[Cryokeratoplasty and keratoplasty in the treatment of chronic bullous keratopathy]. / Kriokeratoplastika i keratoplastika v lechenii bulleznoi khronicheskoi keratopatii.

Comparative analysis of the results of cryokeratoplasty by the Kasparov-Gorkiladze method (72 operations) and common perforating keratoplasty (60 operations) in patients with bullous keratopathy of the third-fourth stages (mean period of observation 48 months) demonstrated the advantages of cryokeratoplasy: transparent healing of corneal transplant was attained in 69.4 and 50% cases, while the incidence of relapses of bullous keratopathy was 8.3 and 23.3%, respectively. Cryopexy leads to elimination of defective epithelial cells and creation of anti-edema barrier in the corneal limb with bullous keratopathy, thus preventing the dissemination of edema per continuatuum to the transplanted donor cornea with viable epithelium. This effect promotes transparent healing of the transplant and decreases the risk of relapse.

[Total posterior cryopexy of the cornea in the treatment of chronic bullous keratopathy]. / Total'naia zadniaia kriopeksiia rogovitsy v lechenii bulleznoi khronicheskoi keratopatii.

The proposed method, in contrast to methods used in the treatment of bullous chronic keratopathy with the painful syndrome, suggests cryo applications on the entire posterior surface of the cornea through a short (2.5-3 mm) corneal or scleral incision. Posterior cryopexy can be combined (if necessary) with other reconstructive interventions (anterior vitrectomy, separation of synechiae, reposition of intraocular lens, antiglaucoma surgery). The intervention leads to the formation of a semipermeable fibrocellular film representing a cicatricial biological barrier at the level of endothelial Descemet's membrane for chamber humor. Total posterior cryopexy of the cornea relieves pain due to antiedematous effect, which was noted clinically, by evaluation of corneal permeability by keratopenetrofluorometry, and from improvement of visual acuity.

[Use of endothelial protector Softel in surgery of the anterior eye segment]. / Primenenie protektora éndoteliia "Softel'" v khirurgii perednego otdela glaza.

Endothelium protector SOFTEL is developed by Ekran firm and Institute of Eye Diseases, Russian Academy of Medical Sciences. The drug was used in 157 patients aged 28-79 years. Perforating keratoplasty for corneal leukoma and keratoconus was carried out in 46 patients, cataract extraction with implantation of intraocular lens (IOL) in 94, and cataract extraction without IOL implantation in 17 patients. Two patients developed slight hypertension in the postoperative period, which resolved within 24 h, and four patients developed moderate corneal edema persisting for 1-2 days postoperation. The protective effect of softel is compatible with that of its foreign analog Healon. The drug is effective in cataract extractions with IOL implantation and perforating keratoplasty.