[Intraocular correction of ametropia in patients with keratoconus]. / Intraokulyarnaya korrektsiya ametropii pri keratokonuse.

This review was conducted due to the growing number of patients with keratoconus requiring cataract surgery and the complexity of surgical planning. The article reviews preoperative planning, intraoperative options, and postoperative management, which can help obtain high functional results. Treatment of cataracts in keratoconic eyes requires a multifaceted approach. In some cases, in the preoperative period, interventions such as crosslinking and implantation of intrastromal segments or corneal ring may be required to ensure stable keratometry values for accurate intraocular lens (IOL) calculations. The use of stabilizing procedures prior to optical biometrics can assist in preoperative lens selection and provide predictable surgical outcomes. To achieve targeted refraction and reduce unwanted optical effects, it is necessary to take a critical approach when choosing the type of lens (toric, monofocal). This is due to the appearance of aberrations of different order after preliminary surgical interventions on the cornea. The intraoperative decision plays important role in choosing the position of the corneal incisions, how to use sutures for wound adaptation, choosing scleral approaches to minimize possible postoperative complications. In the postoperative period, the degree of irregular astigmatism and the need for rigid gas-permeable or scleral lenses should be assessed.

[Use of macular lenses in patients with age-related macular degeneration]. / Primenenie «makulyarnykh¼ linz pri vozrastnykh degenerativnykh izmeneniyakh setchatki.

The review presents the characteristics and results of clinical studies on implantation of different types of macular lenses (IOL-VIP system, Lipschitz Macular Implant (LMI), Fresnel Prism Intraocular, IOL AMD) installed in the capsular bag after phacoemulsification in patients with age-related macular degeneration (AMD). The literature review shows that up to now, the data on implantation of these lenses was contradictory and generally based only on short-term results. There are quite strict criteria for the selection of patients to evaluate the maximum possible postoperative visual rehabilitation of patients using special programs, the effectiveness of which largely depends on their commitment to postoperative, sometimes long-term treatment. Additional independent clinical studies with longer follow-up periods for patients with AMD are required to determine the efficacy and safety of macular lenses in order to recommend their use in wide clinical practice.

[Results of fistulizing and Ahmed valve surgery for treatment of refractory glaucoma].

Surgical results of 76 patients (76 eyes) aged 25-79 years with secondary refractory glaucoma were analyzed. The best hypotensive effect and visual functions integrity were achieved with Ahmed valve implantation (86.7% and 83.3% of cases respectively); after conventional fistulizing surgery the hypotensive effect was observed in 45.5%, noncompromised vision--in 54.5% of cases. Tunnel trabeculectomy with iridocycloretraction led to normalization of intraocular pressure and stabilization of visual functions in 81.3% and 68.8% of cases respectively and thus can be considered as an alternative to fistulizing surgery in patients with secondary refractory glaucoma. Uveal glaucoma is a relative contraindication to Ahmed valve implantation, while neovascular glaucoma is that to tunnel trabeculectomy with iridocycloretraction.

[Anti-VEGF-agents in treatment of neovascular glaucoma].

Neovascular glaucoma (NVG) is one of the most severe form of refractory glaucoma. Vascular endothelial growth factor (VEGF) is one of the strongest promoters of angiogenesis and was found to be the main neovascularization regulator. The use of anti-VEGF-agents is a rational option because in the majority of cases it allows to reach disappearance or reduction of neovascularization, that significantly reduces the risk of complications in following surgery or laser treatment of NVG.