[Autokeratoplasty in perforation of the ectatic leukoma of the only functionally perspective eye]. / Autokeratoplastika pri perforatsii éktazirovannogo bel'ma edinstvennogo glaza.

Treatment and rehabilitation of patients with destructive lesions of the cornea is a serious problem for ophthalmologists due to severity of the outcome of the disease - the formation of leukomas with a persistent decrease in vision, or even a complete loss of visual functions. The article presents a clinical case of a patient with posttraumatic ectaticized leukoma of the functionally promising eye, which course was complicated by perforation. The authors, in the absence of the donor cornea, faced a complex clinical task - the risk of functional and anatomical death of the single eyeball in the absence of adequate care for the patient. After enucleation of the subatrophic blind right eye, we took a corneal specimen with a scleral rim of 12 mm trepan. To collect the material, we used an original method of introducing viscoelastic into the vitreal cavity of the hypotonic enucleated eyeball through the intersected optic nerve. This allowed to create the normotony of the enucleated eyeball and perform trepanation of the corneoscleral disc. Trepanation of the sharply ectatic cornea of the left eye was performed after paracentesis and massage of the dome of ectatic cornea with a spatula, which led to the 'subsidence' of the hyperinflated tissue. The corneoscleral disc was fixated with interrupted suture with a 9-0 thread. The postoperative period proceeded smoothly. The autograft has taken with active vascularization. For optical rehabilitation, the patient is scheduled to undergo a keratoprosthetic operation in a planned manner.

[Preservative-free betaxolol for POAG patients: evaluation of hypotensive effect and ocular surface safety].

AIM: To evaluate ocular surface changes in patients with primary open-angle glaucoma (POAG) as well as the hypotensive effect of preservative-free betaxolol eye drops. MATERIAL AND METHODS: A total of 22 patients (42 eyes) aged 55-83 with POAG stage I-II were examined. All of them were switched from betaxolol b.i.d. to its preservative-free analogue (Xonef BK). The baseline examination included visual acuity measurement, Morisky-Green test (questionnaire), Norn test, Schirmer's test, lissamine green staining, and ocular tonometry. The latter was repeated 2 and 4 weeks after the drug had been switched, while the whole complex--2 months after the beginning of the study. RESULTS: The total tear production in POAG patients under betaxolol therapy was 19.1 ± 10.6 mm. After the 2 months of preservative-free betaxolol use there were no statistically significant changes in Schirmer's test results (p = 0.248). Tear film break-up time (Norn test) improved from 7.8 ± 0.5 secto 9.8 ± 0.8 sec (p = 0.067) as well as the results of lissamine green staining (W = 90.0, p < 0.022). In the Morisky-Green Test betaxolol patients scored only 2.6 ± 0.05 points on average, thus showing non-compliance. After the 2 months of preservative-free betaxolol instillations the scores increased up to 3.1 ± 0.07 (p = 0.04). According to Dunnett's test, used for multiple comparisons, intraocular pressure did not change significantly in either of the study periods (baseline and follow-up measurements at weeks 2, 4, and 8 were taken into account). CONCLUSION: The study proves Xonef BK safe, effective, and appropriate in all types of glaucoma.