4 research outputs found
Biometric changes in highly myopic eyes before and after phacoemulsification with intraocular lense implantation
High short-sightedness is a complicating factor in phacoemulsification cataract affecting the achievement of high visual results. There are no data in the literature that would reflect changes in the biometric parameters of eyes with high myopia after cataract phacoemulsification with intraocular lens implantation. The authors have shown the reliability of this surgical treatment, the absence of complications and a negative effect on the hydrodynamics of the eye. Patients underwent the ophthalmic examination and for patients preparing for phacoemulsification + IOL: A- and B-scanning, endothelial microscopy, optical biometry. In the group of patients with high myopia, regardless of the age, ranged from 3.1 mmto 3.9 mmwith a mean of 3.52 Β± 0.34 mm(variation within 10%), while in the group of patients with myopia and concomitant cataract the fluctuations in anterior chamber depth were recorded in the range from 2.6 mmto 4.4 Β± 0.1 mmwith average values of 3.14 Β± 0.038 mm(variation within 25%). In the dynamics of treatment, a significant reduction in intraocular pressure according to Maklakov by 6.9% was noted in 6 months from baseline (p <0.001) - from 18.6 Β± 2.34 to 17.4 Β± 1.09 mmHg. Art. At the same time, it should be emphasized that the main effect of reducing intraocular pressure was expected already within 1 month (17.9 Β± 1.06 mmHg) after surgery (3.9%, p = 0.006), followed by decrease by 3.1% after 6 months of follow-up (p = 0.008). The research results showed a direct correlation between the endothelial layer density and the anterior chamber depth. Thus, before surgery r = 0.248, and after surgery r = 0.119, i.e. after phacoemulsification with IOL implantation, the density of the endothelial layer depends on changes in the anterior chamber depth (p <0.05). This research has shown that phacoemulsification with IOL implantation is accompanied by positive changes in the size of the mutually located structures of the anterior chamber of the eyeball
Impact of corneal astigmatism on refractive outcomes after phacoemulsification with implantation of a spherical IOL
Background: To date, particular emphasis is being put to correction of preoperative corneal astigmatism in phacoemulsification, since approximately 30% of the worldβs population has astigmatism of at least 0.75D which results in decreased visual acuity after cataract surgery.
Purpose: To assess the effect of corneal astigmatism on refractive outcomes of phacoemulsification with implantation of a spheric intraocular lens (IOL).
Material and Methods: We retrospectively analyzed the outpatient medical records of 39 patients (50 eyes) who received phacoemulsification with a spherical IOL and had corneal astigmatism of 0.5-3.75D (as assessed by keratometry). Eyes were divided into four groups based on the degree of corneal astigmatism. We assessed changes in visual acuity and corneal astigmatism and refractive outcomes of cylindrical correction at one month after surgery.
Results: The greater the presurgical astigmatism, the lower was uncorrected visual acuity at one month after surgery. There was no significant difference (Ρ > 0.05) in change in corneal astigmatism values after phacoemulsification. In group 1 (preoperative astigmatism of 0.75 D or less) and group 2 (preoperative astigmatism of 1.0 to 1.5 D), the mean increase in visual acuity after cylindrical refractive correction was 10% or less, and had no significant impact on the quality of vision. In group 3 (preoperative astigmatism of 1.75 to 2.5 D) and group 4 (preoperative astigmatism of 2.75 D or more), the mean increase in visual acuity was 15% and 25%, respectively.
Conclusion: Surgically induced astigmatism after phacoemulsification had no substantial impact on refractive outcomes. When planning refractive outcomes for eyes with astigmatism after cataract surgery, it should be taken into account that implanting a spherical IOL is acceptable only for eyes with an amount of preoperative astigmatism of 0.75 D or less and vertical axis of astigmatism. Cataract patients with preoperative corneal astigmatism of >0.75 D will require implantation of a toric IOL or a plan for astigmatism correction with another method
Anatomical optical, biomechanical and morphometric parameters of the eye in children with acquired myopia and syndrome of undifferentiated connective tissue dysplasia
Aim of the research β to make a comprehensive assessment of anatomical, optical, biomechanical and morphometric parameters of the eye in children with acquired myopia and syndrome of undifferentiated connective tissue dysplasia.
Materials and methods. We examined patients of 2 groups: the I group β 44 children (88 eyes) with myopia of mild degree and phenotypic manifestations of connective tissue dysplasia, the II group β 40 patients (80 eyes) with myopia and without signs of connective tissue dysplasia. We measured the following parameters: corneal refractive power, corneal diameter and radius, thickness of the cornea, anterior chamber depth, lens thickness, sagittal length of the vitreous body, axial length of the eye, corneal hysteresis, peripapillary retinal nerve fiber layer thickness.
Results. We revealed significant differences in the anatomical, optical and biomechanical parameters of the visual analyzer in children with myopia of mild degree on the background of the UCTD, in contrast to children with myopia and without connective tissue dysplasia, which consisted in corneal refractive power reduction to an average of 41.25 [40.62; 41.75] D, increase in the corneal radius to an average of 8.13 [7.97; 8.28] mm, the corneal diameter to an average of 12.5 [12.1; 12.7] mm, the anterior chamber depth to an average of 3.8 [3.4; 4.0] mm, the sagittal length of the vitreous body to an average of 17.6 [17.3; 18.0] mm, the axial length of eye to an average of 24.9 [24.4; 25.4] mm, decrease in corneal hysteresis to an average of 11.2 [10.6; 11.7] mm Hg. Peripapillary retinal nerve fiber layer thickness was reduced to an average of 87 [85; 93] ΞΌm.
Conclusions. The obtained data can be useful in a comprehensive assessment of ophthalmic manifestations of undifferentiated connective tissue dysplasia syndrome, in myopic process development prediction and in individual treatment tactics determination
ΠΠ½Π°ΡΠΎΠΌΠΎ-ΠΎΠΏΡΠΈΡΠ½Ρ, Π±ΡΠΎΠΌΠ΅Ρ Π°Π½ΡΡΠ½Ρ ΡΠ° ΠΌΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ½Ρ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ ΠΎΠΊΠ° Π² Π΄ΡΡΠ΅ΠΉ ΡΠ· Π½Π°Π±ΡΡΠΎΡ ΠΌΡΠΎΠΏΡΡΡ ΡΠ° ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π½Π΅Π΄ΠΈΡΠ΅ΡΠ΅Π½ΡΡΠΉΠΎΠ²Π°Π½ΠΎΡ Π΄ΠΈΡΠΏΠ»Π°Π·ΡΡ ΡΠΏΠΎΠ»ΡΡΠ½ΠΎΡ ΡΠΊΠ°Π½ΠΈΠ½ΠΈ
Aim of the research β to make a comprehensive assessment of anatomical, optical, biomechanical and morphometric parameters of the eye in children with acquired myopia and syndrome of undifferentiated connective tissue dysplasia.Materials and methods. We examined patients of 2 groups: the I group β 44 children (88 eyes) with myopia of mild degree and phenotypic manifestations of connective tissue dysplasia, the II group β 40 patients (80 eyes) with myopia and without signs of connective tissue dysplasia. We measured the following parameters: corneal refractive power, corneal diameter and radius, thickness of the cornea, anterior chamber depth, lens thickness, sagittal length of the vitreous body, axial length of the eye, corneal hysteresis, peripapillary retinal nerve fiber layer thickness.Results. We revealed significant differences in the anatomical, optical and biomechanical parameters of the visual analyzer in children with myopia of mild degree on the background of the UCTD, in contrast to children with myopia and without connective tissue dysplasia, which consisted in corneal refractive power reduction to an average of 41.25 [40.62; 41.75] D, increase in the corneal radius to an average of 8.13 [7.97; 8.28] mm, the corneal diameter to an average of 12.5 [12.1; 12.7] mm, the anterior chamber depth to an average of 3.8 [3.4; 4.0] mm, the sagittal length of the vitreous body to an average of 17.6 [17.3; 18.0] mm, the axial length of eye to an average of 24.9 [24.4; 25.4] mm, decrease in corneal hysteresis to an average of 11.2 [10.6; 11.7] mm Hg. Peripapillary retinal nerve fiber layer thickness was reduced to an average of 87 [85; 93] ΞΌm.Conclusions. The obtained data can be useful in a comprehensive assessment of ophthalmic manifestations of undifferentiated connective tissue dysplasia syndrome, in myopic process development prediction and in individual treatment tactics determination.Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ β ΠΏΡΠΎΠ²Π΅ΡΡΠΈ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΡΡ ΠΎΡΠ΅Π½ΠΊΡ Π°Π½Π°ΡΠΎΠΌΠΎ-ΠΎΠΏΡΠΈΡΠ΅ΡΠΊΠΈΡ
, Π±ΠΈΠΎΠΌΠ΅Ρ
Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΌΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ Π³Π»Π°Π·Π° Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ΅Π½Π½ΠΎΠΉ ΠΌΠΈΠΎΠΏΠΈΠ΅ΠΉ ΠΈ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π½Π΅Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΈ ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π»ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² 2 Π³ΡΡΠΏΠΏ: Π Π³ΡΡΠΏΠΏΠ° β 44 ΡΠ΅Π±Π΅Π½ΠΊΠ° (88 Π³Π»Π°Π·) Ρ ΠΌΠΈΠΎΠΏΠΈΠ΅ΠΉ ΡΠ»Π°Π±ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΠΈ ΡΠ΅Π½ΠΎΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡΠΌΠΈ ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΠΊΠ°Π½Π½ΠΎΠΉ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΈ, ΠΠ Π³ΡΡΠΏΠΏΠ° β 40 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (80 Π³Π»Π°Π·) Ρ ΠΌΠΈΠΎΠΏΠΈΠ΅ΠΉ ΠΈ Π±Π΅Π· ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΠΊΠ°Π½Π½ΠΎΠΉ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΈ. ΠΠ·ΠΌΠ΅ΡΡΠ»ΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ ΠΏΡΠ΅Π»ΠΎΠΌΠ»ΡΡΡΠ΅ΠΉ ΡΠΈΠ»Ρ ΡΠΎΠ³ΠΎΠ²ΠΈΡΡ, Π΄ΠΈΠ°ΠΌΠ΅ΡΡ ΡΠΎΠ³ΠΎΠ²ΠΈΡΡ, ΡΠ°Π΄ΠΈΡΡ ΠΊΡΠΈΠ²ΠΈΠ·Π½Ρ ΡΠΎΠ³ΠΎΠ²ΠΈΡΡ, ΡΠΎΠ»ΡΠΈΠ½Ρ ΡΠΎΠ³ΠΎΠ²ΠΈΡΡ, Π³Π»ΡΠ±ΠΈΠ½Ρ ΠΏΠ΅ΡΠ΅Π΄Π½Π΅ΠΉ ΠΊΠ°ΠΌΠ΅ΡΡ, ΡΠΎΠ»ΡΠΈΠ½Ρ Ρ
ΡΡΡΡΠ°Π»ΠΈΠΊΠ°, ΡΠ°Π³ΠΈΡΡΠ°Π»ΡΠ½ΡΡ Π΄Π»ΠΈΠ½Ρ ΡΡΠ΅ΠΊΠ»ΠΎΠ²ΠΈΠ΄Π½ΠΎΠ³ΠΎ ΡΠ΅Π»Π°, Π°ΠΊΡΠΈΠ°Π»ΡΠ½ΡΡ Π΄Π»ΠΈΠ½Ρ Π³Π»Π°Π·Π½ΠΎΠ³ΠΎ ΡΠ±Π»ΠΎΠΊΠ°, ΠΊΠΎΡΠ½Π΅Π°Π»ΡΠ½ΡΠΉ Π³ΠΈΡΡΠ΅ΡΠ΅Π·ΠΈΡ, ΠΏΠ΅ΡΠΈΠΏΠ°ΠΏΠΈΠ»Π»ΡΡΠ½ΡΡ ΡΠΎΠ»ΡΠΈΠ½Ρ ΡΠ»ΠΎΡ Π½Π΅ΡΠ²Π½ΡΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Ρ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΡΠ΅ ΡΠ°Π·Π»ΠΈΡΠΈΡ Π² Π°Π½Π°ΡΠΎΠΌΠΎ-ΠΎΠΏΡΠΈΡΠ΅ΡΠΊΠΈΡ
, Π±ΠΈΠΎΠΌΠ΅Ρ
Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΌΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΡ
Π·ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π°ΡΠΎΡΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΌΠΈΠΎΠΏΠΈΠ΅ΠΉ ΡΠ»Π°Π±ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π½Π° ΡΠΎΠ½Π΅ Π‘ΠΠΠ‘Π’ ΠΈ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΌΠΈΠΎΠΏΠΈΠ΅ΠΉ Π±Π΅Π· ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΠΊΠ°Π½Π½ΠΎΠΉ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΈ, ΠΊΠΎΡΠΎΡΡΠ΅ Π·Π°ΠΊΠ»ΡΡΠ°ΡΡΡΡ Π² ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ ΠΏΡΠ΅Π»ΠΎΠΌΠ»ΡΡΡΠ΅ΠΉ ΡΠΈΠ»Ρ ΡΠΎΠ³ΠΎΠ²ΠΈΡΡ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΎ 41,25 [40.62; 41.75] Π΄ΠΏΡΡ, ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ ΡΠ°Π΄ΠΈΡΡΠ° ΡΠΎΠ³ΠΎΠ²ΠΈΡΡ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΎ 8,13 [7.97; 8.28] ΠΌΠΌ, Π΄ΠΈΠ°ΠΌΠ΅ΡΡΠ° ΡΠΎΠ³ΠΎΠ²ΠΈΡΡ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΎ 12,5 [12.1; 12.7] ΠΌΠΌ, ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ Π³Π»ΡΠ±ΠΈΠ½Ρ ΠΏΠ΅ΡΠ΅Π΄Π½Π΅ΠΉ ΠΊΠ°ΠΌΠ΅ΡΡ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΎ 3,8 [3.4; 4.0] ΠΌΠΌ, ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ ΡΠ°Π³ΠΈΡΡΠ°Π»ΡΠ½ΠΎΠΉ Π΄Π»ΠΈΠ½Ρ ΡΡΠ΅ΠΊΠ»ΠΎΠ²ΠΈΠ΄Π½ΠΎΠ³ΠΎ ΡΠ΅Π»Π° Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΎ 17,6 [17.3; 18.0] ΠΌΠΌ, ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ Π°ΠΊΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π΄Π»ΠΈΠ½Ρ Π³Π»Π°Π·Π° Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΎ 24,9 [24.4; 25.4] ΠΌΠΌ, ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ ΠΊΠΎΡΠ½Π΅Π°Π»ΡΠ½ΠΎΠ³ΠΎ Π³ΠΈΡΡΠ΅ΡΠ΅Π·ΠΈΡΠ° Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΎ 11,2 [10.6; 11.7] ΠΌΠΌ ΡΡ. ΡΡ., ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ ΡΠΎΠ»ΡΠΈΠ½Ρ ΡΠ»ΠΎΡ ΠΏΠ΅ΡΠΈΠΏΠ°ΠΏΠΈΠ»Π»ΡΡΠ½ΡΡ
Π½Π΅ΡΠ²Π½ΡΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π΄ΠΎ 87 [85; 93] ΞΌm.ΠΡΠ²ΠΎΠ΄Ρ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ ΠΏΠΎΠ»Π΅Π·Π½ΡΠΌΠΈ Π² ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΎΡΡΠ°Π»ΡΠΌΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° Π½Π΅Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΈ ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ, ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΌΠΈΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ.Β ΠΠ΅ΡΠ° ΡΠΎΠ±ΠΎΡΠΈ β Π²ΠΈΠΊΠΎΠ½Π°ΡΠΈ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½Π΅ ΠΎΡΡΠ½ΡΠ²Π°Π½Π½Ρ Π°Π½Π°ΡΠΎΠΌΠΎ-ΠΎΠΏΡΠΈΡΠ½ΠΈΡ
, Π±ΡΠΎΠΌΠ΅Ρ
Π°Π½ΡΡΠ½ΠΈΡ
Ρ ΠΌΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ½ΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΡΠ² ΠΎΠΊΠ° Π² Π΄ΡΡΠ΅ΠΉ ΡΠ· Π½Π°Π±ΡΡΠΎΡ ΠΌΡΠΎΠΏΡΡΡ ΡΠ° ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π½Π΅Π΄ΠΈΡΠ΅ΡΠ΅Π½ΡΡΠΉΠΎΠ²Π°Π½ΠΎΡ Π΄ΠΈΡΠΏΠ»Π°Π·ΡΡ ΡΠΏΠΎΠ»ΡΡΠ½ΠΎΡ ΡΠΊΠ°Π½ΠΈΠ½ΠΈ.ΠΠ°ΡΠ΅ΡΡΠ°Π»ΠΈ ΡΠ° ΠΌΠ΅ΡΠΎΠ΄ΠΈ. ΠΠ±ΡΡΠ΅ΠΆΠΈΠ»ΠΈ ΠΏΠ°ΡΡΡΠ½ΡΡΠ² Π΄Π²ΠΎΡ
Π³ΡΡΠΏ: Π β 44 Π΄ΠΈΡΠΈΠ½ΠΈ (88 ΠΎΡΠ΅ΠΉ) Π· ΠΌΡΠΎΠΏΡΡΡ ΡΠ»Π°Π±ΠΊΠΎΠ³ΠΎ ΡΡΡΠΏΠ΅Π½Ρ ΡΠ° ΡΠ΅Π½ΠΎΡΠΈΠΏΠΎΠ²ΠΈΠΌΠΈ ΠΏΡΠΎΡΠ²Π°ΠΌΠΈ ΡΠΏΠΎΠ»ΡΡΠ½ΠΎΡΠΊΠ°Π½ΠΈΠ½Π½ΠΎΡ Π΄ΠΈΡΠΏΠ»Π°Π·ΡΡ, ΠΠ Π³ΡΡΠΏΠ° β 40 ΠΏΠ°ΡΡΡΠ½ΡΡΠ² (80 ΠΎΡΠ΅ΠΉ) ΡΠ· ΠΌΡΠΎΠΏΡΡΡ ΡΠ° Π±Π΅Π· ΠΎΠ·Π½Π°ΠΊ ΡΠΏΠΎΠ»ΡΡΠ½ΠΎΡΠΊΠ°Π½ΠΈΠ½Π½ΠΎΡ Π΄ΠΈΡΠΏΠ»Π°Π·ΡΡ. ΠΠΈΠΌΡΡΡΠ²Π°Π»ΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊ Π·Π°Π»ΠΎΠΌΠ»ΡΠ²Π°Π½ΠΎΡ ΡΠΈΠ»ΠΈ ΡΠΎΠ³ΡΠ²ΠΊΠΈ, Π΄ΡΠ°ΠΌΠ΅ΡΡ ΡΠΎΠ³ΡΠ²ΠΊΠΈ, ΡΠ°Π΄ΡΡΡ ΠΊΡΠΈΠ²ΠΈΠ·Π½ΠΈ ΡΠΎΠ³ΡΠ²ΠΊΠΈ, ΡΠΎΠ²ΡΠΈΠ½Ρ ΡΠΎΠ³ΡΠ²ΠΊΠΈ, Π³Π»ΠΈΠ±ΠΈΠ½Ρ ΠΏΠ΅ΡΠ΅Π΄Π½ΡΠΎΡ ΠΊΠ°ΠΌΠ΅ΡΠΈ, ΡΠΎΠ²ΡΠΈΠ½Ρ ΠΊΡΠΈΡΡΠ°Π»ΠΈΠΊΠ°, ΡΠ°Π³ΡΡΠ°Π»ΡΠ½Ρ Π΄ΠΎΠ²ΠΆΠΈΠ½Ρ ΡΠΊΠ»ΠΎΠΏΠΎΠ΄ΡΠ±Π½ΠΎΠ³ΠΎ ΡΡΠ»Π°, Π°ΠΊΡΡΠ°Π»ΡΠ½Ρ Π΄ΠΎΠ²ΠΆΠΈΠ½Ρ ΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ±Π»ΡΠΊΠ°, ΠΊΠΎΡΠ΅Π°Π»ΡΠ½ΠΈΠΉ Π³ΡΡΡΠ΅ΡΠ΅Π·ΠΈΡ, ΠΏΠ΅ΡΠΈΠΏΠ°ΠΏΡΠ»ΡΡΠ½Ρ ΡΠΎΠ²ΡΠΈΠ½Ρ ΡΠ°ΡΡ Π½Π΅ΡΠ²ΠΎΠ²ΠΈΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΠΈ. ΠΠΈΡΠ²ΠΈΠ»ΠΈ Π²ΡΡΠΎΠ³ΡΠ΄Π½Ρ Π²ΡΠ΄ΠΌΡΠ½Π½ΠΎΡΡΡ Π·Π° Π°Π½Π°ΡΠΎΠΌΠΎ-ΠΎΠΏΡΠΈΡΠ½ΠΈΠΌΠΈ, Π±ΡΠΎΠΌΠ΅Ρ
Π°Π½ΡΡΠ½ΠΈΠΌΠΈ ΠΉ ΠΌΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ Π·ΠΎΡΠΎΠ²ΠΎΠ³ΠΎ Π°Π½Π°Π»ΡΠ·Π°ΡΠΎΡΠ° Π΄ΡΡΠ΅ΠΉ ΡΠ· ΠΌΡΠΎΠΏΡΡΡ ΡΠ»Π°Π±ΠΊΠΎΠ³ΠΎ ΡΡΡΠΏΠ΅Π½Ρ Π½Π° ΡΠ»Ρ Π‘ΠΠΠ‘Π’ Ρ Π΄ΡΡΠ΅ΠΉ ΡΠ· ΠΌΡΠΎΠΏΡΡΡ Π±Π΅Π· ΡΠΏΠΎΠ»ΡΡΠ½ΠΎΡΠΊΠ°Π½ΠΈΠ½Π½ΠΎΡ Π΄ΠΈΡΠΏΠ»Π°Π·ΡΡ, ΡΠΎ ΠΏΠΎΠ»ΡΠ³Π°ΡΡΡ Ρ Π·Π½ΠΈΠΆΠ΅Π½Π½Ρ Π·Π°Π»ΠΎΠΌΠ»ΡΠ²Π°Π½ΠΎΡ ΡΠΈΠ»ΠΈ ΡΠΎΠ³ΡΠ²ΠΊΠΈ Π² ΡΠ΅ΡΠ΅Π΄Π½ΡΠΎΠΌΡ Π΄ΠΎ 41,25 [40.62; 41.75] Π΄ΠΏΡΡ, Π·Π±ΡΠ»ΡΡΠ΅Π½Π½Ρ ΡΠ°Π΄ΡΡΡΠ° ΡΠΎΠ³ΡΠ²ΠΊΠΈ Π² ΡΠ΅ΡΠ΅Π΄Π½ΡΠΎΠΌΡ Π΄ΠΎ 8,13 [7.97; 8.28] ΠΌΠΌ, Π΄ΡΠ°ΠΌΠ΅ΡΡΠ° ΡΠΎΠ³ΡΠ²ΠΊΠΈ Π² ΡΠ΅ΡΠ΅Π΄Π½ΡΠΎΠΌΡ Π΄ΠΎ 12,5 [12.1; 12.7] ΠΌΠΌ, Π·Π±ΡΠ»ΡΡΠ΅Π½Π½Ρ Π³Π»ΠΈΠ±ΠΈΠ½ΠΈ ΠΏΠ΅ΡΠ΅Π΄Π½ΡΠΎΡ ΠΊΠ°ΠΌΠ΅ΡΠΈ Π² ΡΠ΅ΡΠ΅Π΄Π½ΡΠΎΠΌΡ Π΄ΠΎ 3,8 [3.4; 4.0] ΠΌΠΌ, Π·Π±ΡΠ»ΡΡΠ΅Π½Π½Ρ ΡΠ°Π³ΡΡΠ°Π»ΡΠ½ΠΎΡ Π΄ΠΎΠ²ΠΆΠΈΠ½ΠΈ ΡΠΊΠ»ΠΎΠΏΠΎΠ΄ΡΠ±Π½ΠΎΠ³ΠΎ ΡΡΠ»Π° Π² ΡΠ΅ΡΠ΅Π΄Π½ΡΠΎΠΌΡ Π΄ΠΎ 17,6 [17.3; 18.0] ΠΌΠΌ, Π·Π±ΡΠ»ΡΡΠ΅Π½Π½Ρ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΡ Π΄ΠΎΠ²ΠΆΠΈΠ½ΠΈ ΠΎΠΊΠ° Π² ΡΠ΅ΡΠ΅Π΄Π½ΡΠΎΠΌΡ Π΄ΠΎ 24,9 [24.4; 25.4] ΠΌΠΌ, Π·Π½ΠΈΠΆΠ΅Π½Π½Ρ ΠΊΠΎΡΠ½Π΅Π°Π»ΡΠ½ΠΎΠ³ΠΎ Π³ΡΡΡΠ΅ΡΠ΅Π·ΠΈΡΡ Π² ΡΠ΅ΡΠ΅Π΄Π½ΡΠΎΠΌΡ Π΄ΠΎ 11,2 [10.6; 11.7] ΠΌΠΌ ΡΡ. ΡΡ., Π·Π½ΠΈΠΆΠ΅Π½Π½Ρ ΡΠΎΠ²ΡΠΈΠ½ΠΈ ΡΠ°ΡΡ ΠΏΠ΅ΡΠΈΠΏΠ°ΠΏΡΠ»ΡΡΠ½ΠΈΡ
Π½Π΅ΡΠ²ΠΎΠ²ΠΈΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½ Ρ ΡΠ΅ΡΠ΅Π΄Π½ΡΠΎΠΌΡ Π΄ΠΎ 87 [85; 93] ΞΌm.ΠΠΈΡΠ½ΠΎΠ²ΠΊΠΈ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΠΈ ΠΌΠΎΠΆΡΡΡ Π±ΡΡΠΈ ΠΊΠΎΡΠΈΡΠ½ΠΈΠΌΠΈ Π² ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠΌΡ ΠΎΡΡΠ½ΡΠ²Π°Π½Π½Ρ ΠΎΡΡΠ°Π»ΡΠΌΠΎΠ»ΠΎΠ³ΡΡΠ½ΠΈΡ
ΠΏΡΠΎΡΠ²ΡΠ² ΡΠΈΠ½Π΄ΡΠΎΠΌΡ Π½Π΅Π΄ΠΈΡΠ΅ΡΠ΅Π½ΡΡΠΉΠΎΠ²Π°Π½ΠΎΡ Π΄ΠΈΡΠΏΠ»Π°Π·ΡΡ ΡΠΏΠΎΠ»ΡΡΠ½ΠΎΡ ΡΠΊΠ°Π½ΠΈΠ½ΠΈ, ΠΏΡΠΎΠ³Π½ΠΎΠ·ΡΠ²Π°Π½Π½Ρ ΡΠΎΠ·Π²ΠΈΡΠΊΡ ΠΌΡΠΎΠΏΡΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡ Ρ Π²ΠΈΠ·Π½Π°ΡΠ΅Π½Π½Ρ ΡΠ½Π΄ΠΈΠ²ΡΠ΄ΡΠ°Π»ΡΠ½ΠΎΡ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π»ΡΠΊΡΠ²Π°Π½Π½Ρ.