Modern possibilities of optical reconstructive surgery in patients after removal of the iridociliary zone tumor

Choroid neoplasms account for two-thirds of all intraocular tumors, of which 23% are tumors of the iris and ciliary body, and the rest are choroidal tumors. After removing the tumor of the iridociliary zone (ICZ) it is necessary to perform optical reconstructive surgery to reduce light aberrations and increase visual functions.Purpose. To identify key features of the complex rehabilitation of patients after removal of the ICZ tumor.Material and methods. The clinical and functional results of the complex rehabilitation of 12 patients (12 eyes) aged from 35 to 84 years (average 66 years) were studied at least 1 year after removal of the ICZ tumor. The area of the iris defect before the reconstructive surgery ranged from 15 to 55%. Preoperative uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were 0.26±0.19 (from 0.01 to 0.6) and 0.46±0.22 (from 0.1 to 0.8) respectively. All patients underwent phacoemulsification of cataract and implantation of the irislens diaphragm.Results. After the reconstructive surgery, UCVA and BCVA increased: 0.5±0.17 (from 0.2 to 0.7) and 0.61±0.27 (from 0.3 to 0.9) respectively. Undesirable optical effects were decreased, and patients were satisfied with the cosmetic result.Conclusion. The presented algorithm of optical reconstructive surgery after removal of the ICZ tumor creates necessary conditions for increasing postoperative functional results and improving the quality of life of these patients

Melatonin level as a risk factor for age-related macular degeneration

Background. The current trend towards an increase in age-related macular degeneration (AMD) incidence rate in the population, including the working-age population, with a possible loss of professional activity, indicates the need for early preclinical identification of risk groups, timely prevention and treatment. In the prevention and treatment of AMD, the prospect of using melatonin is being actively discussed.Aim: to analyze serum and tear fluid levels of melatonin in patients with AMD and study their correlation with risk factors.Materials and methods. In the course of the study, two groups were formed: the main group - patients with non-exudative AMD and senile cataract (n = 40) and the reference group - conditionally healthy patients without AMD and cataract (n = 20). Patients of both groups were surveyed to identify risk factors for AMD. The content of melatonin in blood serum and lacrimal fluid was determined by enzyme-linked immunosorbent assay using the Melatonin ELISA Kit (USA).Results. In the course of the study, it was found that the concentration of melatonin in blood serum and tear fluid in patients with AMD was significantly lower than in patients of the reference group (p <0.05). Serum and tear fluid melatonin levels depend on the following factors: age, body mass index (BMI), arterial hypertension, eye color, insomnia, and night work. It is possible that the local determination of melatonin in the lacrimal fluid can be a biomarker in the determination of ophthalmic pathological conditions.Conclusion. The obtained results can be used as recommendations for clarifying individual regimens for the use of melatonin, especially in the treatment of patients with AMD

The state of indicators of the angio-OCT of the macular area in pregnant women with preeclampsia in conjunction with the content of the factor of endothelial dysfunction, their importance for predicting vascular retinal pathology in the postpartum period

Purpose. Clinical assessment of the hemodynamic state of the macula in pregnant women with preeclampsia in conjunction with the content of endothelial dysfunction factors, their importance in predicting vascular retinal pathology in the postpartum period.Material and methods. The main group consisted of 46 pregnant women with preeclampsia (PE) from 19 to 40 years. 36 women had a moderate degree of PE, and 10 women had a severe degree. The 1st comparison group included 20 pregnant women with a physiological course of pregnancy, from 18 to 38 years. The 2nd comparison group included 16 non-pregnant women with occlusions of the branches of the central retinal vein (CRV), aged 34 to 45 years. The control group consisted of 20 healthy, non-pregnant women from 19 to 38 years. All patients underwent determination of the level of endothelin-1 (E) in the lacrimal fluid (LF), the state of hemodynamics of the macular area was investigated using optical coherent tomography with angiography function (angio-OCT).Results. The highest values of the average level of E in LF occurred in the main group and in the 2nd comparison group (2.5±1.1 and 2.6±0.4 ng / ml, respectively). In the 1st comparison group in the 3rd trimester of pregnancy, the indicators of the total average density of the superficial vascular plexus in the macular region (DS), the density of the superficial vascular plexus in the fovea (DF), the density of the superficial vascular plexus in the parafova (DP), the area of the retinal avascular area (NFA) and subfoveal thickness of the choroid (CTX) had statistically significant differences from the control (p<0.01), but after 6–9 months after birth, these differences disappeared, although the difference in DS, DP values remained.Conclusion. In women with PE in the 3rd trimester of pregnancy, there was a statistically significant increase in E level in the LF and the deterioration of the angio-OCT of the macular ar ea

Терапия неоваскулярной глаукомы

Neovascular glaucoma is a severe pathology of the eye, which is difficult to treat. It is characterized by rapid progression, high intraocular pressure (IOP) level, severe pain and an acute decrease in visual acuity. Its most common causes include diabetic retinopathy and ischemic central retinal vein occlusion. The endothelial vascular cells respond to a specific stimulus (tissular hypoxia) and secrete proangiogenic factors. The most significant is VEGF. The resulting imbalance between pro- and antiangiogenic factors produces neovascularization of the eye tissues. Panretinal photocoagulation and anti-VEGF therapy are used to reduce iris neovascularization and reduce the complications of surgical treatment. Currently, surgical methods such as trabeculectomy and tubular drainage implantation are used to treat neovascular glaucoma. An alternative to surgical interventions is presented by cyclodestructive procedures. Transscleral diode-laser micropulse cyclophotocoagulation is the latest technology, characterized by the absence of a pronounced damaging effect on tissues and a small number of complications.Неоваскулярная глаукома является тяжелой патологией органа зрения, которая трудно поддается медикаментозному и хирургическому лечению. Данная форма глаукомы характеризуется быстрым прогрессированием, высоким уровнем внутриглазного давления, выраженным болевым синдромом и снижением зрительных функций вплоть до полной их утраты. Наиболее частыми состояниями, при которых развивается неоваскулярная глаукома, являются диабетическая ретинопатия и тромбоз центральной вены сетчатки. Эндотелиальные клетки сосудов в ответ на специфический стимул в виде гипоксии вырабатывают проангиогенные факторы, наиболее значимым из которых является VEGF. Возникающий дисбаланс между про- и антиангиогенными факторами провоцирует развитие неоваскуляризации структур глаза. С целью уменьшения неоваскуляризации и снижения осложнений хирургического лечения применяются панретинальная лазеркоагуляция и введение анти-VEGF препаратов. В настоящее время для лечения неоваскулярной глаукомы применяются такие хирургические методы, как трабекулэктомия и имплантация трубчатых дренажей. Альтернативой хирургическим вмешательствам являются циклодеструктивные вмешательства. Новой технологией, характеризующейся отсутствием выраженного повреждающего действия на ткани и малым количеством осложнений, является транссклеральная циклофотокоагуляция в микроимпульсном режиме с использованием диодного лазера

ИВЛИНДУЦИРОВАННЫЕ ПОВРЕЖДЕНИЯ ЛЕГКИХ (ЭКСПЕРИМЕНТАЛЬНОЕ ИССЛЕДОВАНИЕ)

Objective: to evaluate the impact of highfrequency jet ventilation (HFJV) and traditional positive endexpiratory pressure (PEEP) ventilation on blood oxygenation, gas exchange, and hemodynamics on an experimental model of acute lung injury.Material and methods. Thirty albino outbred laboratory male rats weighing 200—300 g were randomly selected for investigations and further divided into groups: 1) traditional ventilation (TV) (n=15); 2) HFJV (n=15). The rats were anesthetized with intraabdominal ketamine (6—8 mg/kg) and sibasone (15—45 mg). Anesthesia was maintained by the bolus administration of ketamine (1 mg/kg every 15—20 min). Tracheostomy was carried outwith a 0.2—0.4 mm diameter endotracheal tube that was then fixed using surgical thread 2—2.5 cm deep to the cricoid cartilage.Results. Acute respiratory distress syndrome (ARDS) has clear histological criteria for lung tissue structural injury; it is widely prevalent in clinical practice and associated with high mortality rates. The paper describes anexperimental ARDS model, the essence of which is 45—55% aspiration of the circulating blood volume for 10—15 minutes. A Reosorbilact® solution was used to compensate for the volume of blood loss, which was followed by the administration of autothromboplastin (16—20 mg/kg animal weight). PEEP was studied for its impact on gasexchange, hemodynamics, and blood oxygenation during HFJV and TV. Gas exchange parameters during TV and HFJV were comparatively analyzed.Conclusion. The use of PEEP for ARDS was ascertained to improve blood oxygenation due to decreased pulmonary shunt, better respiratory muscle performance, lower infiltrated and atelectatic tissue volumes, and higher lung functional residual capacityЦель исследования. Изучить влияние ВЧС ИВЛ и ТИВЛ с ПДКВ на оксигенацию крови, газообмен и гемодинамику на экспериментальной модели острого повреждения легких.Материал и методы. для проведения исследований на животных были отобраны в случайном порядке 30 самцов белых беспородных лабораторных крыс весом 200—300 г, с последующим разделением их на группы. 1 группа — для ТИВЛ (n=15). 2 группа — для ВЧС ИВЛ (n=15). Крысы были наркотизированы внутрибрюшинным введением кетамина (6—8 мг/кг) и сибазона (15—45 мг). Анестезию поддерживали болюсным введением кетамина (1 мг/кг каждые 15—20 мин.). Была произведена трахеостомия для установки эндотрахеальной трубки диаметром 0,2—0,4 мм, которая затем была фиксирована хирургической нитью на глубине 2—2,5 см от перстневидного хряща.Результаты. Острый респираторный дистресссиндром (ОРДС) имеет четкие гистологические критерии повреждения структур ткани легкого, широко распространен в клинической практике и сопровождается высокой летальностью. В статье описана экспериментальная модель ОРДС, сущность которой состоитв аспирации 45—55% от объема циркулирующей крови в течение 10—15 минут. Объем потери крови восполняли раствором Реосорбилакта® с последующим введением аутотромбопластина (16—20 мг/кг веса животного). Проведено исследование влияния положительного давления в конце выдоха (ПДКВ) на газообмен, гемодинамику и оксигенацию крови при высокочастотной струйной вентиляции легких (ВЧС ИВЛ) и традиционной искусственной вентиляции легких (ТИВЛ). Проведен сравнительный анализ параметров газообмена при применении ТИВЛ и ВЧС ИВЛ.Заключение. Выявлено, что применение ПДКВ при ОРДС улучшает оксигенацию крови вследствие уменьшения легочного шунта, облегчения работы дыхательных мышц, уменьшения объемов инфильтрированных и ателектатических тканей, а также повышения функциональной остаточной емкости легких

The Problem of Satisfying Consumer Demand

Possibilities for the direct solution of the basic problem of economic development â the increasingly complete satisfaction of people's material and nonmaterial needs â are created under the conditions of developed socialist society. This is specifically the way in which the supreme goal of social production under socialism is formulated in Article 15 of the new Constitution of the USSR. The acceleration of production and the improvement of the quality of consumer goods become very important in this connection. The Twenty-fifth Congress of the Communist Party of the Soviet Union noted that this is one of the key problems of economic development of the USSR in the Tenth Five-Year Plan. These processes are based on the further development of the complex of branches that satisfy the population's material needs. Primary among these branches are light and food industry, agriculture, machine building, and trade.