Evaluation of the efficiency of refractive error correction using phakic intraocular lens implantation

Background. Myopia is the most common clinical refractive error of the eye. Only in Russia, there are about 15 million myopic people. Currently, in addition to traditional correction (glasses, soft contact lenses), keratorefractive surgery actively develops; however, due to the initial parameters of the cornea or the magnitude of the refractive error, it may be contraindicated to the patient. Nowadays an alternative to these correction methods for young patients with refractive errors of high and ultra-high degrees is the implantation of a phakic intraocular lens.The aim. To evaluate the efficiency of refractive errors correction using phakic IOL implantation.Materials and methods. We carried out a retrospective analysis of outpatient records of 56 patients who received surgical treatment for myopia and complex myopic astigmatism at the Orenburg branch of the S. Fyodorov Eye Microsurgery Federal State Institution in the period from 2019 to 2020 (110 eyes), all patients underwent implantation of a phakic intraocular lens IPCL V2.0, IPCL V2.0 TORIC. Patients were examined before surgery and on the first day after surgery. In addition to standard, special clinical and functional examination methods were used: optical biometry on the IOL-Master 700, determination of the density of endothelial cells using an endothelial microscope, examination of the fundus under cycloplegia; if necessary, peripheral laser coagulation of the retina was performed before calculating phakic IOLs.Results. All operations and the early postoperative period went without complications. The target BCVA (0.75–1.0) was achieved in 90 (81.8 %) eyes. All patients were satisfied with the treatment results.Conclusion. Implantation of IPCL V2.0 and IPCL V2.0 TORIC phakic IOLs is an effective method for correcting refractive errors, regardless of the degree of myopia and the presence of astigmatism

Features of Progress and Treatment of Postprimary Refractory Glaucoma in a Patient with Progressive Mesodermal Iris Atrophy

The problem of degenerative diseases of the vascular tract of the anterior eye`s segment is one of the insufficiently explored in ophthalmology. The relevance of the problem lies in the tactical difficulties in treatment of patients with atypical current secondary glaucoma, that develops as a result of degenerative changes of the eye`s anterior segment. First of all this refers to diseases combined by term thе iridocorneal endothelial syndrome. On the foot of the syndrome is the proliferation of pathologically altered corneal endothelium and its migration as a membrane on the trabecular area of the anterior chamber angle and anterior surface of the iris. This leads to development of secondary angle-closure glaucoma. Purpose. To optimize the approaches to the treatment of secondary decompensated refractory glaucoma on the basis of the clinical case analysis. Patient and methods. A case of bilateral progressivemezodermal atrophy of the iris and the cornea on 49 years old patient, who appealed to the Kirov clinical Ophthalmology hospital in February 2015 year with repeatedly operated decompensated refractory glaucoma. The local status of the patient included: thinning of the front layer of iris, sometimes up to full atrophy with non-through defects and deformation of the pupil, precipitates and spots on the endothelium of the cornea, the anterior peripheral adhesions, membrane-like tissue on the trabecula and the front surface of the iris, glaucoma excavation of the optic disc. Results and discussion. A rare form of corneal endothelial syndrome: essential progressive atrophy of mezodermal of the iris and the cornea has been diagnosed. Pharmacological correction of the intraocular pressure and original drainage surgery was performed. As a result, the patient’s IOP decreased from 38 mm to 16 mm Hg pressure. Conclusions.The unusual nature of secondary glaucoma, according with the progression of essential mezodermal atrophy of iris and cornea caused difficulties in diagnosing and treatment tactics. Correct diagnosis helped to choose the proper individual tactics of combined treatment that allowed to compensate glaucomatous process and save the visual functions for restore an active lifestyle of the patient

DISSEMINATED CUTANEOUS TUBERCULOSIS

Cutaneous tuberculosis is a clinically and morphologically heterogeneous group of skin diseases directly or indirectly caused by mycobacteria of the tuberculosis complex, occupying the 5th place among all localizations of extra-pulmonary tuberculosis. Manifestations of cutaneous tuberculosis are extremely diverse and depend on the immune status and ways of penetration of mycobacteria into the skin. Skin involvement can occur as a result of exogenous inoculation, contiguous spread from an adjacent focus, or hematogenous spread from other foci. Family cases of disseminated cutaneous tuberculosis are described. A combination of several clinical forms of cutaneous tuberculosis — scrofuloderma, tuberculosis cutis lichenoides (moniliformis scrophulosorum) and lupus — are observed in a 5 year old child with a family history of tuberculosis. The issues of pathogenesis and advanced methods of diagnosis of cutaneous tuberculosis are also discussed

LASER POSTERIOR CAPSULOTOMY IN CASE OF THE 1ST DEGREE OF POSTERIOR CAPSULAR OPACITY OF THE LENS IN PSEUDOPHAKIC EYES

Purpose. To identify indications for laser posterior capsulotomy in case of the 1st degree of posterior capsular opacity (PCO) of the lens in pseudophakic eyes.Material and methods. The study was carried out in 43 patients (43 eyes) aged 45-74 years old, 58% of them – female and 42% – male, with the 1st degree of posterior capsular opacity of the lens. Biomicroscopy and optical coherence tomography (OCT) were performed to evaluate changes in the posterior capsule. All patients underwent the laser posterior capsulotomy. The follow-up was 2 years.Results and discussion. In PCO of the 1st degree a reduction of the best corrected visual acuity (BCVA) by 2-3 lines from the initial line was revealed in all cases. In 35% of patients with a transparent posterior capsule according to the OCT an increase in the optical density of the posterior capsule was noted, as well as increase in the space between the posterior surface of the IOL and the posterior capsule, inclusions were different in the optical density in the pre-capsular interface. Folds of the transparent posterior capsule were detected in 25% of patients. About 5% of patients had a change of posterior capsule according to the type of a «vitreous» loose membrane. Mixed changes of posterior capsule were observed in 35% of patients. After the laser posterior capsulotomy the BCVA was increased up to the initial level in all patients. In the analysis of OCT images of macular retinal area before and after the laser posterior capsulotomy any reliable signs of edema were not revealed.Conclusions.1. In case of PCO of the 1st degree a reduction of the BCVA by 2-3 lines from the initial level was found. 2. Changes in the posterior capsule of the lens of the 1st degree can be detected using the OCT despite the absence of changes in the biomicroscopy. 3. Indications for laser posterior capsulotomy in case of the 1st degree of posterior capsule opacity of the lens are: an increased optical density of posterior capsule confirmed by the OCT data, posterior capsular thickening and folds, complaints of patients on the reduced visual acuity by 2-3 lines in the postoperative period. 4. Complications in the form of macular edema after the laser posterior capsulotomy in case of the 1st degree of posterior capsular opacity of the lens are not revealed, that was connected with the adequate choice of laser capsulotomy technique

Certain aspects of amblyopia treatment in children

Purpose: to identify treatment efficiency factors in various forms of amblyopia. Material and methods. Histories of 31945 amblyopic children aged 17 or under over a 5-year period were analyzed retrospectively. The analysis showed that 30 % of patients (9587 children, 14431 eyes) were diagnosed with amblyopia during this period. The treatment methods included a laser ophthalmotherapeutic device “Speckle-M”, an Ambliokor-0 complex, and a Vizotronik eye muscle training device and relaxer. Results. Of the 14431 eyes with amblyopia, 4101 eyes (28.4%) received no treatment or irregular treatment. In treated patients with low amblyopia, had pre-treatment visual acuity of 0.62 ± 0.02, which increased to reach 0.88 ± 0.08 after the fifth course of treatment. Conclusion. Amblyopia was diagnosed for the first time at an age over 6 years in more than 30 % of children, which is an unfavorable factor affecting the prognosis of amblyopia treatment. Despite the absence or irregularity of instrumental treatment, patients with refractive amblyopia showed an increase in visual acuity over the 5-year period. Instrumental treatment is necessary for patients with anisometropic, dysbinocular and obscuration amblyopia. For citation: Chuprov A.D., Borshchuk E.L., Voronina A.E. Certain aspects of amblyopia treatment in children. Russian ophthalmological journal. 2018; 11 (1): 24-9. doi: 10.21516/2072-0076-2018-11-1-24-29 (In Russian)

Passive estimation of the waveguide invariant per pair of modes

WOSInternational audienceIn many oceanic waveguides, acoustic propagation is characterized by a parameter called waveguide invariant. This property is used in many passive and active sonar applications where knowledge of the waveguide invariant value is required. The waveguide invariant is classically considered as scalar but several studies show that it is better modeled by a distribution because of its dependence on frequency and mode pairs. This paper presents a new method for estimating the waveguide invariant distribution. Using the noise radiated by a distant ship and a single hydrophone, the proposed methodology allows estimating the waveguide invariant for each pair of modes in shallow water. Performance is evaluated on simulated data

Integral Intensities of Absorption Bands of Silicon Tetrafluoride in the Gas Phase and Cryogenic Solutions: Experiment and Calculation

The spectral characteristics of the SiF4 molecule in the range 3100700 cm1, including the absorption range of the band 3, are studied in the gas phase at P = 0.47 bar and in solutions in liquefied Ar and Kr. In the cryogenic solutions, the relative intensities of the vibrational bands, including the bands of the isotopically substituted molecules, are determined. The absorption coefficients of the combination bands 23, 3 + 1, 3 + 4, and 34 are measured in the solution in Kr. In the gas phase of the one-component system at an elevated pressure of SiF4, the integrated absorption coefficient of the absorption band 3 of the 28SiF4 molecule was measured to be A(3) = 700 ± 30 km/mol. Within the limits of experimental error, this absorption coefficient is consistent with estimates obtained from independent measurements and virtually coincides with the coefficient A(3) = 691 km/mol calculated in this study by the quantum-chemical method MP2(full) with the basis set cc-pVQZ. ©2005 Pleiades Publishing, Inc