[First experience of intrastromal ring segments insertion for correction of posttraumatic cicatricial corneal astigmatism].

The potential of MAGELLAN MAPPER corneal topographer in evaluation of corneal refraction in the early postoperative period after surgical debrigement of scleral and corneal penetrating wounds is shown. The accuracy of corneal topography is satisfactory and its results reproducible what makes the method suitable for evaluation of corneal refraction and follow-up in patients with penetrating wounds and scarring of sclera and cornea. The possibility of posttraumatic cicatricial astigmatism correction by insertion of Keraring intrastromal corneal ring segments (ICRS) using femtosecond surgical laser FEMTO LDV were studied. Results of cicatricial corneal astigmatism correction in early posttraumatic period are encouraging.

[Value of eye haemodynamics examination in surgery of traumatic retinal detachment].

Literature on eye microhaemodynamics in patients with traumatic retinal detachment is reviewed. The main noninvasive methods of eye microhaemodynamics examination and potentials of their use in traumatic retinal detachment are analyzed

[Posterior approach for foreign body removal from optic nerve head. Case report].

A technique of foreign body removal from optic nerve head performing an external approach and optic nerve transection is described. After 3 months of follow-up cosmetic result is satisfactory and there are no surgery related complications.

[Analysis of ocular prosthetic care on the territory of Russia].

The results of ocular prosthetic help analysis in different regions of the country is presented based on estimation of number of patients who need ocular prostheses; analysis of quality and quantity of produced prostheses in the country; evaluation of demand for glass and plastic prostheses and price determination; study of regulations.

[An experience of dried cornea transplantation].

Sometimes an urgent lamellar keratoplasty remains the only treatment option for corneal defect closure. When fresh donor tissue is absent as it is regular in recent years dried cornea transplantation becomes reasonable. In recent years in ocular trauma department 320 transplantations of dried on silicagel cornea were performed. Analysis of results allows to conclude that use of dried cornea is a promising surgical procedure to preserve the globe and in some cases to prepare the eye with severe trauma for subsequent optic surgery.

[Bases for resuscitation of the eye in its severe injury at the present stage].

The paper gives an algorithm for qualified care given to victims in the first hours and days after the moment of ocular injury. It outlines resuscitation of a severe injured eye and a possibility of combating any complications of traumatic disease at the present stage. Based on their many years' experience, the authors have developed and present a multifaceted system of measures to provide the victim with intensive care in combination with adequate surgical and pharmacotherapeutic correction, which enables one to preserve the organ of vision and to have good functional and cosmetic results, which is of not only great clinical, bur also social value.

[Rendering of emergency specialized ophthalmic traumatology care under the present conditions].

The paper presents a detailed analysis of 27700 patients with ocular injury who received a therapeutic-and-diagnostic care at the first specialized stage. The specific features of an oculist's care in an intensive care unit and the required volume of diagnostic studies in different types of posttraumatic pathology of the eye and its appendages are defined. Indications for emergency hospitalization in fresh trauma and sequels are presented. Algorithms of treatment have been developed and are recommended in relation to the pattern and severity of injuries of the organ of vision.

[Rehabilitation of patients with burn injury to the eye].

Based on the analysis of the results of treatment in patients with severe and particularly severe burn injuries to the eye, the authors developed principles in the rehabilitation of such patients. The rehabilitation period was divided into 4 stages: 1) treatment of burn injury (removal of necrotic tissues; revascularization of the outer membrane of the eyeball; prevention of cicatricial deformity of the eyelids); 2) treatment of burn disease complications (blood blepharorrhaphy, soft contact lenses, maximum antihypertensive therapy, treatment of cataract and glaucoma); 3) reconstruction of the eyelids, conjunctival vaults, eyeball surface (transplantation of autologous skin flaps, oral mucosa, fixation of leukoma with the automucosa, autocartilage); 4) functional rehabilitation (limbic transplantation, keratoplasty, keratic replacement with a Fedorov-Zuyev prosthesis). The use of the scheme in clinical practice can achieve a considerable reduction in the time of rehabilitation and the rate of functional and anatomic death of the injured eye and improve the functional outcomes of treatment in patients with severe and especially severe burn injury to the eye.

[Surgical treatment policy for concomitant burn injury to the eye in patients admitted to burn units].

The investigation was undertaken to study the causes of ocular complications in patients with extensive body surface burns. Ninety-five patients with concomitant eye burn injury and its consequences, of them 50 victims who had been first admitted to the unit after long-term treatment in burn centers and 45 patients observed jointly with the combustiologists of the Moscow City Burn Center were followed up. The frequency and pattern of destructive complications and, a result, eye burns were ascertained to be associated with the possibility of delivering a specialized ophthalmic care, its period, and nature.

[Alterations in ocular biomechanical properties after non-automated endokeratoplasty].

The study was undertaken to determine the parameters of corneal hysteresis in healthy individuals and patients before and after non-automated endokeratoplasty. An Ocular Response Analyzer (Reichert Inc., USA) was used to study ocular biochemical properties. At the same time, the value of corneal hysteresis (mm Hg) and the central corneal thickness (microm) were evaluated. The study demonstrated lower corneal hysteresis in primary and secondary corneal dystrophy than that in normal eyes.

[A model of retinal ischemia: clinicofunctional and histological studies].

A new procedure is proposed for the experimental simulation of retinal ischemia, which develops the latter of the preset area and depth. The clinical and morphofunctional characteristics of retinal ischemia are given. Simulation of retinal ischemia via the photocoagulation effect of argon laser on the rabbit great retinal vessels demonstrated an inflammatory reaction, followed by occlusion and the development of ischemia in the blood-supplied retinal layers, vascular endothelial damage at the site of laser coagulation. There was a persistent (as long as 3 weeks) impairment in retinal electrogenesis with two-phase changes in the amplitude of a- and b-waves on an electroretinogram and in the hypoxia index b/a. Histological studies showed that evolving ischemia afflicted the internal retinal layers, primarily involving the layer ofganglionic cells and nerve fibers, which was also attended by a significant reduction in the level of venous outflow and, thus, it was of mixed (arteriovenous) nature.

[Impact of xenotransplantation of multipotent mesenchymal stem cells of the bone marrow on the recovery of the structural organization and functional activity of the retina in its damage].

Among the potential sources of cells for transplantation, the most promising autologous material for cell therapy and tissue engineering are multipotent mesenchymal stem cells (MMSC). The authors carried out an experiment dealing with MMSC xenotransplantation into the rabbit suprachoidal space on a model of laser retinal coagulation. For objective assessment of the magnitude and pattern of changes in the functional activity of different retinal cellular elements and the efficiency of MMSC transplantation, they performed electroretinographic and histological studies. The study indicated that MMSC transplantation into the suprachoroidal space is a safe and effective procedure for cell incorporation in order to treat retinal diseases. Electroretinography provided evidence that single MMSC transplantation better preserved the function of photoreceptors (a-wave). Histomorphometric studies demonstrated that the inserted cells stimulated reparative processes in the laser-induced damaged retina.

[Changes in an electroretinogram and biochemical parameters of tear in simulated rabbit retinal ischemia].

The pattern of functional impairments and the antioxidative and antiproteolytic status of tear were studied, by experimentally simulating retinal ischemia in rabbits and during treatment with Selecarten. Simulated retinal ischemia resulted in the development of persistent (up to 3 weeks) retinal electrogenetic disorder. Selecarten instillations produced a moderate neuroprotective effect, by positively affecting retinal function early after ischemia stimulation and accelerated the recovery of retinal electrogenesis late after laser coagulation of retinal vessels. The altered metabolic processes were characterized by an increase in the tear antiproteolytic potential. The antioxidative activity and the activity of a2-macroglobulin proteolysis inhibitor increased in the tears of Selecarten-treated rabbits.

[Contemporary achievments in ophthalmotraumatology].

The paper presents the results of research work carried out in Eye Trauma Department during the last 30 years, covering in particular new issues in penetrating wound management and astigmatism prevention, original methods of foreign body removal, some approaches to eye transplantation, the pathogenesis and treatment of eye burn disease, surgical treatment of close eye injury, and research performed in collaboration with the center of disaster medicine Zaschita.

[Electroretinography in the evaluation of vitreoretinal proliferative changes due to penetrating shell injury to the eye].

The influence of vitreoretinal proliferative changes on retinal electrogenesis and glioneuronal relationships was studied in 41 patients with penetrating shell injury to the eye. The early data of studies indicated that there is a reduction in the hanz-feldt amplitude on an electroretinogram (ERG). According to the data of optic coherent tomography (OCT), this corresponds to an exudative reactive response and to the development of vitreoretinal tractional changes in the retina in the central zone and at the site of a foreign body. Retinal electrogenetic changes were most pronounced at months 1 to 6 of a follow-up. The integral glial index was decreased and the central index of Müller's cells was drastically increased in the injured eyes. In this period, there was a reduction in an exudative response to injury and an increase in vitreoretinal proliferative changes, as evidenced by OCT. In late posttraumatic period, the injured eyes were characterized by a slow increase in the amplitude of biopotentials that did not achieve the lower normal range just 1 year or more after injuring. Late posttraumatic inhibition is likely to be caused by vitreoretinal complications of mainly dystrophic nature in the central retinal zone and at the site of fragment bedding or removed foreign body.

[Limbic transplantation in the surgical rehabilitation of patients with prior severe ocular burns].

The paper provides the results of limbic transplantations in 21 patients with varying postburn leukomas. Autolimbic (n = 6; 28.6%) and limbic (n = 15; 71.4%) transplantation was performed 34.27 +/- 13 months after injury. Limbic transplantation with removal of the fibrovascular pannus resulted in improved visual acuity in all cases with the relatively transparent corneal stroma (Group 1; n = 10). In some cases, limbic transplantation could circumvent the problems associated with corneal graft epithelization after further corneal transplantations in Group 2 patients (n = 8) with turbid corneal stroma. In Group 3, surgery was made to prevent corneal changes occurring when the bulbar conjunctiva was removed during plastic repair of mucosal fornices from the lip. Postoperative recurrent corneal conjunctivization and epithelial erosion were observed only in 4 patients. The findings are of value in defining the site and indications for limbic transplantations in the surgical rehabilitation of patients who have experienced severe eye burns.

[Epidemiology and rehabilitation of persons with anophthalmos in the Russian Federation].

The time course of changes in the rate of enucleations and the prevalence of anophthalmos in the Russian Federation, which have recently been growing steadily, were studied. By analyzing a great body of clinical materials from 1337 patients with anophthalmos, they show the ways of forming a locomotor stump and the most commonly used implants and recommend the optimal shapes of standard artificial eyes for the rehabilitation of persons with anophthalmos and a cosmetically defective blind eye. Ocular prosthetic repair as a method of social, psychological, and medical rehabilitation is one of the principal stages of upgrading the quality of life in the patients who have lost eyes.

[Deep layer posterior keratoplasty: preliminary data].

The paper presents preliminary results of deep layer keratoplasty first performed in Russian ophthalmology. It describes its surgical techniques. Deep layer posterior keratoplasty was made in 3 patients with epithelial-and-endothelial dystrophy of the cornea. The operation was simultaneously made with ultrasound cataract phacoemulsification and intraocular lens (IOL) implantation artificial in one case. In the early postoperative period, the fixed position of a transparent keratograft was achieved and the epithelial layer also recovered without signs of bullous keratopathy. The immediate results of posterior keratoplasty inspire optimism. Deep layer keratoplasty is technically more difficult than penetrating keratoplasty, more painstaking and more prolonged. At the same time it has no shortcomings typical of penetrating keratoplasty. The procedure of deep layer keratoplasty requires further long-term study, simplification of surgical techniques, detection of possible complications, and modes of their correction.

[Injuries to the organ of vision. Issues to be further developed].

The paper analyzes the topical problems of injuries to the organ of vision. It mentions the basic trends in the pattern of ocular traumatism. The ways of further studies of a number of issues of eye traumatology are defined. The significance of basic studies in solving the problems of eye traumatology is shown.