2018, volume 14

 The purpose of the work. To evaluate the destructive ability of vacuum pulsation in cataract phacoemulsification. Materials and Methods. The experiments were performed on 40 separate pig eyes, in which cataract was induced in 3 stages of density according to the WetLab method. In the study group (n=20), phacoemulsification was carried out using a vacuum pulsation generation unit, in the control group (n=20) by the method of traditional ultrasonic phacoemulsification. For comparison of the two methods in both groups, the time of complete destruction of the lens fragment in seconds was recorded. Results. The average time of destruction of a 5x5 mm fragment of the lens, using vacuum pulsation was 23.6±4.9 seconds, for traditional ultrasonic phacoemulsification 17.7±8.9 seconds (p<0.05). Vacuum pulsation has a destructive power, but at the same time requires further refinements to increase the efficiency of phacoemulsification. Conclusions. Phacoemulsification based on vacuum pulsation is promising for further study, since it has a destructive ability. This method does not imply the use of high-energy effects, due to which there are no prerequisites for heating the tunnel incision and negative effects on the corneal endothelium.

Purpose: to evaluate the effectiveness of using Pentacam HR sheimpflug camera for objective determination of cataract density. Material and Methods. The subject of the study was the method of determining the density of the lens (densitometry) by the Pentacam HR sheimpflug-camera. The object of the study were patients with age-related cataracts (147 eyes). All patients underwent ultrasound phacoemulsification with implantation of various types of intraocular lenses (IOL). Before treatment, the density of the lens was determined by non-contact method using PNS (Pentacam Nucleus Staging). During the surgery, the density of the lens was determined by the surgeon on a set of factors: the color of the nucleus, the mechanical density, the emulsification easiness. The equivalent ultrasound time and the fact of compliance or discrepancy in the degree of density of the lens with two methods of its determination were recorded for each patient. Results. It was found that the density of the lens recorded by the Pentacam HR is in a direct strong correlation with the equivalent ultrasound time. It was shown that the discrepancy between the PNS method and the contact method performed by the surgeon significantly lengthens the surgery time. Conclusion. The Pentacam HR sheimpflug-camera is an accurate method of determining the density of the cataract before the surgery. The advantage of this method is that it is non-contact, quick and relatively easy-to-perform with the possibility of objective assessment.

Purpose: to study the performance and safety of the use of system for cortex aspiration with the possibility of additional dosed low power ultrasound during phacoemulsification. Material and Methods. The comparative evaluation of developed system for cortex aspiration with the possibility of additional dosed low power ultrasound (main group, n=36, ophthalmological surgical platform Optimed Profi) and the traditional system for cortex aspiration (control group, n=40, ophthalmological surgical platform Centurion Vision System) were performed. Results. Using the system for cortex aspiration decreases mean time of cortex aspiration. In the main group the mean time of cortex aspiration was 72.6±24.3 s, in the control group 93.9±48.0 s (p<0.05). Intraoperative complications were not observed in the main group. Posterior capsule rupture was detected during the cortex aspiration in 1 patient (2.5%) in the control group. Conclusion. The system for cortex aspiration with the possibility of additional dosed low power ultrasound allows decrease the time of cortex aspiration, to create conditions for a safer removal of cortex, compared with traditional technology.

Purpose: to evaluate the volume of accommodation in students with the help of Tonoref III (Nidek, Japan) apparatus before and after the visual load, and also to identify the correlation of the volume of accommodation with the refraction indices and papilla size. Material and Methods. We investigated 204th year students of BSMU who passed the test of accommodation and refraction on the device Tonoref III (Nidek, Japan) 10 minutes before and immediately after a lecture. Results. We identified that the accumulative response after the exercise was weakened and clinical refraction was increased. The accommodation afterthe load was decreased. By reducing the amount of accommodation revealed an increase in the diameter of a pupil. Students with less severe refractive disorders showed a stronger increase in clinical refraction after exercise than students with moderate to high degrees of myopia. Conclusion. We concluded that the load reduces the absolute volum of accommodation, and this, in turn, leads to an increase in clinical refraction, dilated pupil and reduced visual acuity. Students with emmetropia and mild myopia are particularly susceptible to the above-mentioned changes.

Purpose: to study clinical efficacy of a surgical modality of treatment for bullous keratopathy (BK), which is based on cell technology and involves intrastromal injection of autologous mononuclear leukocytes suspension, in comparison with medical therapy. Material and Methods. All patients with BK in this study were divided into two groups: treatment group, which consisted of 14 subjects who underwent intrastromal injection of autologous mononuclear leukocyte suspension; and control group, which included 13 subjects who received conservative treatment. Results. In treatment group corneal edema significantly subsided 1 month after treatment, which was accompanied by a decrease in corneal thickness by 24% and a 3.4-fold increase in visual acuity. After 6 months pachymetry index decreased by 32.8% from the initial value, visual acuity increased 10-fold from the initial value as well, and these parameters remained stable for 8 months. In control group, biomicroscopic pattern and pachymetry index had unstable dynamics, which was accompanied by only a 2.7-fold maximum increase in visometry after 1 month with a gradual decrease observed later on. Conclusion. Our method of surgical treatment for BK which involves injection of suspension of autologous mononuclear leukocytes into a posterior third of corneal stroma leads to a faster relief of corneal syndrome symptoms, restoration of normal corneal thickness within reference values and to a significant and stable increase in visual acuity when compared to a course of medical treatment.

Aim: to evaluate the effect of the drug Cytoflavin (CFL), containing mitochondrial substrates and co- factors, on tear production in arc welders, gas welders and office workers with dry eye syndrome (DES). Material and Methods. 124 patients (248 eyes) with DES of professional etiology were enrolled in this study. Patients of the experimental group (CFL) took three 25-day courses of cytoflavin separated by 1 month intervals, while the control group received placebo. Results. Reception of CFL over 3-month cycles with intervals of 30 days contributed to an increase in visual acuity (VA) by 29,0-34,0%, Schirmer's test (ST) by 27.0-51.0%, and Norn's test (NT) by 7.5-11.0%, meniscus measurements (MM) by 32.0-37.0% and lower indices of intraocular pressure (IOP) by 3-5% in both occupational groups. Conclusion. The resulting increase in values of parameters characterizing the functional activity of the lacrimal gland under the action of the CFL suggest that pharmacological energy protection contributes to the improvement of tear production and eye hydrodynamics in welders and office workers.

Due to the high prevalence of dry eye syndrome (DES) among patients ophthalmologists need in an outpatient setting in a real equipment quickly and accurately diagnose this disease to provide successful and effective treatment. The article summarizes the experience of clinical use. traditional research methods for dry eye syndrome (slit lamp inspection, biomicroscopy using vital dyes; Schirmer's test, Norn's test or test to determine the time of tearing of the tear film) in ambulatory conditions reception of the ophthalmologist. This review presents the most optimal algorithm for examination of patients with DES. The authors of the article pointed to the most informative diagnostic methods for detecting changes in each of the layers of the tear film.

The article is devoted to medical, scientific, pedagogical and public activity of S. R. Utz — a prominent scholar, dermatologist, chief physician of the clinic of skin and venereal diseases, Professor of the Saratov State Medical University.

The article presents information about the establisment and development of the Saratov Regional Clinical Skin and Venereal Dispensary, the most prominent representatives of the dispensary, the main directions of scientific, educational and therapeutic activities. The role of the dispensary in the development of health education, prevention and improvement transmitted infections and infectious skin diseases is shown.

Objective: to evaluate effectiveness, safety and feasibility of using modern domestic ASD-containing liposomal cosmetics (all type shampoo and balm for dry scalp) in combined treatment of psoriasis patients with scalp involvement. Material and Methods. Sixty three patients (35 women and 28 men) with disseminated guttate-plaque psoriasis with scalp involvement were observed in Saratov Regional Clinical Dermatovenerologic Dispensary. The disease was in the stage of progression in all patients. All type shampoo and balm for dry scalp were included in the treatment regimen of all patients, while no other topical preparations were used on the scalp. Results. We observed good therapeutic and cosmetic effect in all patients, who encountered noside effects during the use of ASD-containing liposomal cosmetics. Conclusion. Combined scalp skin care with the use of modern domestic ASD-containing cosmetics will help doctor and patient to achieve the optimal result in treatment of psoriasis with scalp involvement, effectively eliminating main symptoms of the disease in a shorter time, improving patients' quality of life and giving them opportunity to lead normal life and feel comfortable in society.