[Laser corepraxy in mesodermal iris dysgenesis (Axenfeld-Rieger syndrome) (case report)]. / Lazernaya korepraksiya pri mezodermal'nom disgeneze raduzhki (sindrom Aksenfel'da‒Rigera) (klinicheskoe nablyudenie).

The article describes a case of 7-year-old child with rare Axenfeld-Rieger syndrome demonstrating the effectiveness and safety of combined laser reconstructive surgeries - a non-invasive alternative to ordinary operations without needing anesthesia. The diversity of ophthalmic pathologies in this syndrome is the reason why the target, indications and optimal time for operation should be chosen individually. It is reasonable to suggest widening the indication spectrum for laser reconstructive surgery with consideration of surgeon experience and availability of high-tech equipment.

[Long-term functional outcomes after congenital cataract extraction with intraocular lens implantation in children of the first year of life]. / Otdalennye funktsional'nye rezul'taty posle ekstraktsii vrozhdennoi katarakty s implantatsiei intraokulyarnykh linz detyam pervogo goda zhizni.

PURPOSE: To study best corrected visual acuity (BCVA) and identify its relationship with various factors in eyes with pseudophakia in long-term periods after removal of congenital cataract (CC) in the first year of life. MATERIAL AND METHODS: The study included 54 children (72 eyes) aged 4 to 12 years who had undergone CC removal with intraocular lens (IOL) implantation at the age of 2-11 months. Examination included: visual acuity testing, Flicker ERG 30 Hz electroretinography (MBN, Russia), optical coherence tomography (HRT-OCT) on the Heidelberg Spectralis (Heidelberg Engineering, Germany) platform. RESULTS: The best results were obtained after removal of bilateral congenital cataract (BCC): BCVA in 58.0% of cases was 0.15-0.3, and in 12.0% of cases - 0.4-0.8. BCVA was 0.1 or less in 95.5% of cases and only one child had 0.2 after removal of unilateral congenital cataract (UCC). The best BCVA was achieved in children operated on the 2-5 month of age (BCVA more than 0.3 in 68.7%; only children from that group had 0.5-0.8), without any concomitant pathology and with normal indicators of ERG Flicker 30 Hz. Deviations from physiological formation of the macula were revealed using OCT. The direct relationship was shown between BCVA, and the maximal retinal thickness in parafovea and choroidal thickness in the subfoveal area. CONCLUSION: BCVA significantly varies after CC removal with IOL implantation in infancy: 0.02-0.8. The main factors influencing BCVA in that case are: laterality of cataract, child age at the time of operation, duration of visual deprivation, concomitant eye pathology and refractive amblyopia accompanying incomplete correction of aphakia.

[Results of long-term observation of extremely premature babies with retinopathy]. / Rezul'taty dlitel'nogo nablyudeniya gluboko nedonoshennykh detei s retinopatiei.

PURPOSE: To study the long-term clinical and functional outcomes of retinopathy in extremely premature infants. MATERIAL AND METHODS: The study included 42 patients (84 eyes) with retinopathy of prematurity (ROP) at the age of 9-18 years. All patients underwent comprehensive ophthalmological examination, including morphometric (OCT), functional (ERG) and psycho-physical (computer perimetry) methods. RESULTS: A high occurrence of low vision (67%) was revealed in extremely premature children with ROP during school years and adolescence, which depended on the severity of active ROP and the formation of pronounced residual changes in the fundus during the cicatricial phase of the disease, a high occurrence of refractive errors (92%), including high degree myopia (46%), late complications that develop with ROP of any degree (68%), impaired retinal electrogenesis - due to both ROP and deep morphological and functional immaturity of the retina. CONCLUSION: Patients with any degree of cicatricial ROP born in the early stages of gestation and with extremely low body weight need regular complex ophthalmologic examination and lifelong follow-up.

[Refraction in pseudophakic eyes after surgical treatment of congenital cataracts]. / Refraktsiia pri artifakii posle khirurgicheskogo lecheniia vrozhdennykh katarakt.

The optimal method of correcting aphakia in infants with congenital cataract (CC) is intraocular correction. Considering the growth of the eyes, most authors implant an IOL with lower dioptric power to try to anticipate the refractive indices after the growth, which in some cases do not match the prediction. PURPOSE: To evaluate the achieved refraction and its relation to the anterior-posterior axis of pseudophakic eyes after extraction of CC in children of up to one year of age. MATERIAL AND METHODS: The study included 115 children (159 eyes) examined 1 to 11 years after the extraction of bilateral or unilateral CC at the age of 2-11 months. Optical power of the implanted IOL had been calculated using SRKII formula for hypercorrection to result in emmetropic or weak myopic refraction by the time the eye growth finishes. The subjects underwent autorefractometry on Retinomax K-Plus 3 device and ultrasonic biometry on Humphrey 835 A/B-scan system. RESULTS: The incidence of unplanned refraction in children aged 1 to 3 years was 61.2%, aged 3 years to 5 years 11 months - 24.4%, and in children of 6-11 years - 50.0%; it was associated with pronounced unplanned eye growth in 48.6% of cases with bilateral CC and in 27.3% of cases with unilateral CC. CONCLUSION: The main cause of unplanned refraction in pseudophakic eyes in children with CC is unpredictable increase of the length of anterior-posterior axis after surgery.

[Secondary IOL implantation in aphakic children after early surgery for congenital cataracts].

UNLABELLED: The purpose of the study was to develop differentiated approach for secondary intraocular lens (IOL) implantation in children after congenital cataract extraction in infancy. MATERIAL AND METHODS: Secondary IOL implantation was performed in 42 children (56 eyes) aged from 1.5 to 6 years who underwent congenital cataract surgery at the age of 2-10 months. A total of 19 children had unilateral involvement. In 14 cases of bilateral aphakia the implantation was performed on both eyes. In 9 children a single-step cataract extraction with unilateral IOL implantation was followed by a delayed IOL implantation on the previously operated contralateral eye. The posterior lens capsule was intact in 39 eyes, while in 17 it had various congenital defects. Capsule opacification was found in 34 eyes, either congenital (8 eyes) or acquired (26 eyes). Along with conventional ophthalmic assessment, other examinations that are essential for IOL power calculation (autorefractomentry and ultrasound biomicroscopy - UBM) and posterior chamber assessment (UBM) were performed. The injection of either monoblock (Acrysof SN60 WF; SN60AT, (Alcon)) or tripartite (Acrysof MA60AC (Alcon)) intraocular lens was done through a tunnel corneal incision. Monitoring period varied from 6 months to 4 years. RESULTS: The choice of surgical tactics, IOL model and fixation method depended on the integrity of the capsular bag, condition of the posterior capsule, and presence of iridocapsular adhesions. Intracapsular IOL implantation was performed in 28.2% of eyes with intact posterior capsule and in 11.8% of eyes with the capsule defects. In three eyes with no capsular support IOLs were sutured to the sclera. In most children (76.8%) posterior chamber reconstruction had to be performed due to iridocapsular adhesions. CONCLUSION: The choice of surgical tactics and the extent of surgical intervention for the purpose of secondary IOL implantation in children who underwent congenital cataract extraction are individual and depend on the integrity of the capsular bag.

[Peculiarities of intraocular lens power calculation in infants under 1 year of age with congenital cataract].

The study enrolled 76 infants under 1 year of age (120 eyes) who underwent a total of 837 complex ophthalmological assessments, including ultrasound biometry and automatic refractometry. The assessment consisted of keratometry performed prior to cataract surgery, ultrasound biometry before and in different terms after the surgery, and evaluation of refraction in pseudophakic eyes. The power of intraocular lenses to be installed was determined using the principle of undercorrection. The follow-up periods ranged from 1 to 4 years. In 3.5-4.0 years after the surgery developmentally normal refraction was present in 58.5% of cases. According to analysis of refractive errors, the undercorrection prescribed to infants with preexisting II degree axial microphthalmia should be 2-3 diopters.

[The specificity of surgery of congenital cataract with implantation of folding "Acrysof" IOL in children].

Described in the paper are the results of surgical treatment of 25 children (37 eyes), aged 3 months to 12 years, with congenital and secondary cataracts. The treatment schemes were based on new technologies including tunnel incisions, continuous round anterior capsulorhexis and aspiration-irrigation as well as implantation of different-model posterior-chamber flexible "Acrysof' IOLs into the capsular sac or ciliary sulcus. A high treatment efficiency as well as a need in a differentiated approach to choosing an IOL fixation, diameter and technique of anterior capsulorhexis and a model of the implanted "Acrysof' IOL made with respect to individual age and clinical peculiarities of eyes of children with congenital cataracts as well as with respect to a potential general somatic pathology (galactosemia) are demonstrated.

[Transcutaneous electrostimulation of the primary elements of the visual system in children after the extraction of a congenital cataract]. / Chreskozhnaia élektrostimuliatsiia pervichnykh élementov zritel'noi sistemy u detei posle ékstraktsii vrozhdennoi katarakty.

Courses of transcutaneous electrostimulation of the visual analyzer periphery according to E. B. Kompaneets were administered to 31 children (56 eyes) aged 4 to 12 because of low vision acuity after congenital cataract extraction. The amplitude of stimulating pulses was from 150 to 400 microA. The first course consisted of 5-8 sessions, repeated courses of 4 sessions. The results were assessed by vision acuity check-ups and recordings of visual [correction of auditory] evoked potentials (AEP). Vision acuity improved from 0.1 to 0.9 after a course of treatment. AEP amplitude was reduced in all the patients to 15.4 microV on an average, the time of the pulse conduction in the auditory system was normal (113.2 ms). Electrostimulation effects on the AEP were negligible. Electrostimulation may be recommended to children with low vision acuity and low values of the AEP amplitude after congenital cataract extraction.

[Intraocular correction in the restorative therapy of children with congenital and traumatic cataracts]. / Intraokuliarnaia korrektsiia v vosstanovitel'nom lechenii detei s vrozhdennymi i travmaticheskimi kataraktami.

A total of 140 surgeries making use of aspiration irrigation technique were carried out in 105 children with congenital and traumatic cataracts, aged 4 to 14. The Fyodorov-Zakharov iris clips lenses were implanted. The method was found highly effective and low traumatic. Grave complications, such as iridocyclitis, secondary glaucoma, macular edema, retinal detachment were recorded in late period in just few children, in 0.7-5% of cases. Vision acuity of at least 0.3 diopters was achieved in 87.1% of children with congenital and in 85.7% of those with traumatic cataracts. Binocular vision was restored in 81.4 and 83.3%, respectively.

[Autoimmune mechanisms of eye involvement in congenital cataracts in children]. / Autoimmunnye mekhanizmy porazheniia glaz pri vrozhdennykh katarakt u detei.

A total of 112 children aged 6 months to 8 years with congenital cataracts (69 ones with bilateral and 43 with unilateral forms) and 34 mothers of these children were examined to estimate the activity of local and systemic autoimmune reactions to lenticular crystallines and retinal S antigen, differentiation between and diagnosis of congenital cataract pathogenetic forms. Lacrimal fluid antibodies were measured in 80 eyes with congenital cataracts and 29 ones with strabismus, blood serum antibodies in 72 children with cataracts, 20 without cataracts, 34 mothers of children with cataracts and 20 mothers of children without cataracts by the passive hemagglutination test (micromethod) with stable erythrocytic diagnostic agents. alpha, Bh, Bl, gamma crystallines and summary extracts of the cortical and nuclear layers were tested. The studies have demonstrated the significance of autoimmune reactions to lenticular crystallines in the pathogenesis of congenital cataracts and in involvement of the retina in the immunopathologic process.

[Congenital cataract extraction in children during lst months of life]. / Ekstraktsiia vrozhdennykh katarakt u detei pervykh mesiatsev zhizni.

The examinations have involved 89 children with bilateral congenital cataracts aged 2-6 months (n = 68) and 7-10 months (n = 21). The preoperative examinations have been carried out under anesthesia and included biomicroscopy, retinoscopy, ultrasonic and electrophysiologic examinations. A number of specific clinical and functional features have been revealed in these babies. Surgery has been performed in 148 eyes. Various types of microsurgical techniques of the closed type have been employed: aspiration-irrigation method; operations with ultrasonic equipment y3X-phi-p04-0 and Sparta, lensectomy using the Okutom system. An anterior approach to the lens via an incision in the limbus has been used. Good optical and functional results have been achieved. No grave intraoperative complications have been recorded. The postoperative period has been areactive in 84.5% of cases. In 6% of cases secondary cataracts have developed, mostly of Elschnig's pearls. Early surgery (at the age of 2-6 mos) is indicated in all forms of congenital cataracts inducing deprivation amblyopia.

[The prognosis of the visual results of treating children with congenital cataracts based on visual evoked potentials]. / Prognozirovanie vizual'nykh rezul'tatov lecheniia detei s vrozhdennymi kataraktami po zritel'nym vyzvannym potentsialam.

Examination of visual induced potentials on reversible chess-pattern in 46 children with bilateral congenital zonular cataracts before and after surgical intervention has revealed correlation between these potentials and degree of lens opacification. After cataract extraction, positive dynamics of the potentials was observed in case of slightly opacified lenses and was absent in intensive lens opacification. The authors consider it reasonable to use visual induced potentials for prognosticating visual results after surgical treatment of bilateral congenital zonular cataracts, this being of particular importance for early surgical interventions.