Vestnik oftalmologii最新文献

{"title":"[Correction of myopia with implantable collamer lenses].","authors":"S V Trufanov, X Jia, I A Riks, X Lu, Y Lu, Y Fu, G Liu","doi":"10.17116/oftalma20251410215","DOIUrl":"https://doi.org/10.17116/oftalma20251410215","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the effectiveness of the implantable collamer lens (ICL) V4c in the surgical treatment of myopia.</p><p><strong>Material and methods: </strong>The study analyzed the outcomes of ICL V4c implantation in 616 eyes with myopia. Visual acuity, refraction, intraocular pressure (IOP), anterior chamber angle (ACA), vault height, and corneal endothelial cell density (ECD) were evaluated. Patients were examined preoperatively and followed up for one year.</p><p><strong>Results: </strong>Preoperative uncorrected and best-corrected visual acuity were 0.04±0.02 and 0.83±0.12, respectively, improving to 0.97±0.10 and 0.97±0.10 one year postoperatively. The efficacy index was 1.17±0.17, and the safety index was 1.18±0.18. The spherical equivalent (SE) decreased from a preoperative value of -8.79±2.62 to 0.20±0.58 D at one year (<i>p</i><0.0001). The ACA decreased from 39.46±4.97° preoperatively to 22.79±4.74° at one year. Vault height was 747±280 μm on the first postoperative day and 755±285 μm at one year (<i>p</i><0.72), with no tendency for reduction over time. ECD was 2784±244 cells/mm² preoperatively and 2755±254 cells/mm² at one year (<i>p</i><0.29).</p><p><p>No significant linear regression was found between IOP, vault, and ACA.</p><p><strong>Conclusion: </strong>In a large cohort of patients who underwent ICL V4c implantation using the standardized technique, the procedure was demonstrated to be a highly effective, safe, and predictable refractive surgery option for correction of myopia of various degrees, and helped achieve stable visual outcomes. The decrease in spatial relationships in the anterior chamber following standard ICL V4c implantation did not lead to increased IOP.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 2","pages":"5-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current approaches to improving the effectiveness of multifocal and extended depth of focus intraocular lenses].","authors":"A E Birukova, Kh I Meslaurova, N D Fokina, A S Vvedenskiy, M N Ivanov","doi":"10.17116/oftalma2025141041110","DOIUrl":"https://doi.org/10.17116/oftalma2025141041110","url":null,"abstract":"<p><p>Phacoemulsification with intraocular lens (IOL) implantation has become the standard method for cataract extraction regardless of its etiology. In modern phaco surgery, implantation of multifocal IOLs is considered the most advanced method for correcting aphakia following lens extraction. The wide range of available multifocal IOLs is promoting the ongoing discussion regarding the advantages of each type, as well as potential strategies for optimizing surgical outcomes. This literature review presents current methods for improving the performance of various types of multifocal and extended depth of focus IOLs.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 4","pages":"110-116"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ciliochoroidal detachment as a complication of glaucoma surgery. Part 1. Theories of pathogenesis, symptoms and diagnosis].","authors":"Yu Yusef, A A Antonov, A A Vitkov, A A Komarov, I V Kozlova","doi":"10.17116/oftalma202514103179","DOIUrl":"https://doi.org/10.17116/oftalma202514103179","url":null,"abstract":"<p><p>Choroidal detachment is one of the most common complications of glaucoma surgery. It frequently develops following filtering and drainage glaucoma operations, as well as some laser interventions. The onset of this condition is associated with a variety of factors, most notably fluctuations in intraocular pressure and the anatomical and biomechanical features of the eye. This article reviews the main theories of pathogenesis, symptoms and diagnosis12 of this pathology. Understanding the underlying pathogenetic mechanisms of ciliochoroidal detachment is essential for ophthalmologists to ensure proper management and prevention of this condition.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 3","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ciliochoroidal detachment as a complication of glaucoma surgery. Part 2. Treatment and prevention].","authors":"Yu Yusef, A A Antonov, A A Vitkov, A A Komarov, I V Kozlova","doi":"10.17116/oftalma202514103185","DOIUrl":"10.17116/oftalma202514103185","url":null,"abstract":"<p><p>The introduction of new methods of surgical treatment of glaucoma reduces the risks, but does not exclude the development of choroidal detachment. The incidence of this complication has been reduced thanks to microinvasive techniques. This article analyzes the most widely recognized medical and surgical approaches to the treatment of ciliochoroidal detachment. The correct choice of preventive measures may help reduce the occurrence of this complication of glaucoma surgery.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 3","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New options determining the success of treatment for neovascular age-related macular degeneration].","authors":"A Zh Fursova, I F Nikulich, M A Vasilyeva, A S Derbeneva, Yu A Karlash","doi":"10.17116/oftalma202514103171","DOIUrl":"10.17116/oftalma202514103171","url":null,"abstract":"<p><p>Neovascular age-related macular degeneration (nAMD) is a progressive retinal disease that can lead to severe and irreversible vision loss despite the availability of effective anti-VEGF agents. One of the potential causes of suboptimal treatment outcomes in nAMD is undertreatment, which may result from the need for frequent injections and follow-up visits, limitations in public healthcare funding, and challenges in achieving sustained and long-term control of disease activity (DA). Aflibercept 8 mg is a novel formulation with a higher concentration and improved molecular stability, enabling a fourfold increase in the molar dose of the active substance delivered to the vitreous body. The phase III PULSAR trial, a 96-week randomized, double-masked, active-controlled study, evaluated the efficacy and safety of 8 mg aflibercept compared with the standard 2 mg dose in treatment-naïve patients with nAMD. Participants were randomized 1:1:1 into three groups: aflibercept 2 mg every 8 weeks (2q8), 8 mg every 12 weeks (8q12), or 8 mg every 16 weeks (8q16) after three initial monthly loading doses. The study demonstrated the benefits of the 8 mg dose in extending interinjection intervals. By week 96, 88% of patients achieved an interval of ≥12 weeks, 71% ≥16 weeks, and 47% ≥20 weeks; in the 8q16 group, 53% of patients reached an interval of ≥20 weeks and 31% - 24 weeks. Over the 2-year period, patients in the 8q16 group received approximately 8 injections, compared to around 13 in the 2q8 group, with comparable anatomical and functional outcomes and no additional safety concerns. Given the proven effectiveness in improving best-corrected visual acuity (BCVA), superior outcomes in resolving intra- and/or subretinal fluid (IRF/SRF), and reduced treatment burden, it appears optimal to broadly transition patients already receiving aflibercept 2 mg to the higher molar concentration (aflibercept 8 mg) regardless of treatment phase or the interinjection interval. This approach aims to achieve a longer anti-VEGF effect duration and sustained DA control with the fewest possible injections.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 3","pages":"71-78"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Angiographic parameters of the retina after various methods of membrane peeling in the treatment of diabetic maculopathy].","authors":"Yu Yusef, V M Filippov, D V Petrachkov, A L Sidamonidze","doi":"10.17116/oftalma202514101137","DOIUrl":"10.17116/oftalma202514101137","url":null,"abstract":"<p><p>The rising prevalence of diabetes mellitus increases the need for treatment of diabetic maculopathy (DM). Evaluation of surgical outcomes in DM, including postoperative microstructural changes in the retina and its vascular plexuses, remains a relevant challenge.</p><p><strong>Purpose: </strong>This article assesses changes in angiographic parameters of the retinal capillary plexuses after surgical treatment of DM using various methods of internal limiting membrane (ILM) peeling.</p><p><strong>Material and methods: </strong>Vitreoretinal surgery, including vitrectomy with membrane peeling, was performed in comparable groups of patients with proliferative diabetic retinopathy and DM. The surgical methods differed in the approach to retinal ILM peeling: in group 1 the ILM was completely removed; group 2 underwent dosed fovea-sparing peeling (DFSP) of the ILM; in group 3 the ILM was left intact. Postoperative outcomes were compared between groups using optical coherence tomography angiography (OCT-A).</p><p><strong>Results: </strong>Intergroup comparisons across all time points and parameters did not reveal statistically significant differences. The analysis showed no significant changes in angiographic parameters in groups 1 and 3. In group 2 significant changes were observed in the parameters of deep capillary plexus: increased vessel density, vessel skeleton density and vessel perimeter index, as well as reduced foveal avascular zone (FAZ) area. Correlation analysis revealed that high FAZ area values in the deep capillary plexus were predictors of the development of retinal atrophy in the long-term.</p><p><strong>Conclusion: </strong>The obtained results demonstrate the dynamics of changes following DFSP of the ILM in both the neuronal structures of the retina and its capillary plexuses, with these changes tending toward normalization of retinal structure.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 1","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[On correct clinical and pathogenetic OCT-based classification of vitreomacular interface pathologies].","authors":"S A Kovalev, Yu A Ivanishko, V V Miroshnikov","doi":"10.17116/oftalma202514102116","DOIUrl":"10.17116/oftalma202514102116","url":null,"abstract":"<p><p>Currently, there is no universally accepted classification of vitreomacular interface (VMI) pathology, which complicates professional communication and the choice of treatment strategies.</p><p><strong>Purpose: </strong>This article presents our perspective on a feasible and prognostically significant clinical and pathogenetic OCT-based classification of surgical VMI pathologies.</p><p><strong>Material and methods: </strong>In order to develop a classification approach to categorize the most common changes in VMI based on pathogenesis we summarized published literature and our own observations.</p><p><strong>Results: </strong>Based on pathogenesis, classification begins with vitreomacular adhesion. The formation of an epiretinal membrane (ERM) can result from the development of posterior vitreous detachment (PVD) along the path of vitreoschisis. The severity of retinal changes and the presence of ectopic internal foveal layers distinguish four stages of ERM. ERM can exhibit various contraction patterns. If proliferative tissue contracts with centripetal tension on the retina, it may result in ERM with a macular pseudohole. Centrifugal contraction may may lead to the formation of intraretinal cystic spaces, resulting in ERM with foveoschisis. If PVD occurs in the presence of strong local vitreomacular fixation, vitreomacular traction (VMT) may develop, which is also classified into four stages. VMT can resolve either asymptomatically or with the formation of a retinal tissue defect, leading to the development of a full-thickness macular hole (FTMH). In cases where tractional forces during PVD create a retinal defect without causing an FTMH, secondary processes may be initiated, leading to an OCT pattern of lamellar macular hole, which in rare instances may progress to FTMH.</p><p><strong>Conclusion: </strong>The proposed classification scheme encompasses the full spectrum of primary surgical VMI pathologies, is based on modern pathogenetic concepts, and relies on clear OCT-defined criteria for each nosological entity. The scheme relies on specific morphological criteria and delineates the stages of pathological processes, facilitating research standardization and streamlining treatment decision-making.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 2","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Osmogenic causes of reversible changes in light scattering power and refraction of hydrophilic intraocular lens in the early postoperative period].","authors":"I A Novikov, Yu N Pyrkov, M N Narbut, Yu Yusef, S E Avetisov, O A Pak, G M Tuaev, R R Agliamutdinov, G V Voronin","doi":"10.17116/oftalma202514103127","DOIUrl":"https://doi.org/10.17116/oftalma202514103127","url":null,"abstract":"<p><p>Recently, hydrophilic acrylic intraocular lenses (IOLs) have become the most widely used in clinical practice due to simpler manufacturing process and known optical disadvantages of hydrophobic lenses (e.g., dysphotopsia effect). Acrylic hydrophilic lenses, similar to polymethylmethacrylate and silicone IOLs, are susceptible to both reversible and irreversible optical changes intraoperatively and in the early postoperative period. The optical properties of the IOL may be affected by its transfer from one medium to another with a short-term shock effect on the lens polymer followed by chemical relaxation within the IOL-medium system.</p><p><strong>Purpose: </strong>This study evaluated potential changes in the optical power and light-scattering properties of the IOL material resulting from rapid changes in the osmolarity of the surrounding medium.</p><p><strong>Material and methods: </strong>Physical models based on a commercially available hydrophilic IOL were created to assess changes in the refractive index of the polymer and the quality of light transmission in response to the change of bathing solution. An original photometer and a series of test saline solutions with varying osmolarities were prepared for this purpose.</p><p><strong>Results: </strong>The most pronounced refractive effect was observed when the bathing solution was switched from isotonic to hypertonic. The increase in the refractive index of the IOL material amounted to Δn = +0.0038, which could translate into clinically significant changes of 0.25-0.6 diopters depending on the initial IOL power. Returning the IOL to isotonic conditions after prolonged exposure to hypo- or hyperosmolar environments led to reversible opacification of the lens material. Optical destabilization effects were observed within the first hours (refraction) and could persist for up to 24 hours.</p><p><strong>Conclusion: </strong>The conducted experiments model potential violations of IOL storage and transportation guidelines prior to implantation. The findings provide insights into certain reversible optical phenomena in hydrophilic IOLs, and can help explain the results of clinical assessments in the early postoperative period.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 3","pages":"27-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Outcomes of modified lateral orbital wall decompression using ultrasonic bone removal].","authors":"Y O Grusha, A S Kolodina, P A Kochetkov, K V Chetkarev, N Yu Sviridenko","doi":"10.17116/oftalma202514104121","DOIUrl":"https://doi.org/10.17116/oftalma202514104121","url":null,"abstract":"<p><strong>Objective: </strong>This study presents a comparative analysis of outcomes of lateral orbital wall decompression performed using ultrasonic bone removal with standard and modified techniques.</p><p><strong>Material and methods: </strong>The study included 78 patients (109 orbits) with exophthalmos without visual impairment (subgroups 1A and 1B) and with optic neuropathy (ON) due to thyroid eye disease (TED) (subgroups 2A and 2B). Lateral wall decompression (LWD) was performed using ultrasonic bone removal with a modified (<i>n</i>=58, patient subgroups 1A and 2A) or standard (<i>n</i>=51, subgroups 1B and 2B) technique. Postoperative evaluation included visual function, degree of exophthalmos, and palpebral fissure parameters.</p><p><strong>Results: </strong>In subgroup 1A, exophthalmos regression averaged 3.8±0.9 mm, while in subgroup 1B it amounted to 2.9±0.8 mm. Comparable improvement in visual acuity was observed in subgroups 2A and 2B, with a median gain of 0.4, along with positive changes in perimetry and color vision.</p><p><strong>Conclusion: </strong>The modified LWD technique using ultrasonic bone removal achieved a mean exophthalmos reduction of approximately 4 mm. In cases complicated by ON, improvement in visual function was observed for up to 4 years.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 4","pages":"21-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Autologous oral mucosal epithelial transplantation in the treatment of bilateral limbal stem cell deficiency].","authors":"R S Isabekov, B E Malyugin, A M Gelyastanov, M Yu Gerasimov","doi":"10.17116/oftalma202514104196","DOIUrl":"https://doi.org/10.17116/oftalma202514104196","url":null,"abstract":"<p><p>This review analyzes Russian and international literature on the treatment of bilateral limbal stem cell deficiency (LSCD), focusing on the use of Simple Oral Mucosal Epithelial Transplantation (SOMET) as a surgical method for restoring the ocular surface. Contemporary sources report 64 cases of SOMET used in the treatment of bilateral LSCD: 35 cases of chemical burns, 16 of thermal burns, 7 cases of Stevens-Johnson syndrome, 1 keratitis, 1 cicatricial pemphigoid, 1 dermoid, 1 case of drug-induced LSCD (mitomycin C), etc. Notably, all transplantations resulted in complete epithelialization, and in 3 cases, penetrating keratoplasty was subsequently performed with favorable functional and anatomical outcomes.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 4","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}