Russian Journal of Clinical Ophthalmology最新文献

{"title":"Complex treatment for dry eye disease in intermediate uveitis","authors":"E. Tatarnikova, O. I. Krivosheina","doi":"10.32364/2311-7729-2022-22-1-30-35","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-1-30-35","url":null,"abstract":"Aim: to study clinical presentations of dry eye disease (DED) in intermediate uveitis (pars planitis) and develop a complex treatment algorithm including tear substitutes, reparative, and anti-inflammatory therapies combined with laser photocoagulation. Patients and Methods: the study enrolled 98 patients divided into the study group (n=78) and the comparison group (n=20). Study group patients received complex treatment, including tear substitutes, anti-inflammatory therapies, and laser photocoagulation. Comparison group patients received topical medications only. All patients underwent a complex examination including the OSDI questionnaire, visual acuity, IOP measurements, slit lamp examination, binocular dilated fundus examination with scleral indentation, and Schirmer’s test 1 at baseline, after baseline three and six months. Treatment efficacy was assessed based on the severity of intermediate uveitis presentations. Results: intermediate uveitis exacerbates DED. The more active chorioretinal inflammation near the ora serrata is, the more severe clinical, functional changes of the ocular surface are. Complex treatment significantly improved typical DED complaints by the OSDI score (by 34.8%), ocular surface by slit-lamp examination (lower occurrence of conjunctival fold overhang, by 51.8%), mild eyelid and conjunctival hyperemia, and conjunctival discharge. Six months after treatment, a 2-fold (vs. baseline) increase in total tear secretion and resorption of vitreous exudates and retinal edema were reported in the study group. Changes in all parameters in the study group were more significant than in the comparison group. Conclusion: complex treatment algorithm (tear substitutes, reparative, and anti-inflammatory therapies combined with laser photocoagulation) provides a more rapid and stable reduction in chorioretinal inflammation near the ora serrata. It significantly improves subjective and objective DED signs compared to conventional pharmacotherapy. Keywords: dry eye disease, intermediate uveitis, laser photocoagulation, ora serrata. For citation: Tatarnikova E.B., Krivosheina O.I. Complex treatment for dry eye disease in intermediate uveitis. Russian Journal of Clinical Ophthalmology. 2022;22(1):30–35 (in Russ.). DOI: 10.32364/2311-7729-2022-22-1-30-35.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86051153","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":"Genetic testing of ocular manifestations of proliferative syndrome to provide pathophysiology-oriented treatment","authors":"M. Weener, N. A. Bakunina, J. Salmasi, G. V. Poryadin, D. Barh, Y. Kuznetsova, L. Balashova","doi":"10.32364/2311-7729-2022-22-1-16-22","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-1-16-22","url":null,"abstract":"Background: uncontrolled cell proliferation of the ocular blood network is one of the leading causes of blindness and low vision worldwide. We summarize relevant published data and our 5-year experience in searching treatment tools for excessive non-productive proliferation. Aim: to describe genetic patterns in patients with ocular blood network proliferation for predicting disease course and selecting adequate treatment. Patients and Methods: 1210 patients with proliferative ocular disorders, retinopathy of prematurity, and diabetes were enrolled. Patients were divided into three groups: (1) monogenic disorders, (2) proliferative vitreoretinopathy and diabetes mellitus, (3) retinopathy of prematurity. Follow-up was 6 to 36 months. Laboratory, genetic, and relevant clinical tests were pursued in all patients. Results: proprietary approach of bioinformatic analysis of whole exome/whole genome sequencing data allows for specifying the proliferative process’s prognosis and severity given clinical and genetic findings. This approach includes the analysis of gene mutations directly or indirectly involved in angiogenesis and key signaling pathways. The analysis of mutation identified in group 2 revealed 509C>T TGFB1 gene polymorphism in two patients and c.3174G>A IGF1R gene polymorphism in three patients. In group 3, the most common VEGFA gene polymorphisms were +13553C>T, -634G>C, +405G>C (rs2010963), and -460C>T (rs833061). Conclusion: specifying the prognosis of the course and severity of proliferative ocular disorders pathogenically-oriented targeted treatment requires specialized genetic testing using an improved data analysis approach. Keywords: proliferative syndrome, diabetes, retinopathy of prematurity, VEGFA, TGFB1, IGF1R, Stickler syndrome, Wagner syndrome, Wolframe syndrome, Marshall syndrome, Norrie disease, Coats disease, retinoschisis. For citation: Weener M.E., Bakunina N.A., Salmasi J.M. et al. Genetic testing of ocular manifestations of proliferative syndrome to provide pathophysiology-oriented treatment. Russian Journal of Clinical Ophthalmology. 2022;22(1):16–22 (in Russ.). DOI: 10.32364/2311-7729- 2022-22-1-16-22.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72624322","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":"Surgical repair of conjunctival defects: perspectives and limitations","authors":"M. Gushсhina, A. V. Tereshchenko, A. Gushchin, D. Afanasyeva","doi":"10.32364/2311-7729-2022-22-2-137-144","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-2-137-144","url":null,"abstract":"Background: conjunctival disorders are associated with multiple anatomical functional impairments of the eye and ocular adnexa. Rehabilitation of these patients implies the recovery of both macroanatomy and functions of damaged tissues and structures. Aim: to analyze the outcomes of surgical repair of conjunctival defects from the viewpoint of the recovery of ocular anatomy and functions and ocular adnexa. Patients and Methods: a retrospective analysis of the outcomes of surgical repair of conjunctival defects using full-thickness and/or split- thickness autografts of the labial or cheek mucosa in 27 patients. The mean age of participants was 36.86±19.46 years. Follow-up was 1.5 to 6.5 years. The patients were divided into two groups. Group 1 included 21 patients with local symblepharon. Group 2 included patients with subtotal or total conjunctival adhesions of a healthy eye (group 2A, n=3) or in anophthalmia (group 2B, n=4). Results: surgical repair of conjunctival defects provided a complete anatomical functional rehabilitation of patients with local symblepharon and esthetical rehabilitation of patients with subtotal conjunctival adhesions or ankyloblepharon in anophthalmia, whereby allowing keratoprosthesis in a patient with one potentially seeing eye. Meanwhile, we failed to achieve a complete functional rehabilitation and recovery of vision in patients with a potentially seeing eye due to the loss of the palisades of Vogt and/or tear-producing conjunctival structures. Conclusions: surgical repair of conjunctival defects using the technique proposed completely recovers the macroanatomy of the conjunctival fornices and sac and, therefore, improves eyeball and eyelid mobility. However, impossibility of recovering histology in virtually complete loss of native conjunctiva does not allow complete rehabilitation of patients with symblepharon or ankyloblepharon of a potentially seeing eye. Keywords: symblepharon, anlyloblepharon, limbal deficiency, tear production, corneal leucoma, mucosal autograft. For citation: Gushсhina M.B., Tereshchenko A.V., Gushchin A.V., Afanasyeva D.S. Surgical repair of conjunctival defects: perspectives and limitations. Russian Journal of Clinical Ophthalmology. 2022;22(2):137–144 (in Russ.). DOI: 10.32364/2311-7729-2022-22-2-137-144","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79902670","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":"Diagnosis and treatment of descending optic neuritis developed as a manifestation of local viral encephalitis (a clinical case)","authors":"N. Korsakova, E.I. Korsakova","doi":"10.32364/2311-7729-2022-22-4-273-278","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-4-273-278","url":null,"abstract":"It is well known that the incidence of encephalitis and optic neuritis is relatively high worldwide. Moreover, it is associated with high mortality and disability rates. At the same time, in 45–75% of cases, optic neuritis affects the central nervous system causing its disorders of various severity. Unfortunately, for practicing ophthalmologists and neurologists it is difficult to find a relationship between optical neuritis and inflammation of the brain tissue (especially when it is limited by a certain part of the brain) which underlies the diagnosis of opticoencephalitis. In this context, an ophthalmologist who can use methods of ophthalmological diagnostics will play a more important role. The ophthalmologist will be able to arrive at a topical diagnosis and localize a level of the brain tissue lesion, which is essential for determining the disease but cannot be done by neurologist. This publication presents our own clinical observation describing the specific aspects of diagnosis and treatment of descending optic neuritis co-occurring with viral inflammation of the brain tissue. The article provides analysis of the clinical signs which both impeded and facilitated the process of making the accurate diagnosis. It should be recognized that during the process of opticoencephalitis development, its ophthalmic manifestations for a long time will not only remain a single sign of this focal neurological disorder, but will require timely initiation of etiotropic drugs, using the appropriate routes of administration, doses, and duration of treatment. Thus, it is important to be aware and prepared for detecting viral encephalitis (opticoencephalitis) even at the slightest suspicion for a descending pathway of the diagnosed inflammation of the eye tissues. Keywords: optical neuritis, encephalitis, herpes virus, markers, antibodies, vesicles, ophthalmoscopy, perimetry. For citation: Korsakova N.V., Korsakova E.I. Diagnosis and treatment of descending optic neuritis developed as a manifestation of local viral encephalitis (a clinical case). Russian Journal of Clinical Ophthalmology. 2022;22(4):273–278 (in Russ.). DOI: 10.32364/2311-7729- 2022-22-4-273-278.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80234740","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":"Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients","authors":"M. Tereshchenko, A. Egorov, A. Movsisyan","doi":"10.32364/2311-7729-2022-22-4-234-239","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-4-234-239","url":null,"abstract":"Glaucoma is one of the socially significant and disabling diseases highly prevalent worldwide. Population ageing and increase in life expectancy will result in even a bigger growth of glaucoma cases. The main principle of medical management of primary open-angle glaucoma (POAG) is to provide a timely ocular hypotensive therapy directed at lowering intraocular pressure, the only modifiable risk factor in the disease progression, to a target level. The article describes specific approaches to the medical management of elderly and senile patients with POAG, taking into consideration age-related eye problems and medications used for comorbidities. The selection of drugs is based on the assessment of their efficacy, probability of adverse events, dosage frequency, convenience of use and the cost of treatment. For a long time, β-adrenergic blocking agents were considered a first line medication for POAG. However, due to the adverse events, including systemic side effects, β-blockers have become second-line drugs for the treatment of elderly and senile patients. First-line medications now include prostaglandin analogues characterized by a higher efficacy and a lower rate of adverse events. The best option for patients with POAG is the use of preservative-free highly selective prostaglandin analogues which reduce intraocular pressure to a target level, maintain patient’s visual functions for a long time, improve the quality of life and cause significantly less adverse reactions on the ocular surface. Keywords: glaucoma, prostaglandin analogues, β-blockers, dry eye syndrome, preservatives, travoprost. For citation: Tereshchenko M.V., Egorov A.E., Movsisyan A.B. Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients. Russian Journal of Clinical Ophthalmology. 2022;22(4):234–239 (in Russ.). DOI: 10.32364/2311-7729-2022-22-4-234-239.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80276800","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":"Ocular changes after simultaneous kidney-pancreas transplant","authors":"I. Vorobyeva, E. Bulava, L. Moshetova, A. Pinchuk","doi":"10.32364/2311-7729-2022-22-2-132-136","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-2-132-136","url":null,"abstract":"Type 1 diabetes (T1D) is one of the most common chronic diseases in young individuals. Diabetic nephropathy, being one of the most dangerous complications of T1D, progresses to end-stage renal disease within 10–15 years in 80%. The simultaneous kidney-pancreas transplant prevents insulin therapy and dialysis, thereby avoiding further progression of complications of diabetes. Normalization of carbohydrate metabolism and resolving of uremia after simultaneous kidney-pancreas transplant are beneficial for ocular structures. This article reviews studies on the pattern of changes in ocular structures in the post-transplant period. The procedure improves peripheral microcirculation of the bulbar conjunctiva and corneal innervation. Most studies demonstrate stabilization and improvement of the course of diabetic retinopathy as illustrated by the reduction in active vascular proliferation, need for retinal laser photocoagulation and vitrectomy. Meanwhile, some studies failed to reveal any differences in the morphological functional status of the retina in the pre- and postoperative periods. An increase in cataract rate among simultaneous kidney-pancreas transplant recipients receiving immunosuppressant therapy remains a challenge. Keywords: type 1 diabetes, kidney transplant, pancreas transplant, simultaneous kidney-pancreas transplant, diabetic retinopathy, diabetic macular edema. For citation: Vorobyeva I.V., Bulava E.V., Moshetova L.K., Pinchuk A.V. Ocular changes after simultaneous kidney-pancreas transplant. Russian Journal of Clinical Ophthalmology. 2022;22(2):132–136 (in Russ.). DOI: 10.32364/2311-7729-2022-22-2-132-136.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76191498","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":"Anti-VEGF therapy for diabetic macular edema: up-to-date approaches to the management of patients with high and low baseline functional parameters","authors":"E. V. Bobykin","doi":"10.32364/2311-7729-2022-22-3-181-186","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-3-181-186","url":null,"abstract":"Diabetic macular edema (DME) is a serious complication of diabetes mellitus (DM) and a vision-threatening condition which can lead to irreversible blindness. Its prevalence correlates with the number of cases of DM and diabetic retinopathy and demonstrates a stable upward trend. Though modern medicine has made tremendous strides and developed several options for DME treatment which comply with the efficacy and safety criteria from a perspective of evidence-based medicine, DME remains a challenge in the clinical practice. There is no doubt that the key role is played by anti-angiogenic (anti-VEGF) therapy which has become the gold standard treatment for DME and is supported by a strong evidence base. However, some aspects of this method application are understudied. Thus, most of the randomized clinical studies (RCSs) of anti-VEGF therapy included patients with the \"averaged\" baseline values of visual acuity (within the range of 23–79 letters using ETDRS chart / 0.06–0.7 in decimal system). But in real clinical practice ophthalmologists often observe atypical DME cases where the baseline visual acuity values fall outside the range described in RCSs. The present literature review is aimed at considering tactics of the rational management of patients with atypically low and high baseline visual functions and provides analysis of the recent publications in which the outcomes of anti-VEGF therapy are discussed in the context of this problem. Keywords: macular edema, anti-VEGF therapy, diabetic retinopathy, diabetes, diabetic macular edema, high visual acuity, low visual acuity. For citation: Bobykin E.V. Anti-VEGF therapy for diabetic macular edema: up-to-date approaches to the management of patients with high and low baseline functional parameters. Russian Journal of Clinical Ophthalmology. 2022;22(3):181–186 (in Russ.). DOI: 10.32364/2311-7729- 2022-22-3-181-186.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80281799","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":"Risk factors affecting progression and course of primary open-angle glaucoma in patients with different disease stages (multicenter study)","authors":"N. E. Fomin, P. Zavadskiy, A. Kuroedov, A. V. Seleznev, Z. M. Nagornova, D. Baryshnikova, R. Avdeev, A. Getmanova, I. A. Glushnev, A. A. Gusarevich, D. A. Dorofeev, S.V. Kosmynina, O.S. Myakonkaya, N. A. Rebenok, Yu.I. Razhko, I.I. Semenova, T. V. Chernyakova","doi":"10.32364/2311-7729-2022-22-2-80-90","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-2-80-90","url":null,"abstract":"Aim: to identify certain risk factors and their associations, which determine the prognosis of primary open-angle glaucoma (POAG) in patients with different disease stages. Patients and Methods: the final protocol of this clinical research combines multicenter study included the results of dynamic follow-up of 293 patients (293 eyes) with different stages of POAG. The mean age at the time of diagnosis was 65 (59; 70) years. The duration of verified POAG history was 3 (1; 6) years. Age, medical history, disease stage, IOP levels, IOP-lowering medications, comorbidities, other (social) factors (in total, 23 entities considered potential causes of refractory glaucoma) were investigated. All participants were divided into two groups (non-refractory glaucoma and refractory glaucoma) that included six subgroups according to current guidelines on achieving target IOP in various treatment approaches. Results: at the time of verified diagnosis and final examination of POAG patients, IOP levels were higher in the refractory glaucoma group and patients with advanced glaucoma (p<0.001). The most common risk factors, comorbidities, and other variables characterizing refractory glaucoma were pseudoexfoliative syndrome/PEX (53.5%), pigment dispersion syndrome/PDS (16.7%), dry eye disease/DED (38.6%), high myopia (7.9%), coronary heart disease/CHD (40.3%), smoking (16%), and disability resulting from a general illness (12.6%). The rate of these entities varied from 11.1% to 69.4%, being most common in the refractory glaucoma group. Refractory glaucoma patients had a tendency to a slow return to topical treatment in the early postoperative period after glaucoma surgery, despite the lack of achieving target IOP. Conclusion: our study has demonstrated that IOP levels at the time of verified diagnosis directly correlate with the stage of newly diagnosed glaucoma and IOP levels in the setting of glaucoma treatment and predetermine future refractory disease. Moreover, PEX, PDS, DED, CHD, prior myocardial infarction, and disability resulting from a general illness are additional factors determining POAG resistance to treatment. Keywords: glaucoma, intraocular pressure, refractory, risk factors, progression. For citation: Fomin N.E., Zavadskiy P.Ch., Kuroedov A.V. et al. Risk factors affecting progression and course of primary open-angle glaucoma in patients with different disease stages (multicenter study). Russian Journal of Clinical Ophthalmology. 2022;22(2):80–90 (in Russ.). DOI: 10.32364/2311-7729-2022-22-2-80-90.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77060694","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":"Three-year experience of posterior chamber phakic intraocular lens implantation in the high myopia correction","authors":"I. Saliev, A. Yusupov, N.I. Mukhamedova","doi":"10.32364/2311-7729-2022-22-3-156-160","DOIUrl":"https://doi.org/10.32364/2311-7729-2022-22-3-156-160","url":null,"abstract":"Aim: to evaluate the efficacy and safety of posterior chamber phakic intraocular lens (pIOL) implantation for the high myopia correction. Patients and Methods: 37 patients (55 eyes) aged 20 to 43 years were included in the study. All patients underwent the following ophthalmic examinations before surgery: visometry, autorefractometry, biometry, tonometry, optical coherence tomography, evaluation of corneal endothelial cell density, peripheral retinal exam using a Goldmann lens. pIOL power calculation was conducted using a modified vergence formula. All surgeries were performed by one surgeon according to the standard procedure. Patients were examined after surgery after 1 day, 1 month, 3 months, then every 6 months for 3 years. Visometry was performed 1 day and 1 month after the surgery. During subsequent visits, all of the listed examinations were performed, except for peripheral retinal exam using a Goldmann lens. Results: all patients completed the study. There were no intraoperative complications. No cases of cataracts or other postoperative complications were observed during 3-year follow-up. Uncorrected visual acuity 3 years after surgery was 18.4% higher than the maximum corrected visual acuity before surgery, and target refraction was observed in 86% of the eyes. Intraocular pressure during 3-year follow-up was within the normal range and averaged 17.04 mmHg. Fluctuations in the lens vault from the pIOL posterior surface to the anterior surface of the lens (VAULT) were within the normal range. Corneal endothelial cell density decreased by an average of 0.09% 3 years after surger During 3-year follow-up, there were no clinically significant changes in the anterior chamber depth of the eye. The average change in the axis orientation was also <6° for all visit intervals. At the same time, the patients did not notice a change in the pIOL orientation up to 10°. Conclusion: pIOL implantation is a safe and effective method for high myopia surgical correction. Keywords: myopia, myopia correction, implantation, phakic intraocular lens, VAULT, endothelial cell density, anterior chamber of the eye. For citation: Saliev I.F., Yusupov A.F., Mukhamedova N.I. Three-year experience of posterior chamber phakic intraocular lens implantation in the high myopia correction. Russian Journal of Clinical Ophthalmology. 2022;22(3):156–160 (in Russ.). DOI: 10.32364/2311-7729- 2022-22-3-156-160.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83358121","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":"Realization of a cascade treatment algorithm for glaucoma in St. Petersburg","authors":"A. V. Antonova, V. Nikolaenko, V. Brzheskiy","doi":"10.32364/2311-7729-2021-21-3-123-128","DOIUrl":"https://doi.org/10.32364/2311-7729-2021-21-3-123-128","url":null,"abstract":"Aim: to analyze the duration and regimen of topical treatment and the pattern of prior laser and surgical procedures in patients with glaucoma who were admitted to the hospital for IOP-lowering interventions. Patients and Methods: this study included 500 consecutively enrolled patients who underwent surgery for uncontrolled glaucoma in 2016– 2020 and were followed up for 6–24 months. Disease history, cumulative \"preservative\" load, clinical examinations, and surgical outcomes were assessed. Results: preoperatively, most patients received the maximum medical therapy (i.e., three agents in two bottles). Simultaneous use of all four major classes of IOP-lowering medications occurred in 10% of patients only. Two-third of patients required surgical interventions to reduce IOP after a 6-year medical therapy. By the time of admission, 60% of patients were diagnosed with advanced or end-stage glaucoma. Prior laser or surgical procedures to reduce IOP were performed only in 142 patients and 52 patients, respectively. Treatment adherence was lower in men compared to women, irrespective of its stage. Conclusion: most patients received adequate medical therapy. However, in general, surgery was performed too late. It gives the impression that the efficacy of therapeutic and laser stages of cascade glaucoma treatment is no more than five years. In addition to the obvious drawbacks of a laissez-faire strategy (irreversible vision loss), the risk of surgical failure significantly increases. Long-term (at least 3-year) therapy using (non)fixed-dose combinations of agents containing preservatives is the major modifiable risk factor for early filtration loss. Preservativefree prostaglandin analogues improve treatment tolerability, adherence to treatment, and chances for success of IOP-lowering surgery. The authors’ results demonstrate that gender differences should be considered when planning treatment and follow-up visits. Keywords: glaucoma, IOP-lowering therapy, glaucoma surgery, ocular surface, preservatives, benzalkonium chloride. For citation: Antonova A.V., Nikolaenko V.P., Brzheskiy V.V. Realization of a cascade treatment algorithm for glaucoma in St. Petersburg. Russian Journal of Clinical Ophthalmology. 2021;21(3):123–128 (in Russ.). DOI: 10.32364/2311-7729-2021-21-3-123-128.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89017159","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}