Qualitative analysis of changes in the posterior segment of the eye wich femtosecond laser–assisted cataract surgery

Purpose: Analysis of the qualitative changes in the posterior eye segment structures – choroid thickness (CT) and distance height of vitreous posterior hyaloid membrane (VPHM) from retina by spectral optical coherence tomography (SOCT) method in femtosecond laser–assisted cataract surgery (FLACS). Methods and Materials: 46 eyes with immature cataract and retinal SOCT possibility before the operation. Average corrected visual acuity – 0.3±0.05; eye length - 22.51±0.9 mm; IOP – 20 mm Hg; age - 65 years. Before and after surgery (1, 3, 5 days), SOCT of vitreoretinal interface and choroid was performed, RTVue XR 100 «Avanti», Optovue. Group 1, 24 patients, ultrasound FEM of cataract, «Stellaris», B&L. Group 2, 22 patients – FLACS, LenSx, Alcon. Capsulorhexix diameter – 4.9-5.2 mm (energy 12.5 μJ). Fragmentation of the lens nucleus by «chop», «cylinder» methods (energy 10-15 μJ). The main corneal incision – 2.5 mm (energy 5 μJ). Phakoaspiration on «Stellaris», elastic IOLs were implanted. FLACS duration – 9-10 minutes, femtolaser effect ≤ 2 minutes. Results: Before the surgery CT in Group 1 was 253.1±62.1 microns. In 1, 3, 5 days after FEM of cataract CT were 310.4, 262.7, 258.1 microns. Distance height of VPHM before the surgery was 400.1 microns. In 1, 3, 5 days after surgery – 505.6, 492.7, 500.3 microns. In Group 2 before the surgery CT was 256.4±60.3 microns. In 1, 3, 5 days after FLACS CT were 333.1, 279.4, 259.1 microns. Distance height of VPHM before the surgery – 366.2 microns. In 1, 3, 5 days after FLACS – 510.8, 506.2, 508.9 microns. Reactive thickening of the choroid after surgery was determined in both groups. Group 1, 1th day – 57.3 microns (22.6%). By the 5th day CT became initial. Distance height of VPHM increased by 105.5microns. By the 5th day the situation was not changed. Group 2, FLACS, thickening of CT per 1 day is 76.7 microns, (29.9%). By the 5th day CT returned to previous values. VPHM was increased by 144.6 microns. By the 5th day the situation was not changed. Conclusion: Increase of TC and distance height of VPHM in the early postoperative period was noticed in the both groups. After FLACS big figures are conditioned apparently by intraoperative vacuum effect and/or sudden IOP changes during femtolaser stage. Return of CT to initial state indicates processes reversibility. Patients with vitreomacular adhesion when FLEC are highly risky of vitreomacular traction

Self-determined citizens? New forms of civic activism and citizenship in Armenia

This article examines the recent emergence and growth of grassroots social movements in Armenia which are locally known as ‘civic initiatives’. It considers what their emergence tells us about the development of civil society and the changing understandings and practices of citizenship in Armenia in the post-Soviet period. It analyses why civic initiatives explicitly reject and distance themselves from formal, professionalised NGOs and what new models of civic activism and citizenship they have introduced. It argues that civic initiatives embrace a more political understanding of civil society than that which was introduced by Western donors in the 1990s

Thulium laser versus cold steel tonsillectomy: a prospective pilot study in adult patients

Abstract Background The aim of this pilot study was to compare the operation time, intraoperative and postoperative bleeding, postoperative pain, and wound healing of the thulium RevoLix laser tonsillectomy method over the more commonly practiced cold steel tonsillectomy. Methods A prospective, single-blinded randomized pilot trial was conducted. Twenty-four adult patients with a mean age of 28.7 years with chronic recurrent tonsillitis were observed and underwent tonsillectomy. The patients were randomly assigned to have one tonsil removed with a thulium RevoLix laser 200, and the conventional cold steel tonsillectomy method was used for the other side. Results The tonsillectomy time from incision to hemostasis was 12.08 ± 0.77 (SE) min with the laser method and 10.92 ± 1.31(SE) min with the cold dissection method, with no statistically significant difference (P < 0.121). Intraoperative blood loss in the cold dissection method was 10.92 ± 1.31 ml, and 2.04 ± 1.62 ml was observed during laser treatment (P < 0.000, t = 8.363). In the cold steel tonsillectomy group, the pain score was significantly higher than that in the laser tonsillectomy group on the 7th and 12th postoperative days. Conclusion The use of the thulium RevoLix 200 laser for tonsillectomy in the present pilot study of 24 patients showed significantly better outcomes than those in conventional cold dissection methods in terms of intraoperative bleeding and postoperative pain; however, there was no statistically significant difference in other parameters, such as operational time and late postoperative bleeding. A large full-scale prospective study is needed to increase the generalizability and reliability of the results. Clinical trial registration ISRCTN16280803, registered on 25 March 2020, https://www.isrctn.com/ISRCTN16280803

Resonance phenomena in microwave nonmagnetized plasma source. Plasmachemical application

Scheme of coaxial microwave gas-discharge plasma source based on a “plasma resonance” phenomenon is presented. Possibility of conditions realization at which energy of accelerated in the “resonance” electrons goes into ionization processes (in volume of chamber outside of “resonance” region) is discussed. Results of experimental investigation of a coaxial microwave plasmatron in which “resonance” mechanisms have been manifested are presented. A plasmachemical reactor based on a “resonance” plasmatron is described. The data on plasmachemical decomposition of CF2Cl2 are displayed