[The problems of cataract surgery and intraocular correction: Russian school achievements and modern trends].

The development of the safest and, at the same time, efficient methods of cataract surgery, is not only a topical task of medical science and practice, but also, taking the demographic situation into account, a solution to a social problem. The article describes the main achievements of academician S. N. Fyodorov's school in the field of cataract surgery with intraocular lense (IOL) implantation. Special attention is paid to the key components of cataract extraction technique named "small incision surgery", which is based upon the use of ultrasmall surgical approaches with self-sealing ability and no need for suturing. The main advantages and disadvantages of various types of cataract lense fragmentation, including ultrasound emulsification, mechanic and hydraulic fragmentation, and laser destruction, are described. Topical issues concerning cataract extraction technique under the conditions of complicating ophthalmopathology including the weakness of ciliary zonule system, high-degree myopia, glaucoma, pseudoexfoliative syndrome, small pupil, past injuries and eye surgery, are outlined. The paper also reflects a new qualitative step in the development of intraocular aphakia correction technique under modern conditions. Basic requirements to design parameters and IOL materials are determined from the position of reestablishing the accommodative function and fine visual functions. Ways of IOL design improvement are described especially for their application in non-standard and complicated cases.

[The prognostic significance of tissue-specific antibodies in the extraction of cataracts of different etiologies]. / Prognosticheskoe znachenie tkanespetsificheskikh antitel pri ékstraktsii katarakty razlichnoi étiologii.

The authors demonstrate a high informative value of preoperative lacrimal fluid examinations to predict postoperative uveitis in patients with complicated cataracts. Detection of antituberculin antibodies in titers 1:128 or higher is a factor of risk of development of a postoperative inflammatory reaction. The risk of postoperative uveitis is increased to 100% if antibodies to tuberculin, tissue-specific retinal S antigen, and lenticular proteins are simultaneously detected in the lacrimal fluid.

[Laser coagulation of the retina in patients with diabetes after posterior-chamber lens implantation]. / Vozmozhnost' lazernoi koaguliatsii setchatki u bol'nykh sakharnym diabetom posle implantatsii zadnekamernykh linz.

The possibility of laser coagulation of the retina after implantation of posterior-chamber lenses was examined in 44 patients with diabetes mellitus. Three-speculum Goldman's lens could be used to examine the central zone in 40 patients, the median periphery in 36 patients, and the utmost periphery in 6 patients. The principal causes impeding the examination of the retina were (1) posterior capsule opacity, (2) inadequate mydriasis because of synechias between the iris and the intraocular lens. The number of patients in whom the fundus oculi could be examined was reducing with time. Mydriasis of 8 mm was found necessary for the examination of the total fundus oculi of the artiphakic eye.

[Resistance to blindness and frequency-contrast characteristics of the eye with artificial lens]. / Ustoichivost' k oslepleniiu i chastotno-kontrastnaia kharakteristika artifakichnogo glaza.

Contrast sensitivity of vision was examined by the frequency-contrast characteristics method (FCC) and vision resistance to glare studies with Niktoskop equipment in 48 patients with artiphakia. FCC was estimated from the curve shape as well as from the mean threshold contrast in all space frequencies. Blindness resistance was assessed from the period of mesopic vision acuity recovery (MVAR) up to 0.3 diopters after the glare flash. The group included 28 patients with iris clips lenses and 20 with posterior-chamber lenses. Patients with vision acuity of 0.8-1.0 diopters were referred to the first and those with vision acuity of 0.5-0.7 diopters to the second category. The mean threshold contrast, whose normal value is 8.0 +/- 0.7 percent, was drastically elevated 3 months after surgery in all the patients and only in a year normalized in the first-category patients with iris clips lenses or posterior-chamber lenses after posterior chamber dissection. Blindness resistance of patients with intraocular lenses was on the whole worse than in normal eyes: MVAR was by 26.2 +/- 0.7 percent higher than the normal value and normalized to reach 29.0 +/- 0.6 sec only in a year in the first-category patients with posterior-chamber lenses whose posterior capsule was not dissected. Therefore, FCC and MVAR values depend on the end vision acuity and type of intraocular lens and are on an average better after implantation of posterior-chamber lenses and not of iris clips lenses.

[Oxidation of pyridine nucleotides in injuries of the cornea]. / Okislenie piridinovykh nukleotidov pri povrezhdenii rogovitsy.

NADH fluorescence may serve a convenient test indicating the tissue redox status. Rabbit cornea has been incubated at ambient temperature in media of different compositions with 5.10(-5) M NADH at pH 7.0-7.3. Oxidation of NADH in the humor-substituting medium for corneal tissue incubation has been monitored by fluorescent analysis (stimulation maximum at a wavelength of 360 nm, emission maximum 460 nm). Characteristic kinetics of changes in the pyridine nucleotide fluorescence consists in its maximum intensity occurring in 10 min of the tissue incubation, followed by the fluorescence intensity reduction by the 20-30th min of the corneal tissue incubation. These changes are explained by a release of substrates, characterized by NADH oxidizing activity, from the corneal tissue, this resulting from injury to the corneal cells with humor-substituting solutions. Carnosine (10 mM) and taurine (0.05% solutions) have been found to protect the corneal tissue from injuries, in contrast to common salines.