degeneration (AMD) complicated by retinal pigment epithelium tear (RPET), different in involvement of macular zone (MZ), with different time of RPET regarding A-VEGF therapy. Material and methods. The results of treatment 18 patients with wet AMD complicated by RPET during monthly A-VEGF injection were analyzed. In first group (10 eyes) – RPET occurred before treatment, the second (8 eyes) – RPET arisen during A-VEGF. Visometry, ophthalmoscopy, fundus photoregistration, MZ OCT before and in month after each injection. Age – 65–83 years. Results. RPET (1,5 DD) captured fovea in 7 first group patients, in 3 patients RPET (0,5 DD) didn’t affect fovea, In macula registered subretinal fluid (SRF) and hemorrhage (SRH). After 2 A-VEGF injections, resorption of SRF and SRH was observed. VA increased from 0,2 to 0,7 in cases RPET without capture of the fovea. RPET involving fovea occurred in 8 patients of the second group after the first A-VEGF injection. SRH and SRF resorbed. VA of patients decreased from 0,7 to 0,15. In both groups relapses of the SRF in macula after the development of RPET were not observed. Conclusion. Wet AMD complicated by RPET as a result of the pathological process and on the background of A-VEGF therapy. When RPET is involved fovea, VA decreases to 0.15. In case of preservation RPE in fovea – VA is high. A-VEGF therapy for wet AMD with RPET leads to resorption of SRH and SRF, to stop SRF for a long time.

Purpose: to develop approaches to differentiated substitution therapy in patients with dry eye (DE) of mild and moderate severity.Patients and methods. We examined 86 DE patients (22–45 years old; 38 men, 48 women). Group-1 included 54 patients (54 eyes) with mild DE under conditions of combined lipid-mucose-deficiency, group-2 32 patients (32 eyes) with moderate DE against the background of combined lipid-aqua-mucose-deficiency. Conducted: DE symptoms registration (OSDI scale); Norn and Shirmer-1 tests; OCT meniscometry; assessment of the Bijsterveld xerosis index and ‘lid-vipers’ symptom identification; Norn’s compression test. To assessment the therapy effectiveness, patients in both groups were divided into subgroups. Patients of subgroup 1.1 (18 eyes) carried out ‘fat-water’ type emulsion instillations, subgroup 1.2 (18 eyes) — 0.15 % sodium hyaluronate instillation (Hylabak®), subgroup 1.3 (18 eyes) — 3.0 % trehalose (Thealoz®) — 1–2 drops, 4 times a day. All persons included in group-1 were additionally recommended to apply 5.0 % dexpanthenol gel at night. Patients of subgroup 2.1 (16 eyes) received 0.15 % sodium hyaluronate instillation (Hylabak®), patients of subgroup 2.2 (16 eyes) 0.15 % sodium hyaluronate (Hylabak®) and 3.0 % trehalose (Thealoz®) instillation — 4 times a day. All patients included in group-2 were additionally recommended to apply ointment with vitamin A at night. The main criterion for the therapy effectiveness was the tear film brake up time (TBUT, s) two months after the start treatment. Statistical processing included: calculation the mean and its standard deviation (M ± s); assessment of the significance of differences (Wilcoxon’s t-test, KruskalWallis test, Mann-Whitney U-test).Results. In group-1 patients the following TBUT dynamics was recorded: in subgroup 1.1 — from 5.4 ± 0.5 to 6.2 ± 0.6 s (p < 0.05); in subgroup 1.2 — from 5.2 ± 0.4 to 6.6 ± 0.6 s (p < 0.05); in subgroup 1.3 — from 5.3 ± 0.5 to 7.1 ± 0.7 s (p < 0.05). The most pronounced TBUT increase was noted in subgroup 1.3 (trehalose instillation). In group-2, the increase in TBUT was: in subgroup 2.1 — from 3.5 ± 0.3 to 4.7 ± 0.3 s (p < 0.05); in subgroup 2.2 — from 3.4 ± 0.2 to 5.2 ± 0.4 s (p < 0.05). A significantly more pronounced TBUT increase was noted in subgroup 2.2 (sodium hyaluronate and trehalose instillation).Conclusion. In our opinion, differentiated approaches to DE replacement therapy may be included: for mild DE in conditions of lipid-mucose-deficiency — instillation of bioprotector based on 3.0 % trehalose (Thealose®); in case of moderate DE against the background of lipid-aqua-mucose-deficiency — 0.15 % sodium hyaluronate (Hylabak®) instillation in combination with a bioprotector based on 3.0 % trehalose (Thealoz®).

The literature review is devoted to the analysis of modern publications on the immunological and pathogenetic mechanisms of transplanted corneal rejection, risk factors, predictors and methods of the prevention of this complication. The prevention of corneal rejection is challenging.Currently, there is no single algorithm for the predicting methods of the corneal graft rejection, so further research in this area is needed.Purpose. To assemble the current data on immunological and non-immunological predictors of postoperative complications after keratoplasty. The analysis of modern publications on the immunological and pathogenetic mechanisms of corneal transplant rejection, risk factors, predictors and methods of prevention of this complication is presented. The databases used were CyberLeninka, PubMed, and Medline. The focus was on the publications of the last 10 year s.Conclusion. The data presented in the review make it possible to identify signs of corneal transplant rejection and to determine treatment in a timely manner, as well as to implement methods for preventing these complications.

Purpose: to assess the possibilities of ophthalmonutraceuticals using in age-related macular degeneration (AND) patients.Patients Methods. The study included 35 patients (68.3 ± 6.3 years old; 15 men, 20 women) with AMD (AREDS-2 and AREDS-3 categories). As an ophthalmic nutraceutical, a biological active supplement was used, included vitamins C and E, zinc, lutein, zeaxantine, cooper, selenium (Retinorm; 3 capsules per day with meals). The observation period was 12 months (6 courses of therapy). There were the main control points: examination at study entry and examination at study completion. All those observed patients were underwent standard ophthalmological examination; fundus state photo registration (Nidek); OCT (Opto-Vue). The significance of a possible increase in the proportion of AREDS-3–4 AMD category patients was assessed using the Pearson γ2 test. An additional criterion was the maximum corrected visual acuity (MCVA) stabilization. The mean and its standard deviation (M ± s) were calculated, the significance of differences was assessed using the Wilcoxon’s t-test.Results. The study was completed in 33 patients. In 2 eyes a transition of AMD from the AREDS-2 to AREDS-3 category was recorded (an increase in the number and size of druses, with the appearance of large druses). The increase in the proportion of patients with the AREDS-3 AMD category was statistically insignificant (γ2 = 0.267; p = 0.606). In no case was there a transition to the AREDS-4 category. In the vast majority of those who completed the study (31 eyes; 93.9 %), the manifestations of AMD were stable, which, taking in account the chosen criterion, allows us to consider nutraceutical support to be affective. MCVA during the observation period also remained stable with a slight, but statistically insignificant tendency to its increase (from 0.72 ± 0.07 to 0.75 ± 0.09; t = 37.5, p > 0.05). One patient was excluded from the study after 6 months of observation due to development of an allergic skin reaction (presumably to the components of a nutraceutical). In the vast majority of patients (97.1%), no significant side effects of therapy were observed, the nutraceutical regimen was comfortable. One more patient was excluded from the study (after 3 months) due to his failure to appear for next follow-up examination.Conclusion. The use of Retinorm ophthalmonutraceutical can stabilize the manifestations of AMD (AREDS-2–3) in 93.9 % of patients with follow-up periods of up to 12 months. Repeated courses of therapy in 97.1 % of patients are not accompanied by significant side effects, and the regimen for taking ophthalmonutraceuticals is characterized by patients as comfortable.

Purpose. To evaluate the prevalence, clinical and pathogenetic variants and statistically significant risk factors of dry eye (DE) in patients before cataract surgery. Patients and Methods. 600 age-related and complicated cataract patients (70.6 ± 7.8 years old; 269 men, 331 women) were examined. Visometry and biomicroscopy with photographic recording of the lens state and assessment of its opacities according to the LOCS III classification were used to cataract revealing. OSDI testing, lipid interferential test, TBUT, Shirmer-1, -2 tests, visual and OCT meniscometry, evaluation of epitheliopaty and microerosion (with vital staining), compression Norn test in Korb modification, visual and OCT LIPCOF assessment, lid viper epitheliopathy evaluation, anterior segment of the eye photoregistration with computer morphometry were performed to assess the ocular surface condition. The structure of the DE risk factors, was studied both in DE patients and non-DE subjects with calculation of the Pearson xi-square test. To estimate the strength of the connection between the etiological condition and the DE, the normalized value of the Pearson coefficient (C´) was used. Results. The dry eye prevalence was 53.2 % (of them, 25.5 % was mild, 27.7 % — moderate, by Brzhesky). Subclinical DE prevalence was 27 %. Clinical and pathogenetic variants of mild DE included: isolated lipid deficiency (71.9 %), lipid-mucin deficiency (28.1 %). In patients with moderate DE were identified: aqueous-lipid-mucin deficiency (54.8 %), aqueous-lipid deficiency (37.95 %), isolated aqueous deficiency (7.2 %). The most significant systemic-organ DE risk factors were: diabetes mellitus (C´ = 0.302; in 18.8 % DE patients), female sex (C´ = 0.240; in 62.1 % de patients), allergy (С´ = 0.233; in 23.2 % DE patients). Local risk factors most significantly associated with DE were: meibomian glands dysfunction (С´ = 0.58; in 77.7 % DE patients), chronic blepharitis (С´ = 0.233; in 23.2 % DE patients), pterygium (С´ = 0.276; in 13.2 % DE patients), allergic conjunctivitis (С´ = 0.21; in 21.3 % DE patients). Among the exogenous risk factors, the most significant were: the use of medication affecting tear production or tear film stability (С´ = 0.485; in 89.03 % DE patients), preservative eye drops instillation (С´ = 0.2975; in 56.1 % DE patients). Conclusion. In our opinion, data on the high DE prevalence in cataract patients (53.2 %) should be taken into account when planning cataract surgery, since perioperative correction of the ocular surface condition can increase the surgical treatment efficiency, predictability and safety. The data on the structure of significant risk factors and clinical and pathogenetic DE variants in cataract patients can be the basis for the development of measures to ensure timely DE detection and implementation of reasonable therapy. The risk factor most significantly associated with DE in cataract patients was the meibomian gland dysfunction (MGD) (Pearson xi-square test = 88.542, p < 0.001, С´ = 0.58; “relatively strong” strength). Considering the modifiability of this risk factor (MGD), as well as its high prevalence (77.7 %), it can be considered that eye lids hygiene may be a reasonable therapy in most DE and cataract patients before phacoemulsification.

Purpose: to evaluate the efficacy and safety of complex therapy of allergic conjunctivitis, including 0.2 % olopatodin. Patients and methods: In 40 allergic conjunctivitis (AK) patients were performed: assessment of the intensity of itching and tearing, as well as conjunctival hyperemia and folliculosis (points); Schirmer’s test (SHT; mm); tear film break up time (TFBUT, s); assessment of the lid wiper epitheliopathy symptom (LWES, points); calculation of the xerosis indicator (XI; points, according to Bijsterveld). In the 1 group (20 pollen AK patients) were given: 0.2 % olopatadine instillations (1 time per day); preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (2–3 times a day, from 7 days of therapy). Control points: 7 and 30 days of therapy. Patients of 2 group with pollen AK and chronic blepharitis (saprophytic flora and Demodex) were performed: 0.2 % olopatadine instillations (1 time per day); eyelid hygiene (poloxamer 188 and PEG-90 gel; 2 times per day); ointment containing gentamicin and dexamethasone (application on the eyelids margins, 2 times a day, 14 days); acaricidal gel (based on preparations of sulfur, sodium hyaluronate and aloe extract; 2 times a day, from 15 days of therapy); preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (2–3 times a day, from 15 days of therapy). Control points: 14 and 30 days of treatment. Statistical analysis included: calculation of an average and its standard deviation (М ± s); evaluation of reliability of differences in control points (Wilcoxon’s T-criterion; χ2 criterion). Statistically significant was p < 0,05. Results: Patients of both groups had good tolerability of the treatment; no significant systemic and local side effects of treatment were noted. In 1 group patients by the 7th and 30th day of therapy, a significant decrease in the severity of itching, tearing and conjunctival hyperemia was observed. By the 30th day of observation, the complete absence of itching was noted in 85 % of individuals, the absence of hyperemia — in 80 %. The rest of the observed severity of these signs did not exceed the level of one point, and their manifestations were non-permanent. Conjunctival follicular response significantly decreased by 30 days of observation. SHT showed a significant decrease in all control points, remaining within normal limits. Dynamics of TFBUT and XI by 7 days of therapy was unreliable. By the 30th day of treatment, there was a significant positive dynamics of TFBUT and XI, compared with the state before the therapy and 7 days of observation. At the same time, TFBUT and XI have reached values close to normal. In 2 group patients by the 14th and 30th day of therapy, a significant decrease in the severity of itching, tearing, hyperemia and follicular conjunctival reaction was recorded (by 1–2 points). The value of SHT showed a significant decrease in all control points (within the normal values of the indicator). By the 14th day of therapy, a significant decrease of LWES was noted; the NT and XI the dynamics were statistically insignificant. By the 30th day of observation, significant positive dynamics of NT, XI, and LWES were noted, compared with the state before the start of treatment and 14 days of therapy. Despite the almost complete relief of symptoms and signs of allergy and ocular surface condition improvement, by 30 days of observation, the magnitudes of NT, XI and LWES still did not reach the normal state, which determined the need for further artificial tear therapy, eyelid hygiene and acaricide treatment. Conclusion: Combined therapy, including 0.2 % olopatadin instillation, demonstrated high efficacy in relieving symptoms (itching, tearing) and signs (hyperemia and follicular conjunctival reaction) of allergic conjunctivitis, as well as a good safety profile.

Modern human life conditions are associated with the increase of visual load in the volume and intensity. It determines the social and scientific significance of the study of the visual system functional capabilities with refractive errors. Due to peculiarities such types of ametropia as hypermetropia, hypermetropic and mixed astigmatism are the cause of inadequate load on the visual analyzer. Foreign and Russian scientists mainly pay attention to the study of these functions in childhood, adolescence or presbyopic age. We studied the frequency and degree of binocular and accommodative disorders in adult patients (18–48 years) with hypermetropia, complex hypermetropic and mixed astigmatism. Depending on the type of ametropia, the patients were divided into 2 groups. Group I Hm ast included 58 patients with hypermetropia and complex hypermetropic astigmatism, group II Mixed ast — 60 patients with mixed astigmatism. Patients were divided into two subgroups depending on age: subgroup A included patients aged 18–34 years, subgroup B — patients aged 35–48 years. The control group was 50 persons with emmetropic refraction, which were also divided according to age into two subgroups. In the course of the study, there were noted violations of the accommodative, binocular, oculomotor functions in various combinations of one or several parameters in adult patients with hyperopia, complex hyperopic astigmatism, mixed astigmatism in 10–32 % of cases. A significant percentage of detected latent sensory-motor disorders determines the need for a detailed study of these functions to choose the optimal correction method.

Purpose. To evaluate the effectiveness of dry eye syndrome (DES) treatment in patients with meibomian gland dysfunction (MGD) before refractive surgery.Materials and methods. We examined 48 women (aged 29.6 ± 3.9 years) with myopia, DES, and MGD of noninfectious etiology before performing LASIK. Group 1 of these patients received presurgical correction of DES for 2 months, including instillation of 3 % trehalose as a bioprotector (Thealoz®; 3–4 times a day); application of 5 % dexpanthenol in the conjunctival cavity (before going to bed); eyelid hygiene (2 times per day), which included cleaning (Theagel®), warm compresses on eyelid area, massage of eyelid margin (Blephaclean wipes). Group 2 only received bioprotective and reparative therapy for 2 months. Testing included a standard ophthalmological examination; assessment of DES symptoms (OSDI scale, points); BUT test (sec) and Schirmer-1 test (Sh-1, mm); measuring the height of the lower tear meniscus (optical coherence tomography, μm); lissamine green staining with calculation of xerosis index by Bijsterveld (points); assessment of MGD severity (points). Processing of the results included calculation of M ± s; Wilcoxon t-test, Mann Whitney U-test.Results. A positive change of OSDI (decrease from 31.9 ± 2.9 to 8.71 ± 1.1 points), xerosis index (decrease from 4.71 ± 0.5 to 2.1 ± 0.3 points) and BUT test (increase from 4.14 ± 0.53 to 8.66 ± 0.93 sec) was significantly stronger in patients of group 1 (p < 0.05) in comparison with patients of group 2 (decrease in OSDI from 33.2 ± 3.1 to 15.6 ± 2.4 points; decrease of xerosis index from 4.75 ± 0.50 to 3.7 ± 0.5 points; BUT increase from 4.21 ± 0.47 to 6.05 ± 0.73 sec). Apparently, this was caused by a significant decrease in the severity of MGD (from 2.1 ± 0.3 to 0.9 ± 0.2 points) and a decrease in the severity of lipid deficiency due to eyelid hygiene in patients of group 1. In group 2, MGD severity change proved unreliable. Change of Sh-1 and the height of the lower tear meniscus was unreliable in all cases. Conclusion. The inclusion of eyelid hygiene (Theagel and Blephaclean) in the pre-surgery preparation of patients with DES and MGD leads to a more significant correction of eye surface condition compared to isolated bioprotective and reparative therapy, thus providing an opportunity of more favorable conditions for carrying out surgical correction of ametropia.

Age-related cataract is a major medical and social issue as it is the main cause of reversible blindness in the world. Age-related cataract is frequently accompanied by pseudoexfoliation syndrome (PXFS) - a systemic dystrophic process, clinically manifested in the eyeball. Dystrophic changes in XFS bring about a 5-fold increase of the risk of cataract surgery complications, amounting to 49.4 % of cases. Purpose: to study the clinical characteristics of ocular PXFS manifestations in age-related cataract among residents of the South of Russia. Material and methods. A total of 179 patients (277 eyes) with age-related cataract were tested. Of these, 75 patients (41.9 %, 114 eyes) were found to have PXFS while the remaining 104 patients (58.1 %, 163 eyes) had no PXFS. Testing included visometry, autokeratorefractometry, ophthalmic biomicroscopy, pneumotonometry, perimetry, ophthalmoscopy, ultrasound biometry, determination of electrical sensitivity threshold of the optic nerve, and critical flicker frequency. Results. It was found that age-related cataract patients with PXFS were significantly older than those without PXFS. The former showed a lower initial visual acuity and pronounced trophic changes in the anterior segment of the eye. PXFS patients developed iridodonesis 13 times as often as those without PXFS, while lens subluxation occurred 8 times as often. In more than one third of the cases, PXFS patients had dense or very dense lens nucleus. Conclusion. Age-related cataract of South Russia residents having pseudoexfoliation syndrome was found to be more severe and complication-prone than that of patients without PXFS. For citation: Polapina A.A., Komarovskikh E.N., Sakhnov S.N., Zabolotny A.G. Age-related cataract and pseudoexfoliation syndrome among residents of the south of Russia. Russian ophthalmological journal. 2018; 11(3): 19-24 (In Russian). doi: 10.21516/2072-0076-2018-11-3-19-24.

Purpose: To evaluate effectiveness and safety of cataract surgery pharmacological support (which include 0.5 % levofloxacin, 0.09 % bromfenac and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination instillations) in glaucoma patients. Patients and Methods: Standard ophthalmological examination, subjective discomfort level evaluation, tear film break up time, tear meniscus height measurement, index of xerosis, evaluation and ocular surface condition photoregistration were performed in 40 II «A» primary open-angle glaucoma patients, receiving hypotensive therapy, before and after phacoemulsification (Ph). All patients in the postoperative period received instillations: 0.5 % levofloxacin (4 times a day, 7 days), 0.1 % dexamethasone (3 times a day, 7 days), 0.09 % bromfenac (once a day, 30 days) and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (3 times a day, 30 days). Control points were: examination before Ph, on 1, 7 and 30 days after Ph. Results: None cases of infectious or inflammatory surgery complications were recorded. The SD level was significantly increased on the 1 and 7 days after Ph, by the 30 day the SD level was significantly decreased, compared with a state on the 1 and 7 days. On the 1, 7, 30 days after Ph TFBUT significantly decreased. By the 30 day after Ph the TFBUT was significantly increased in compare with 1 and 7 days after operation. TMH changes after Ph had multidirectional character and in general were not significant throughout the observation, with a tendency to increase on the 1 and 30 days after surgery and to decrease on the 7th day. IX dynamics in compare with a state before Ph was not significant in all control points with a tendency to its increase on the 1 and 7 days after operation and to decrease on the 30th day. In general, pharmacological support of Ph was assessed by all patients as comfortable, there was no intolerance. Conclusion: The cataract surgery pharmacological support in glaucoma patients (including 0.5 % levofloxacin, 0.09 % bromfenac and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination instillations) showed: high efficiency (in prevention of infectious and inflammatory complications); safety by influence on the ocular surface; comfort of use.

Purpose. To evaluate the prevalence, clinical severity, clinical and pathogenetic variants and etiology of dry eye (DE) in patientsbefore refractive surgery. Methods. OSDI testing, lipid interferential test, TBUT, Shirmer-1, -2 tests, compression Norn test in Korbmodification, calculation of xerosis index by Bijsterveld, tear meniscus index evaluation, LIPCOF test, evaluation of epitheliopaty and microerosion by Tseng and lid viper epitheliopaty were performed in 600 myopia (with or without astigmatism) patients (234 men, 366 women; 30.1 ± 6.26 years old) before refractive surgery. The structure of the DE etiological conditions, was studied both in DE patients and non-DE subjects with calculation of the Pearson xi-square test. To estimate the strength of the connection between the etiological condition and the DE, the normalized value of the Pearson coefficient (C') was used. Results. The dry eye prevalence was 38.83% (of them, 71.76% was mild, 28.83% — moderate, by Brzhesky). Clinical and pathogenetic variants of mild DE included: lipid deficiency (53.29%); lipid-mucin deficiency (26.95%); mucin deficiency (11.38%); state without signs of lipid or mucin deficiency (8.38%). In patients with moderate DE were identified: isolated aqueous deficiency (6.06%); aqueous-lipid deficiency (34.85%); aqueous-mucin deficiency (7.58%); aqueous-lipid-mucin deficiency (51.52%). Statistically significant (р < 0.01) etiological conditions for the disease in patients with diagnosed DE include: contact lenses wearing (C' = 0.349); visual display use (C' = 0.342); the use of medication affecting tear production or tear film stability (C' = 0.41); application of cosmetics (cosmetic pencil or mascara) in the intercostal space of the eyelid margin — in the area of the excretory ducts of the meibomian glands (C' = 0.44); meibomian glands dysfunction (C' = 0.782); chronic allergic conjunctivitis (C' = 0.543); the presence of gynecological pathology (C' = 0.413); thyroid gland diseases (C' = 0.32); allergy (C' = 0.563); female sex (C' = 0.559). Conclusion: Raising the awareness of ophthalmologists about the prevalence of early DE manifestations in patients before refractive surgery will help optimize the detection of this pathology. The obtained data on the structure of DE clinical and pathogenetic variants and the etiological prerequisites can serve as a basis for the development of therapy. One of the most prevalence and significant etiological condition for DE was MGD, leading to lipid-deficiency, which determines the direction of etio-pathogenetic treatment — the eyelids hygiene.

Purpose. To study the efficiency of a preoperative inhalation session of oxygen-xenon mixture in the mode of analgosedation for stressunstable patients at the preoperative preparation stage for the ReLEx®SMILE method.Material and methods. The study group consisted of 11 patients (mean age 22.76±1.43 years) with a high degree of anxiety (>46 points), according to the Spielberger State-Trait Anxiety Inventory (STAI). The laser correction by the ReLex® SMILE technology was planned for them (average spherical equivalent (SE) 3.38±0.39D) using the VisuMax™ 500 kHz device (Carl Zeiss Meditec AG). As a preoperative preparation, they underwent the inhalation of an oxygen-xenon mixture in the analgosedation mode. The sessions were performed using the anesthesia XENA-01 device, operating on a closed loop, thereby the xenon exposure was carried out in sub-narcotic concentrations – 35-40% (up to 1/3 МАC).Results. During the analgosedation session with the oxygen-xenon mixture before the ReLEx® SMILE, the hemodynamic and ventilation parameters in the patients of the study group remained stable. By the 20th minute the patients calmed down, fell asleep, heart rate decreased up to 55.4±5.3 per minute. The 40% xenon exposition was 20 minutes. The xenon consumption was 4.5±0.7 liters per session.During the ReLex® SMILE, the patients, remaining fully conscious, behaved adequately and calmly. The stage of interface applanation to the cornea, its centering, femto-dissection occurred without complications in all patients. The planned refractive result was achieved in 100% of cases (the mean SE was 0.25±0.1D). The next day after the procedure, the UCVA in all patients was 0.9-1.0.Conclusion. The analgosedation session with an oxygen-xenon mixture provides an adequate nociceptive and anti-stress protection, guarantees safe laser ophthalmic interventions in emotionally labile patients. The obtained results of the study allow to consider this premedication method before the femto-laser correction of ReLEx® SMILE as a new approach to the prevention of such an intraoperative complication as the vacuum loss.

Purpose. To evaluate the efficacy of a fixed combination of sodium hyaluronate, D-panthenol, chondroitin sulfate sodium (SH+D+CS) and a tear substitute based on sodium hyaluronate (SH) in the correction of post-LASIK ocular surface changes. Material and methods. The study involved 60 patients with moderate myopia (before and after LASIK). In the group 1 (30 patients, 30 eyes) the SH+D+CS combination was instilled postoperatively 3-5 times daily, in the group 2 (30 patients, 30 eyes) SH – 3-5 times daily. Ophthalmological examinations, a detection and an evaluation of dry eye (DE) symptoms, tear film break up time (TFBT), optical coherence meniscometry, evaluation of xerosis index (XI) (lyssamine green staining) were performed in all the patients. Results. Significant ocular surface changes were identified in both groups in the postoperative period: DE symptoms, decrease of TFBT, decrease of lower tear meniscus height (LTMH), increase of XI. The DES therapy was effective in both groups. At the same time, significantly more pronounced increase of TFBT and LTMH (10 and 40 days after LASIK, p< 0.05) as well as a significantly more pronounced decrease of XI (40 days after LASIK, p< 0.05) were noted in the group 1. Conclusion. Thus, the application of the fixed combination of SH+D+CS allows to achieve significantly more pronounced improvement of ocular surface conditions in the post-LASIK status than the application of a tear substitute based on SH.

Aim. Analysis of complications arising in the process of fragmentation of the lens nucleus, by various methods the energy of the impact in the surgical treatment of age-related cataracts.Material and methods. The study included 550 patients (677 eyes) operated for cataract in the period from 2015 to 2017 in the Krasnodar branch of the S. Fedorov Eye Microsurgery Federal State Institution. According to the method of energy crushing of the lens nucleus, all patients were divided into 3 groups. For group 1 – ultrasound technology (bimanual phacoemulsification of cataract (FCE) was used; for group 2 – Nd: YAG-laser with a wavelength of 1,44 μm technology of laser cataract extraction (LCE) was used; group 3 – infrared femtosecond laser technology (femtosecond laser support phacoemulsification (FFCE) was used.Results. When using FFCE minimum percentage of complications in comparison with the FCE and LCE in cases of uncomplicated age-related cataracts was observed. In has been proved that in the presence of complicated cataracts, combined with a defect or weakness of the ligamentous apparatus of the lens, a pronounced syndrome, irido-ciliary dystrophy (IFIS-syndrome), bad expanding pupil; as well as in cataract with high degrees of density of nuclei, and in agitated patients, both FCE and LCЕ can be used. In our opinion LCE is preferable.Conclusion. Differentiated approach to the choice of the optimal method of phacofragmentation results in minimum intra – and postoperative complications, as well as better outcome for the patients.

The retrospective analysis of effectiveness of surgical tech medical aid (HTMC) for rehabilitation of children with congenital cataracts (CC). HTMC was carried out in the complex of conservative treatment of deprivation of amblyopia. HTMC was a regional division of the Federal specialized ophthalmologic institutions – «The academician S. N. Fyodorov IRTC «Eye microsurgery» Krasnodar branch.Conclusions: мinimally invasive removal CC with IOL implantation in the capsular bag, flexible IOL makes it possible to remove CC with six months, improves the conditions of treatment of amblyopia and increases the percentage of getting a good view, post-operative response is minimal. The frequency of occurrence of fibrosis back capsules allows to consider capsulectomy as the second stage of surgical treatment of CC.

This article is dedicated to the 45th pediatric department's anniversary of the Kuban state medical university. It reflects the history and prospects for further development of the faculty. Each department of pediatric faculty cherishes its traditions and history.

Purpose. Prospective study of corneal epithelial layer thickness (CET) changes after the ReLEx® SMILE in case of a low and moderate myopia correction.Material and methods. The «SMILE» study group included 46 patients (46 eyes) with the mean age 26.02±5.18, the mean spherical equivalent was 4.02±0.22D, the follow-up period was 6 months and less. All patients were examined using the optical coherence tomography (OCT) with the xR AVANTI (Optovue, Inc) pre-operatively and 1 day, 2 weeks, 1, 3, 6 months post-operatively, the ametropia laser correction was performed by the ReLEx® SMILE method using the VisuMax® (500 kHz, Carl Zeiss Meditec AG).Results. After 6 months in 43 patients the uncorrected visual acuity (UCVA) was 0.9-1.0 (93.5%), the refraction within ±0.5D of the planned one was achieved in 89.1% (41 eyes), ±1.0D – in 100% of cases. Epithelial hyperactivity was noted during the first 3 months (Р

The purpose of research is to conduct a retrospective analysis of the prevalence and incidence of myopia in the Krasnodar region in the different age groups. This paper analyzes the statistics of the annual reports of health care institutions from 2000 to 2012 inclusive.

Aim. To assess the effectivity of autumnal allergic blepharoconjuctivitis complex therapy.Methods. 25 autumnal allergic blepharoconjuctivitis patients (50 eyes) were examined before and after complex treatment that included olopatadine hydrochloride 1 mg / ml (instillations 2 times a day), cetirizine 10 mg (1 tablet a day), and steroid drug (insufflations 2 times a day). Dry eye patients additionally received hyaluronic acid 1 mg / ml (instillations 2 times a day). 10 controls (20 eyes) were prescribed only the above-mentioned treatment. In 15 study group patients (30 eyes), Blepharogel 1 was applied on lid margins. Routine eye examination, clinical symptom assessment, Schirmer’s and Norn’s tests, xerosis meter and lissamine green staining evaluation, and anterior segment photography with computed morphometry were performed.Results. Compositae allergy was diagnosed in all patients. Dry eye due to tear film instability, lipid deficiency, and mucin deficiency and epitheliopathy were diagnosed in 55 %, 35.5 % and 28.3 %, respectively. In study group, the treatment significantly and rapidly reduced patient-reported symptoms and blepharoconjunctivitis signs as well as significantly improved tear stability, lipid deficiency, mucin deficiency, and epitheliopathy as compared with controls.Conclusion. Blepharogel 1 as a component of complex therapy increases the efficacy of autumnal allergic blepharoconjuctivitis treatment.

Currently, most surgeons use 27G needles to perform intravitreal and endolymphatic administration and reflexogenic zone blockade. However, their use is associated with certain disadvantages and complications.Aim. To develop a device for intravitreal and endolymphatic drug administration and sinocarotid zone blockade.Methods. A device for intravitreal and endolymphatic drug administration and sinocarotid zone blockade was developed. It consists of an original adapter, 30G carpule needle, and a syringe. Pre-clinical trials included comparative evaluation of this device and a rather well-known instrument for intravitreal and endolymphatic drug administration and sinocarotid zone blockade (a syringe with 27G needle). Clinical trials involved 150 patients aged 36 years and older.Results. The device consists of a syringe, 30G carpule needle, and an original three-stage hollow adapter that attaches the needle to the syringe. The needle has a cannula to be attached to the adapter. The cannula and the second stage of the adapter have the thread with an aligning arrangement The third stage of the adapter is made in a form of a truncated cone that tightly goes into the cannula thus providing reliable fixation of the needle. The device: (1) minimizes the leakage of a drug in the course of the procedure thus providing more accurate drug administration and preventing its overuse; (2) reduces complication risk and improves the safety of intravitreal and endolymphatic drug administration and sinocarotid zone blockade; (3) improves the tolerability of intravitreal and endolymphatic drug administration and sinocarotid zone blockade; (4) improves personal readiness to undergo maintenance retreatment. The utility model application was filed, and the filing receipt No. 2014109466 was acquired on March 12, 2014.Conclusion. The device provides optimal intravitreal and endolymphatic drug administration and sinocarotid zone blockade.

The study included 45 patients (90 eyes) with ocular surface changes type of dry eye syndrome, etiological prerequisite for the observed was a combination of chronic blepharitis infectious etiology phenomena dysfunction meybomian glands and chronic eye ischemic syndrome. Patients of the main group in addition to tear replacement therapy was performed non-invasive ultraviolet irradiation device «Ecosvet-1», therapeutic effect which is due to its anti-inflammatory and scalp-stimulating effect, as well as the ability to improve the state of the microcirculation of tear production organ. The device enables to achieve a more pronounced eliminating subjective symptoms, functional and objective evidence of the disease than isolated tear replacement therapy, and reduce the instillation of the preparation of artificial tears during the day.

Purpose: To evaluate the effectiveness of complex treatment included the eyelid hygiene in non-infectious chronic blepharitis patients.Methods: 50 non-infectious chronic blepharitis, meibomian gland dysfunction and dry eye patients (18‑46 years) were examined before and after the treatment (eyelid hygiene using Blepharoshampoo, Blepharolotion or Blepharosalfetka, Blepharogel-1; anti-inflammatory therapy; artificial tears). Traditional ophthalmological examination, consideration of subjective discomfort level, evaluation of meibomian gland function (compression test) and severity of eyelid epitheliopaty (lyssamine green staining), lipid-interferential test, Schirmer’s test, tear film break up time, optical coherent meniscometry, computer evaluation of xerosis indicator (lyssamine green staining) and ocular surface microbiological examination were performed in all the patients.Results: Positive therapeutic effect was noted in all of the observed. It included the following significant changes: reducing the level of subjective discomfort; decreasing of sins of eyelid inflammation; increasing of meibomian gland function; improvement of tear film and ocular surface tissues.Conclusion: Complex treatment, including eyelid hygiene (using Blepharoshampoo, Blepharolotion or Blepharosalfetka, Blepharogel-1), antiinflammatory therapy and artificial tears, allows achieving significant reduction of subjective symptoms and both functional and objective signs of the disease in non-infectious chronic blepharitis patients.