[Submuscular decompression multisclerectomy - new operation for neovascular glaucoma]. / Submusculiarnaia dekompressionnaia mul'tiskleréktomiia - novaia operatsiia pri neovaskuliarnoi glaukome.

A new intervention for neovascular glaucoma is suggested: submuscular decompression multisclerectomy with collagen implant impregnated with 5-fluorouracyl. Immediate and remote (up to 2.5 years) results in 29 patients were analyzed. Intraoperative complications were observed in 24.1% cases: vitreous prolapse in 13.8% and hyphema in 10.3%. Ophthalmic tone compensation was attained in 96% cases in the early postoperative period and in 63% in remote period. Painful syndrome was arrested in 96 and 65% cases, respectively. The hypotensive effect of the operation is due to an increase in the volume of the eyeball and enhancement of uveoscleral discharge.

[Experimental use of a cytostatic and a corticosteroid on a collagen implant in surgery for glaucoma]. / Eksperimental'noe izuchenie primeneniia tsitostatika i kortikosteroida na kollagenovom implantate v khirurgii glaukomy.

Clinical and morphologic studies of local application of a cytostatic (5-fluorouracyl) and a corticosteroid (dexasone) on a collagen implant in filtration surgery for glaucoma were carried out. The velocity of regression of filtration cushion (FC), intraocular pressure, and local connective tissue reaction after sinusotrabeculectomy with collagen implant were examined in 30 rabbit eyes. Impregnation of the implant with the preparations prolonged 3-fold the period of FC existence in comparison with the control. The cytostatic 1.5 to 2 times reduced the inflammatory infiltration and fibroblast proliferation in the wound, this creating optimal conditions for the formation of functionally competent discharge canals.

[Use of low-frequency ultrasound in preoperative care of the conjunctival cavity]. / Primenenie nizkochastotnogo ul'trazvuka v predoperatsionnoi podgotovke kon"iunktival'noi polosti.

Experimental and clinical studies of the efficacy of preoperative treatment of the conjunctival cavity with low-frequency ultrasound were carried out. Ultrasound parameters employed were as follows: 20-70 kHz frequency, 25-35 microns oscillation amplitude, length of exposure 60-120 sec. Such treatment was found to reduce bacterial contamination of the conjunctival cavity. Clinical studies were carried out on 20 eyes of 14 patients operated on for cataracts and glaucomas at the department for ocular diseases of the Moscow municipal clinical hospital No. 15. Low-frequency ultrasound treatment of the conjunctival cavity was carried out before surgery in all these patients. In the reference patients (n = 15, 15 eyes) the conjunctival cavity was washed with 1:5000 furacilin solution and 30% sodium sulfacil solution or kanamycin solution (10,000 U in 1 ml) on the operation table. The bacterial contamination of the conjunctival cavity prior to surgery in 24 eyes has made up 84.1 bacterial colonies per Petri dish on an average. Preoperative treatment of the conjunctival cavity with low-frequency ultrasound has reduced the bacterial contamination to 6.3 colonies per Petri dish, i.e. by 13.3 times.

[Use of fresh amnion in the treatment of corneal diseases]. / Primenenie svezhego amniona v lechenii zabolevanii rogovitsy.

The effects of fresh amnion on the course of morbid processes in corneal ulcers and burn disease of the anterior segment of the eye were investigated. The cornea was coated with amnion in 15 eyes with deep bacterial ulcers, in 10 eyes with herpetic ulcers of the cornea, and in 8 eyes with second and third-degree corneal and conjunctival burns. The amnion was obtained in cesarean section and fixed to the limbal conjunctiva with an uninterrupted suture all around. The next day after surgery the pain syndrome reduced, as did photophobia and blepharospasm in all the patients. In the group of patients with bacterial ulcers the cornea epithelialized on days 5-11, in those with herpetic ulcers on days 10-15, and in those with burns on days 8-12 after amnion coating. No cases with suppuration of the burnt surface when coated with the amnion were recorded. The amnion slid off the cornea on days 7-10 after it was layered on.

[The effect of anti-glaucoma surgery on the visual function in patients with primary glaucoma]. / Vliianie antiglaukomatoznykh operatsii na zritel'nye funktsii bol'nykh pervichnoi glaukomoi.

Examinations of the visual field in 25 patients with Stages I and II primary open-angle glaucoma have shown that in the majority of cases surgery results in improvement of stabilization of the visual field status in respect of all its parameters (retinal sensitivity threshold, deficiency of the field and sensitivity). Increase of the number of defects and reduction of the retinal ability to discern light were observed in 5 patients: in 2 with postoperative hypotension and 3 with progressive cataracts.

[Practical value of preventive posterior sclerectomy in trabeculectomy]. / O prakticheskoi tsennosti profilakticheskoi zadnei skleréktomii pri trabekuléktomii.

The results of prophylactic posterior sclerectomy, carried out to prevent ciliochoroid detachment in antiglaucoma fistulization surgery (trabeculectomy in various modifications) are analyzed. A total of 293 patients (303 eyes) were under study. In 51.8 percent of cases (157 eyes) trabeculectomy was combined with prophylactic sclerectomy, carried out both in the upper (121 eyes) and lower (36 eyes) segments of the eye. The results evidence that prophylactic posterior sclerectomy promoted a 2.3 times reduction (from 28.1 to 12.1 percent) in the incidence of ciliochoroid detachments; the site of this operation (upper of lower segment of the eye) was of no essential importance. The authors recommend prophylactic posterior sclerectomy as an effective method for prevention of ciliochoroid detachment.

[Assessment of individual eye protection devices based on their effect on the frequency-contrast characteristics of the visual analyzer]. / Otsenka sredstv individual'noi zashchity glaz po ikh vliianiiu na chastotno-kontrastnuiu kharakteristiku zritel'nogo analizatora.

Assessment of means for individual eye protection by the method of visocontrastometry, allows, already at the stage of projecting, to determine the correctness of selecting vision glasses by conditions of visual work. Investigations of 3 kinds of goggles: for reindeer breeders of Far North (2 variants), for mechanics and for protection from pesticides have shown that by their influence on frequency-contrast characteristic all they comply with physiologic hygienic demands. The value of the used method of control of the quality of individual eye protection means is established.

[Trabeculectomy with laminar resection of the sclera in the treatment of primary open-angle glaucoma]. / Trabekuléktomiia s posloinoi rezektsiei sklery v lechenii pervichnoi otkrytougol'noi glaukomy.

The authors analyze 204 trabeculectomies, 56 of these combined with resection of the episclera, 48 with the formation of an intrascleral canal, and 100 traditional. Late results of surgery were followed up for 6 months to 4 years. The results evidence that laminar resection of the sclera is an essential point that governs the hypotensive effect of trabeculectomy in primary open-angle glaucoma. Positive effect of resection of the episclera consists in a twofold reduction of the trend to filtration pad cicatrization. If an intrascleral canal is formed, cystic filtration pads develop 1.5 times less frequently than after traditional trabeculectomy.

Filtering iridocycloretraction in chronic closed-angle glaucoma.

In 98 patients, 112 eyes with chronic closed-angle or combined glaucoma were operated on using filtering iridocycloretraction, including preparation of two limbal-based scleral strips that were introduced through scleral incisions into the anterior chamber and the supraciliary space. The intraocular pressure was controlled (less than or equal to 21 mm Hg) in 107 eyes by surgery alone and in two eyes with medication by three to four weeks postoperatively. Ninety-one eyes were followed up for 12 to 30 months (mean, 19 months). The intraocular pressure was controlled in 78 eyes by surgery alone and in four eyes with medication. Three eyes were operated on repeatedly.

'Valve trabeculotomy' in glaucoma.

The surgical technique of "valve trabeculotomy" includes preparing the superficial and the inner limboscleral flaps while the midscleral lamina is excised. The operation was performed on 100 glaucomatous eyes of 82 patients. Postoperative complications included hyphema in 11 cases, mild iridocyclitis in four eyes, and choroidal detachment in six cases. Three to four weeks after surgery, the intraocular pressure was controlled (less than or equal to 21 mm Hg) in 96 eyes by surgery alone and in three eyes by surgery and medication. In 11 to 30 months (mean, 18 months) 95 eyes of 77 patients were examined. The IOP was controlled in 84 eyes by surgery alone and in five eyes by surgery and medication.