[Intraocular correction of aphakia in patients after kidney transplantation]. / Intraokuliarnaia korrektsiia afakii u bol'nykh, perenesshikh transplantatsiiu pochki.

It was for the first time in the ophthalmologic practice that a possibility was demonstrated to ensure relatively high and stable functional results, in a significant number of patients with transplanted kidney (TK), related with different-type cataract extraction and with implantation of a variety of PMMA IOLs, i.e. model of B.A. Alexeev, "Storz" company models made from domestic and foreign-made PMMA and domestic-silicone models (P = 70). It was established that IOL implantation in patients with TK is possible in all cases provided the kidney transplant is compensated for and there are no foci of acute or chronic inflammation in the body. A minimal trauma caused by surgery and the suggested scheme of postoperative management (intramuscular injections of antibiotics and supplementary administration of solutions of poludan, naclof, catachrom and actovegin-gel made alongside with routine instillations) cuts the risk of infectious-and-inflammatory as well as of degenerative-and-dystrophic complications in patients with TK receiving the suppressor therapy. Clinical examinations denoted that the intraocular aphakia correction in patients with TK is a method of choice accelerating the medical and social rehabilitation in the discussed patients' category provided the therapeutic-and-diagnostic as well as preventive measures, as required by their status, are being taken.

[The significance of removing the anterior hyaloid membrane and lens capsule in the course of combined surgery in proliferative diabetic retinopathy]. / Znachenie udaleniia perednei gialoidnoi membrany i kapsuly khrustalika v khode kombinirovannykh operatsii pri proliferativnoi diabeticheskoi retinopatii.

Due to the specificity of complications and to peculiarities of the surgical approach the principles of cataract surgery have been changing, when combined with transciliary vitrectomy. The postoperative complications in surgery for proliferative diabetic retinopathy (PDR) are often related with development of proliferative processes in the anterior eye segment. Therefore, a scope and a type of surgical manipulations in the anterior segment affect, to a great extent, the stability of the obtained result. IOL implantation is indicated for a limited category of patients with PDR. The feasibility of preserving the anatomic separation of the eye into the anterior and posterior segments by the anterior hyaloid membrane and by the posterior lens capsule is decisive in combined PDR surgery. In combined surgeries for PDR, transciliary lensectomy can be a method of choice for patients, who do not need IOL implantation.

[Laser-correlation spectroscopy of the lacrimal fluid in the evaluation of the semiotic nature of postoperative inflammatory reaction and the degree of its severity in patients with diabetes mellitus after intraocular lens implantation]. / Lazernaia korreliatsionnaia spektroskopiia sleznoi zhidkosti v otsenke semioticheskogo kharaktera posleoperatsionnoi vospalitel'noi reaktsii i stepeni ee tiazhesti u bol'nykh sakharnym diabetom s implantatsiei intraokuliarnykh linz.

Lavages of the lacrimal fluid were examined, before operation and immediately after operation, in 47 patients with diabetes mellitus and with pseudophakia in order to define the possibilities of the method of laser-correlation spectroscopy (LCS) in evaluating the semiotic nature and a severity degree of postoperative inflammation. It was found that, when the subjective symptomatology of inflammation in the LCS spectrums intensified, there was a higher contribution to the light dissemination of particles with a hydrodynamic diameter of 600 nm and more (i.e. of heavy lipoprotein complexes and of immune complexes), which were determined after a computer-based processing as a condition of primary intoxication and of immune shifts. The LCS results objectively confirmed that the degree of inflammatory changes during the early postoperative period was reliably higher in patients with a level of glycolyzed hemoglobin exceeding 9% versus patients with the above parameter being below 9%.

[An express-method for predicting fibrinous iridocyclitis in the early postoperative period in artiphakia]. / Ekspress-metod prognozirovaniia gibrinoznogo iridotsiklita v rannem posleoperatsionnom periode pri artifakii.

The authors investigated the possibility of using the level of preoperative blood monocytosis as an express method for predicting fibrinous iridocyclitis in planned artiphakia. Extracapsular cataract extraction with intraocular correction (B. N. Alexeev's design) was carried out in 372 patients, 287 of these without non-insulin-dependent diabetes mellitus (NIDDM) (group 1) and 85 with NIDDM (group 2). The patients were divided into 3 subgroups depending on the absolute blood monocyte counts before operation: 1) up to 200 monocytes, 2) 200-400, and 3) more than 400. The incidence of fibrinous iridocyclitis was significantly higher (p < 0.01, 17-18-fold on average) in both subgroups 3 (more than 400 monocytes) in comparison with subgroups 1 (less than 200 monocytes), the treatment strategy being the same in all patients. In NIDDM group the total number of fibrinous iridocyclitis cases was 2 times higher in all 3 subgroups than in group 1. Hence, the level of preoperative blood monocytosis can be used as an express method for predicting fibrinous iridocyclitis in planned artiphakia choosing the treatment strategy during the immediate postoperative period, including that for patients with NIDDM.

[Formula for estimating the optic force of elastic intraocular lenses]. / Formula rascheta opticheskoi sily élasticheskikh intraokuliarnykh linz.

Formula for estimating the optic force of intraocular lenses made from elastic materials has been tried in 106 patients. The formula takes account of forward deflection of the elastic intraocular lens in the posterior chamber of the eye. The proposed method for estimation more than threefold decreases the mean error in estimation of optic force of elastic intraocular lenses in comparison with calculations with the use of known formulas. The mean error is 0.78 +/- 0.13 diopters, which corresponds to modern requirements to the accuracy of formulas for calculating the optic force of intraocular lenses.

[Lymphotherapy of early postoperative period in intraocular cataract correction]. / Limfoterapiia v rannem posleoperatsionnom periode pri intraokuliarnoi korrektsii katarakty.

Potentialities of lymphotropic method of drug administration for arresting inflammation after intraocular cataract correction were studied in 60 patients aged 48-63 years. Extracapsular cataract extraction with implantation of posterior-chamber Alexeev's intraocular lens (IOL) was carried out in all of them. Patients with complications of surgery and a history of inflammations in the operated eye were not included in the study. For assessing lymphotherapy effect on drug concentration in the blood, bloodflow aggregation gradient in the bulbar conjunctiva venules was estimated in the operated on eye. The data indicate that lymphotherapy is an effective method for treating early postoperative inflammations after IOL implantation, shortening the treatment terms in comparison with traditional therapy.

[Clinico-prognostic criteria for the selection of diabetes mellitus patients for the intraocular correction of aphakia]. / Kliniko-prognosticheskie kriterii otbora bol'nykh sakharnym diabetom dlia intraokuliarnoi korrektsii afakii.

The level of glycosylated blood hemoglobin (HbA1c) as a clinical and prognostic criterion for selecting diabetics for implantation of intraocular lens (IOL) is assessed. Extracapsular cataract extraction with intraocular correction was carried out in 68 patients with noninsulin-dependent diabetes mellitus. Preoperative level of HbA1c in group 1 (n = 36) was no more than 8%, and in group 2 (n = 32) it was at least 8%. Both groups were treated similarly. The immediate and late functional results of cataract extraction with IOL implantation were decisively better in group 1 with HbA1c level under 8%, that is, with compensated diabetes. Thus, the level of HbA1c is an accurate and objective clinical and prognostic criterion for selecting patients with diabetes for IOL implantation with good and stable functional results and for precluding unjustified operations.

[Effect of ACTH4-10 on the course of inflammatory and regeneration processes in the rabbit cornea]. / Osobennosti vliianiia AKTG4-10 na techenie vospalitel'nogo regenerativnogo protsessa v rogovitse krolika.

The effect of synthetic peptide ACTH4-10 on the course of healing of an experimental wound of the rabbit cornea was studied. Daily subconjunctival injections of the drug in a dose of 10(-8) M for 25 days boosted the migration of leukocytes and macrophages and increased the interstitial and keratocyte proteolysis during the first 10 days of the experiment. Subsequent follow-up showed manifest proliferation of fibroblasts and formation of fibrosis. These data demonstrate expressed effect of synthetic ACTH4-10 on the course of the inflammatory and regeneratory processes in the cornea after partial keratectomy and prove the possibility of short-term local therapy with this peptide as an agent improving corneal wound healing during the initial phases.

[Effects of protein S-100 beta on the course of corneal healing in rabbits]. / Vliianie belka S-100beta na protsessy zazhivaniia rogovitsy krolika.

Effects of S-100 beta protein on wound healing in rabbit eye cornea were studied. A subconjunctival injection of the protein was found to lead to earlier epithelialization, decrease of the index of migrating inflammation cells, and prevention of fibrous subepithelial growth. Hence, administration of S-100 beta protein resulted in a more effective and rapid healing of the cornea.

[Intracapsular implantation of the Saturn-type intraocular lens during simultaneous cataract extraction and trabeculectomy]. / Vnutrikapsuliarnaia implantatsiia intraokuliarnoi linzy tipa "Saturn" v khode odnomomentnoi ékstraktsii katarakty s trabekuléktomiei.

The authors have developed a method for implantation of the Saturn-type intraocular lens (IOL), designed by Krasnov and Pivovarov, during a simultaneous cataract extraction with trabeculectomy. Such combined operations have been carried out in one of the eyes of 15 patients suffering from senile cataracts and open-angle glaucomas, the vision acuity of the other eye being at least 0.4. The patients have been followed up for 1 to 3 yrs postoperation. The suggested variant of surgery involves but little complications and yields good immediate and late hypotensive effect. Intracapsular implantation of this IOL design provides a better intactness of the posterior epithelium of the cornea than other implantation techniques with other IOL designs. Normal ophthalmic tone has been recorded in late periods after surgery in all the cases; in one patient additional drug therapy has been necessary. The vision acuity in 14 eyes has reached 0.4 and higher, in 9 of these it has been 0.7 and higher as compared to the immediate results. Thirteen patients have recovered binocular vision; the visual field has widened in 5 eyes and has not essentially changed in 10. The authors consider that further clinical studies of the suggested technique hold good promise as regards medical and social rehabilitation of patients with senile cataracts and open-angle glaucomas.

[Secondary implantation of the anterior-chamber intraocular lenses with flexible supportive elements for correction of aphakia]. / Vtorichnaia implantatsiia perednekamernoi intraokuliarnoi linzy s gibkimi opornymi élementami dlia korrektsii afakii.

The authors have designed an anterior-chamber intraocular lens (IOL) with flexible supporting elements and examined the possibility of its application for secondary correction of aphakia. Secondary implantations of such IOLs have been performed in 25 eyes. The implantation has proved to be low-traumatic and effective: the vision acuity has been unchanged or improved in 92% of cases, the loss of endothelial cells has made up 8.5% when the Healon bioprotector has been used and 10.3% without it. Criteria have been developed for the selection of patients for secondary implantation of IOL.