[Comparison of visometry by Sivtsev and ETDRS charts]. / Sravnenie vizometrii po tablitsam Sivtseva i ETDRS.

Most foreign authors currently recommend the protocol and charts developed for the Early Treatment Diabetic Retinopathy Study (ETDRS) as the gold standard for evaluation of visual acuity (VA) in clinical trials and studies. Not every medical facility has equipment required for performing visometry by that method, while Sivtsev tables are found universally. OBJECTIVE: To compare ETDRS and the more common Sivtsev visometry methods. MATERIAL AND METHODS: The study included 100 volunteers - students of the Sechenov University. All participants were examined for VA in both eyes without correction using ETDRS "R" chart and Sivtsev table. Visometry with "R" ETDRS chart involved calculation of the number of named letters, then the number was translated into logarithmic notation by the conventional method. Sivtsev visometry findings were translated into logarithmic notation by two methods: first - standard, line-by-line, second - experimental, letter-by-letter. Subjects were divided into two groups: high VA (higher than 0.4 in decimal scale) and low VA - everyone else. RESULTS: The best agreement with ETDRS was found in letter-by-letter method of Sivtsev table interpretation, especially in the group with high VA with the lowest 95% limits of agreement (LoA) of ±0.157 logMAR, or 8 letters on ETDRS. Clinically significant were also LoA in comparison of ETDRS with line-by-line calculation method in the group with high VA and in letter-by-letter method without dividing groups by VA. CONCLUSION: The use of Sivtsev table in standardized multicenter studies is only reasonable when the ETDRS charts are unavailable.

[Blepharoptosis: diagnostic tests]. / Blefaroptoz: diagnosticheskie testy.

The article discusses diagnostic algorithms for blepharoptosis in patients with Horner's syndrome, myasthenia, chronic progressive ophthalmoplegia, myotonic dystrophy, and acute neurovascular events. Basic methods for evaluating the upper eyelid position and ptosis severity as well as special pharmacologic stress tests to reveal the true etiology of the condition and make the best treatment choice are described.

[To the biometric evaluation in ophthalmoplasty].

The paper gives the preliminary results of an analysis of the metric characteristics of images in 40 patients with the anomalous outline of the lid slit of varying genesis, by applying an original computer program. The program is based on the principle of automatically finding the line of the true symmetry of the face, its paired fixed points, and the orientation of an image. Computer-aided estimation of the shape and width of the lid slit, the parameters of the lids along the conventional lines shows that the measurements are of high accuracy (0.1 mm for linear values and 0.1 for angular values). The paper analyzes the effect of modified resection of the superior tarsal muscle. In a patient with aponeurotic ptosis, the uplift of the upper lid was 4.1 mm (1.9 mm higher than that obtained by a pharmacological test). In the author's opinion, the proposed procedure makes it possible to solve the problems associated with the processing, storage, and transmission of images and with the assessment of relationships of the structures of the appendage of the eye.

[The clinical-and-morphological specificity of using xenopericardium in plasty of the eyelids and orbit]. / Kliniko-morfologicheskie osobennosti ispol'zovaniia ksenoperikarda pri plastike vek i orbity.

The authors analyzed the clinical results of transplantation of the xenopericardium in 60 patients made at the Research institute of eye diseases of the Russian academy of medical sciences from 1999 to 2003. Xenomaterial was used in reconstruction of the lower eyelids after trauma (coloboma, defects of ligaments), in ectropions of the lower eyelids, in paralytic lagophthalmos and in traumas of the orbit. The postoperative follow-up of patients ranged from 2 to 54 months (an average of 28 months). Xenopericardia removed from patients (4 cases) were histologically examined in 6 months and more after surgery. The examination was made by the method of serial sagittal paraffin sections tinted with hematoxylin or eosin or according to I. van Gieson. A moderately pronounced tissue response and good remote clinical results confirmed the possibility of using it in reconstructive surgery, in particular, in plasty of the orbit especially when made through a small incision. The peculiarities of using clinically the xenopericardium denote that it can be used in ophthalmoplasty; however, it should be fixed immediately under the skin of the eyelids very carefully in order to avoid the formation of uneven surface.

[The anatomic and functional specificity of the superior tarsal Mueller's muscle]. / Anatomo-funktsional'nye osobennosti verkhnei tarzal'noi myshtsy Mueller.

The anatomic-and-functional specific features of the structure, topography and of spacious architectonics of the superior tarsal muscle were detected and morphologically confirmed within a case study performed on 16 cadaverous fragments of the superior eyelids. The research of functional biomechanics of the superior eyelids made in 220 healthy subjects made it possible to expand the criteria used in evaluating the results of adrenergic stimulation of unstriped muscles, which must be considered as prognostic criteria in surgical treatment; an appropriate morphometric substantiation is suggested.

[Prospects for using the Mullerectomy for correcting ptosis of the upper eyelid]. / Vozmozhnosti operatsii miulleréktomii pri korrektsii ptoza verkhnego veka.

New anatomic topographic and clinical validation of mullerectomy is presented and more comprehensive evaluation of preoperative adrenergic drug test is suggested. Morphological substantiation of an isolated resection of the superior tarsal muscle (Müller muscle) and orbital conjunctiva of the upper eyelid with subsequent fixation of the proximal part of Müller muscle to the tarsal plate is presented. The results of surgical treatment of 51 patients evidence high reliability, functional and cosmetic efficiency of mullerectomy which does not involve a skin incision, and a low incidence of complications (mean period of observation 35 months).