Saratov JOURNAL of Medical and Scientific Research

Bashkir State Medical University of the Russian Health Care

Intraoperative OCT-assisted vitreoretinal surgery

Year: 2018, volume 14 Issue: №4 Pages: 849-855
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Husniyarova A.R.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Purpose: comparative analysis of clinical and functional results of surgery of vitreomacular interface and rheg-matogenous retinal detachment with the use of intraoperative optical coherence tomography. Material and Methods. Clinical and morphofunctional data were analyzed in 102 patients with epiretinal fibrosis (ERF), idiopathic macular hole (IMH), and rhegmatogenous retinal detachment (RRD), who were divided into 2 groups. In the main group (n=52), the surgery was performed using intraoperative ОСТ control, in the control group without it. In the main group intraoperative control was performed at 4 stages of the surgery: before vitrectomy, after vitrectomy, during the main stage of the surgery and after completion of endotamponade of the vitreous cavity. During surgery for macular disorders intraoperative complications were assessed, in RRD the intraoperative screening for the detection of undiagnosed pathological changes was performed. In the postoperative period, clinical and functional results were assessed in up to 6 months. Results. The use of intraoperative ОСТ control allowed to reduce the frequency of intraoperative complications, such as capillary retinal bleeding (19.2% in the control group, 11.5% in the main group) and pinching of the inner retinal layers (not observed in the main group, in the control group its incidence was 23.1%) in macular surgery. Intraoperative ОСТ made it possible to better identify concomitant retinal pathology (secondary epiretinal membranes in the main group were found during the surgery in 11.5% of cases, in the control group in 4.2%, while in the postoperative period in 12.5%). In complicated cases of RDD, tomographic control allows to identify microstructural features of the posterior pole of the eye, which are important in achieving stability of the anatomical result, such as retinal defects over staphyloma of the posterior pole in high myopia cases. Conclusion. Intraoperative OCT-assisted vitreoretinal surgery reduces the rate of intraoperative complications during macular surgery and gives valuable diagnostic information in complicated retinal detachment cases.

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Clinical and functional results of surgical treatment of regmatogenous retinal detachment by ultrasonic vitrectomy 25G

Year: 2018, volume 14 Issue: №4 Pages: 841-845
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.M., Dibaev T.I., Mukhamadeev T.R., Shatunova A.S.
Organization: Bashkir State Medical University of the Russian Health Care, ZAO Optimedservis
Summary:

Objective: to analyze clinical and functional outcomes of surgical treatment regmatogenic retinal detachment by ultrasound vitrectomy. Material and methods. Clinical and functional results of treatment of 70 patients (70 eyes) with regmatogenous retinal detachment (ROS) who received surgical care in the clinic OPTIMIZED from 2015 to 2018 In the main group (n=33) operations were performed by ultrasound vitrectomy 25G, in the control group (n=37) — by traditional guillotine pneumatic vitrectomy using the tools of the same caliber. During surgery, were analyzed: time of vitrectomy stage (sec), total duration of operation (min), achievement planned anatomical result (%). In the postoperative period (up to 12 months) analyzed: stability of anatomical result (%), maximum corrected visual acuity, intraocular pressure, morphometric criteria retinal conditions (OCT, OCT-angiography), incidence of complicated cataract (%). Results. Average value of vitrectomy stage time in the main group (378.3±125.2 sec) lower than in the control (490.9±175.5 sec), p<0.05. Total duration operations in both groups did not differ, but on average was somewhat shorter in the main group. group (53.6±9.4 and 64.2±23.5 min, respectively). Planned anatomical result in retinal adhesion in all sectors was achieved at the end of the operation in 100% of cases in both groups. No intraoperative complications were recorded in any of the cases. Ultrasonic vitrectomy permits the use of smaller values of the vacuum as on the stage initiation of posterior vitreous detachment (333.3±40.1 mm Hg).St) and at the stage of peripheral vitrectomy (203.2±51.5 mm Hg.art.) compared with traditional vitrectomy, where high vacuum was required: 600 mm Hg.art. at the stage of initiation of ZOST, 305,4±66,4 mm Hg.article on stage of peripheral vitrectomy. The anatomical result remained stable in all terms of the postoperative period in the main group in 100% of cases. In control group relapses of retinal detachment were registered in 8.1% of patients and successfully eliminated conducting an audit of the vitreous cavity. In the late postoperative period the most frequent complication was the development of complicated cataracts (27.1 % in the main group, 40.5% in the control). In both groups, by the 12th month of follow-up, high maximum corrected visual acuity (0.5 and higher in 66.6% of patients and in the main 47.3% of patients in the control group). Conclusion. Comparative study conducted the method of ultrasonic vitrectomy in the surgical treatment of rhegmatogenous detachment the retina has shown that this technique is an effective method that provides and stable anatomical and functional result.

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Glaucoma incidence analysis and prognosis in adult population of Bashkortostan Republic

Year: 2018, volume 14 Issue: №4 Pages: 825-828
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Zagidullina A.Sh., Fakhretdinova E.V.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Purpose: to analyze the general and primary incidence of glaucoma in the adult population in the Republic of Bashkortostan over the 2010-2017 period; make a medium-term forecast for five years. Material and Methods. The analyzed data was based on official statistics of the Ministry of Health of the Russian Federation over the 2010-2017 period. The level of general and primary incidence per 100 thousand population was estimated; the five-year forecast for glaucoma incidence was simulated using mathematical modeling. Results. The Republic of Bashkortostan had the highest rate of general and primary glaucoma incidence in the adult population as compared with the incidence rate in the Russian Federation. The Republic of Bashkortostan ranks first in the absolute number of patient with glaucoma and fourth ranks in general incidence per 100 thousand comparing with Volga Federal District data. The level of general glaucoma incidence in the adult population increased by 23.0% over the 2010-2017 period and primary incidence — by 47.0%. The five-year simulated forecast predicts possible further growth of general and primary glaucoma incidence in the republic by 2022. Conclusion. The performed analysis and simulated forecast of general and primary glaucoma incidence for the adult population in the Republic of Bashkortostan show growth trends.

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Main markers of vascular endothelium dysfunction in primary open-angle glaucoma

Year: 2018, volume 14 Issue: №4 Pages: 820-824
Heading: Ophtalmology Article type: Review
Authors: Nugmanova A.R., Zagidullina A.Sh.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

The review presents current literature data on the functions of the vascular endothelium, its role in the pathogen-esis of vascular pathologies, as well as the main markers of its dysfunction. Vascular endothelium plays a role in the development of thrombosis, angiogenesis, remodeling of the vascular wall. It is involved in the regulation of vascular tone, local hemostasis, proliferation. The results of clinical studies of the endothelium capacity, which disorders may accompany primary open-angle glaucoma and contribute to the progression of glaucomatous optic neuropathy, are presented here.

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Experimental analysis of destructive ability of vacuum pulsation in cataract phacoemulsification

Year: 2018, volume 14 Issue: №4 Pages: 817-820
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Mukhametov R.G.
Organization: Bashkir State Medical University of the Russian Health Care, ZAO Optimedservis
Summary:

 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.

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Lens densitometry in ultrasonic cataract phacoemulsification

Year: 2018, volume 14 Issue: №4 Pages: 815-817
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Munasypova V/V., Khamidov U.B., Mukhamadeeva O.R.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

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.

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Clinical performance of system for ultrasonic cortex aspiration during phacoemulsification

Year: 2018, volume 14 Issue: №4 Pages: 811-815
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.I., Mukhamadeev T.R., Idrisova G.M.
Organization: Bashkir State Medical University of the Russian Health Care, ZAO Optimedservis
Summary:

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.

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Study of the change in the volume of accommodation in students with visual load using Tonoref III (Nidek, Japan)

Year: 2018, volume 14 Issue: №4 Pages: 808-811
Heading: Ophtalmology Article type: Review
Authors: Hanova J.I., Nabiullin A.R., Avhadeeva S.R., Azamatova G.A.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

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.

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Differential approach to the diagnosis of dry eye syndrome in an outpatient setting

Year: 2018, volume 14 Issue: №4 Pages: 795-799
Heading: Ophtalmology Article type: Review
Authors: Azamatova G.A., Aznabaev М.Т., Gaysina G.Ya.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

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.

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Clinical significance of hyperglycemia in acute ischemic stroke

Year: 2018, volume 14 Issue: №2 Pages: 220-225
Heading: Neurology Article type: Original article
Authors: Izhbuldina G.l., Novikova L.B.
Organization: Bashkir State Medical University of the Russian Health Care, Ufa Clinical Hospital №18
Summary:

Aim: to study the effect of hyperglycemia on the course and clinical outcome of ischemic stroke (IS) in the acute period. Material and Methods. A total of 862 patients with IS (370 men, 492 women), mean age was 66.1±10.8 years. The degree of neurological deficit (NIHSS scale) and functional disorders (Rankin scale), clinical outcome were assessed. When admitted to hospital, a study of the level of glycemia on an empty stomach was conducted. Results. In 186 (21.6%) patients type 2 diabetes Mellitus (DM) was diagnosed. In 27.8% of patients without DM and 76.3% of patients with DM hyperglycemia was detected. In patients without DM with hyperglycemia, higher than in patients with normoglycemia, the representation of women (by 9.9%), cardioembolic stroke (by 10.5%), severe neurological deficit (by 14.7%), gross impairment of vital activity (by 14.0%), a decrease in the frequency of noticeable positive dynamics (by 14.8%), an increase in mortality (by 11.5%). In patients with DM, hyperglycemia was associated with a higher assessment rate on the Rankin scale of 4-5 points (by 25.6%) and a decrease in the incidence of noticeable positive dynamics (by 27.7%). Conclusion. Development of IS is characterized by high representation of disorders of carbohydrate metabolism (21,6%). The severity of glucose metabolism disorders is interrelated with the severity and clinical outcome of the disease.

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