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Aim: rectification of indications and contraindications for ectoprosthetics and exploration of its potential as a modern rehabilitation modality., Material and Methods: Here are summarized the results of 89 cases of facial reconstruction with prosthetic means in trauma patients and those who had had congenital or oncological pathology and in whom other methods of rehabilitation were unable to remedy the defect within the orbital region., Results: The indications and contraindications for facial prosthetics as well as the conditions, under which this type of medical and social rehabilitation can be carried out, were clarified. The authors also explained the process of creating an epiprosthesis and how it should be attached to the orbit to have the maximum effect on the existing defects of both the bone and auxiliary apparatus (including eyelid soft tissues, eyelashes, etc.). Because modern ectoprostheses are made of silicone and held in place with magnets, they provide an optimal cosmetic result, so that, regardless of patient's age, no rough defects can be detected on the affected side at a 2-m distance., Conclusion: As the production technology develops, the cosmetic appearance of epiprostheses improves and their use broadens.

Unlabelled: Aim - to justify the use of custom-made ocular prostheses aimed at better functional and cosmetic outcomes., Material and Methods: Cosmetic outcomes in 520 patients operated for either anophthalmia (89.1%), or ocular subatrophy (6.7%), or congenital micro-/anophthalmia have been analyzed. General and ophthalmic assessment was performed., Results: Relationships were investigated between the results obtained in a particular patient, on the one hand, and primary etiology in his/her case, eye removal technique, postoperative management details, complications, treatments, and preventive measures, on the other. It has been found that, if aiming to avoid the development of anophthalmic syndrome, the choice of surgical technique should be done most carefully so that a muscle stump could be formed and primary prosthesis inserted. Indications for the use of complexly shaped ocular prostheses have been identified. We have also explored the possibilities for correction of cosmetic defects associated with the use of modified stock prostheses. Moreover, in this article particular attention is paid to the importance of cooperation between the oculoplastic surgeon and the ocularist in order to ensure timely orbital reconstruction., Conclusion: Indications for the use of custom-made ocular prostheses of complex shapes have been identified. The range of complications that may arise from their irrational use are discussed.

The article is devoted to the problems of eye prosthetics that develops since ancient times till today. Indications for eye prosthesis and its role in rehabilitation of anophthalmic patients are determined. The process of glass prostheses production is described in details, technology is discussed and illustrated. This article is of great interest for opthalmologists and prosthetic technicians as it is proved that glass prostheses are more physiologic and have a number of advantages compared to plasticones.

The results of ocular prosthetic help analysis in different regions of the country is presented based on estimation of number of patients who need ocular prostheses; analysis of quality and quantity of produced prostheses in the country; evaluation of demand for glass and plastic prostheses and price determination; study of regulations.

The study covered 1980 patients with anophthalmos and a cosmetically poor blind eye, who were followed up in the ocular prosthesis room, Helmgoltz Institute of Eye Diseases. The optimal periods of primary and stepwise prosthetic replacement are defined and standard ocular prostheses of the most appropriate shape and size are recommended depending on the specific features of the conjunctival cavity and stump in this period. Recommendations are given on the application of ocular prostheses in congenital pathology and subatrophy.

The paper presents a detailed analysis of 27700 patients with ocular injury who received a therapeutic-and-diagnostic care at the first specialized stage. The specific features of an oculist's care in an intensive care unit and the required volume of diagnostic studies in different types of posttraumatic pathology of the eye and its appendages are defined. Indications for emergency hospitalization in fresh trauma and sequels are presented. Algorithms of treatment have been developed and are recommended in relation to the pattern and severity of injuries of the organ of vision.

The functional and clinical results of implantation of various models of intraocular lenses (IOL) were assessed, by taking into account its procedure (applying a forceps or an injector). The optimum technology for implanting elastic IOLs was proposed, depending on the etiology of cataract. Analysis of surgical outcomes in 172 patients (207 eyes) revealed the characteristic complications, the specificity of implantation of various models of elastic IOLs, the advantages and disadvantages of the forceps- and injector-based implantations in age-related cataract, in patients with complicated cataracts in the presence of glaucoma, myopia, diabetes, and moderate- and high-degree hyperopia.

The time course of changes in the rate of enucleations and the prevalence of anophthalmos in the Russian Federation, which have recently been growing steadily, were studied. By analyzing a great body of clinical materials from 1337 patients with anophthalmos, they show the ways of forming a locomotor stump and the most commonly used implants and recommend the optimal shapes of standard artificial eyes for the rehabilitation of persons with anophthalmos and a cosmetically defective blind eye. Ocular prosthetic repair as a method of social, psychological, and medical rehabilitation is one of the principal stages of upgrading the quality of life in the patients who have lost eyes.

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

Seventeen patients with penetrating injuries in the posterior pole caused by mechanical trauma of the eye were analyzed clinically; such injuries were characterized by the development of the most severe complications, which led to eye loss. An incomplete sealing of the penetrating trauma of the eye fibrous capsule localized in the posterior sclera section was the main reason that predetermined a trauma outcome; it can be rarely diagnosed and is difficult for surgical treatment. Computer tomography, which makes it possible to detect and localize the discussed pathology, is the most informative method in diagnosing the posterior pole. The organ-saving effect and process stabilization were ensured in 98.5% of patients owing to the use of a set of diagnostic pre- and intraoperative techniques.

The key issues related with rendering the ocular prosthetic aid to patients with anophthalmos and with cosmetically inferior, i.e. a smaller-size, blind eye, are in the focus of attention. Around 320,000 persons need ocular prostheses in the territory of the Russian Federation, hence adequate prosthetic measures are taken to cope with the cosmetic, medical and social rehabilitation of patients. The ocular prosthetics service deals with issues related with prostheses manufacturing technologies as well as with other therapeutic and surgical aspects which call for working out a unified policy with its subsequent commissioning into the practice of ophthalmologic institutions.

The offered study is dedicated to an acute ophthalmology issue, i.e. damage to the vision body by irradiation of non-medical lasers used in every-day life, industry and army. A total of 6 patients with damages to the central eye section were analyzed. The results of ultrasound fluorography as well as of electrophysiological examinations are described and conservative therapy schemes are presented. According to a preliminary conclusion, the outcome of the clinical condition can be accompanied by a low and eccentric vision.

The authors offer recommendations on the choice and use of optimal clinically tried drugs in ophthalmic traumatology with consideration for posttraumatic changes, doses, and mechanism of action. The recommendations are based on the clinical observations of 16,000 patients treated at department of ocular injuries, reconstructive surgery, and ocular prosthetics of Helmholtz Institute of Ocular Diseases in Moscow.

Penetrating wounds of the eyeball in 57-66% cases are associated with corneal involvement leading to the development of cicatricial astigmatism and decrease of the functional results. We investigated the causes of posttraumatic cicatricial corneal astigmatism, possibilities of its prediction, prevention, and correction. The results of treatment of 256 patients with corneal wounds and cicatrices are analyzed. Our analysis confirmed that the severity of astigmatism in corneal wounds directly depends on the wound size, edge status, direction, location, and structure of the forming cicatrix. Adequate and timely primary debridement of the corneal wound with intraoperative keratometric control plays the key role in minimization of cicatricial astigmatism. Early therapy with drugs stimulating the regeneration processes promotes more complete recovery of corneal tissue structure and decrease of astigmatism severity. Timely dosed slackening or removal of sutures makes possible modulation of astigmatism development. A formula is proposed, using which makes it possible, on the basis of initial data on the corneal wound, to estimate the possibility of corneal astigmatism, i.e. predict the outcome of the injury.

Congenital anophthalmia and microphthalmia were responsible for 1.7-1.8% cases of all cases treated at laboratory of plastic surgery and ocular prostheses. Clinical picture of the condition is described. The philosophy of rehabilitation of patients with congenital anophthalmia and microphthalmia is as follows: 1) no operations during the first years of life; 2) early staged fitting with prostheses; 3) surgical treatment in older age, when the resources of conservative extension of the cavity are exhausted. The authors emphasize that active conservative treatment should be preferred. Method for nonsurgical extension of the conjunctival cavity by staged insertion of prostheses is described. Positive and negative aspects of surgical treatments are discussed. The authors emphasize that surgical activity in early age is extremely harmful. Results of surgical treatment of 27 patients are presented. The patients were divided into 2 groups differing by the tasks of surgery: repair of consequences of previous operations (59.2% cases) and typical correction of the eye lids (40.8%). Clinical examples are offered.

Results of treatment of 42 patients with a magnetic intraocular fragments (balls, pistons, capsules) are analyzed and indications for various surgical interventions for removal of fragments with the minimal injury for the eye are defined. The role of echo diagnosis (together with x-ray diagnosis and computer-aided tomography) in the selection of operative access to a foreign body and, specifically, echolocation on the operative table during surgery is shown. Combination of informative diagnostic methods with advanced surgical technologies helps save the organ and attain functional results in this extremely grave posttraumatic pathology.

This study was aimed at elucidating the diagnostic potentialities of computer-aided tomography (CAT) in congenital micro- and anophthalmia. Twenty-five young patients with various clinical manifestation of this abnormality were examined. Used in complex with the traditional diagnostic methods, CAT played the key role. It permitted imaging the entire complex of changes in the orbit and its contents, which helped choose adequate therapeutic measures. Surgical treatment was proven to be little effective or useless at all in cases with a more than 4 cm3 deficit of the orbital volume on the involved side; contrary to this, early staged fitting with prostheses is effective and creates favorable conditions for subsequent surgical correction in a less than 4 cm3 deficit of the volume.

Effective cosmetic rehabilitation of patients with anophthalmia can be activated if methods based on the use of the cosmetic parameters for prostheses, listed below, are employed: (1) eyelid position and relief, (2) eye opening, (3) position of the iris and pupil, (4) diameters of the iris and pupil, (5) position and decline of the prosthesis, (6) depth of the prosthesis position in the orbit, (7) cavity filling with the prosthesis, (8) prosthesis mobility, (9) sclera color, (10) iris color. These prosthetic cosmetic parameters are of paramount importance for effective cosmetic rehabilitation of anophthalmia patients.

Orbital ectoprosthesis is a method for rehabilitation of anophthalmia patients with severe extensive injuries in the orbital area. Analysis of 1230 case histories has helped define the indications and contraindications to this type of care. Good cosmetic results have been achieved in all the patients.