Vol 24, No 5 (2018)

Aim. Evaluation of the visual and functional results of bilateral implantation of the diffractive trifocal intraocular lens (IOL), the incidence of adverse optical phenomena and the degree of patient satisfaction. Methods. A prospective, open-label study included 82 patients (164 eyes) with presbyopia who underwent cataract phacoemulsification (n = 128) or refractive lensectomy (n = 36) with bilateral implantation of a new multifocal IOL AT LISA tri 839MP. The mean age of the patients was 61.2 ± 11.8 (32-84) years. The period of observation of patients was from 6 to 36 (18.3 ± 3.9) months. Results. After 1 year of follow-up, the increase in UCNVA was observed from 0.19 ± 0.17 to 0.89 ± 0.21, UCIVA from 0.18 ± 0.20 to 0.78 ± 0.17, UCDVA from 0.26 ± 0, 23 to 0.9 ± 0.12 (p <0.05). The increase in BCNVA was from 0.49 ± 0.23 to 0.99 ± 0.07, BCIVA from 0.44 ± 0.27 before and 0.96 ± 0.11 and BCDVA from 0.58 ± 0.25 to 1.0 ± 0.04 (p <0.05). The greatest visual acuity (0.0 logMAR for OU) was noted with a defocus of 0, which corresponds to the point of clear vision in the distance. At -1.0 D (the point of clear vision at an average distance) and -2.5 D (the point of clear vision near), a high visual acuity (0.04 and 0.09 logMAR, respectively) was noted, which indicates a good vision correction in all investigated distances. The frequency of achieving SE in the range ± 0.5 D was 92.7%. The primary endpoint of the study (BCDVA = 1.0) in the long-term follow-up period was 95.1%. In all cases, high patient satisfaction and a low incidence of undesirable side effects were noted (glare, halo, difficulty in driving). Conclusion. Implantation of the trifocal IOL AT LISA tri 839MP leads to a good level of functional vision restoration at near, average and far distance after cataract surgery and clear lens removal.

The birth of premature children is the cause of the increase in morbidity and perinatal mortality in the country, that is why it is necessary to carry out not only prognosis of premature births but also to correctly determine the tactics of managing patients with premature rupture of membranes. The objective of the study was to evaluate the course of pregnancy, perinatal outcomes, depending on the chosen tactics of managing women with premature discharge of amniotic fluid in the period of 24-32 weeks of pregnancy. Materials and methods: 46 patients were included in this study, 26 of them were the main group with premature rupture of membranes at a gestation period of 24-32 weeks, long anhydrous period (more than 48 hours), and 20 patients were included into the control group. The main criterion for inclusion in the control group was a spontaneous active onset of labor at a gestation period of 24-32 weeks, with an anhydrous period of less than 12 hours. Results: Patients of both groups were comparable in age, frequency of extragenital and gynecological pathology, main characteristics of menstrual function, parity and outcomes of pregnancies. In the presence of certain conditions in the main group, it was possible to apply expectant management tactics, which, on average, prolonged the pregnancy by 12.0 ± 2.3 days, which in 30.8% of cases was accompanied by the development of chorionamnionitis (p = 0.020), without interrelation with duration of anhydrous period and frequency of postpartum purulent-septic complications. It was found that perinatal outcomes, weight and condition of newborns at birth were much better in women in the main group. Conclusion: The reasonably chosen expectant management strategy for women with premature rupture of membranes at the gestational period of 24-32 weeks, subject to certain conditions, will improve perinatal outcomes without significantly increasing the incidence of infectious and inflammatory processes in the mother and newborn.

The article presents scientific approaches to the solution of actual problems of chemotherapy for children and adolescents tuberculosis with multiple pockets and extensively drug-resistant TB (MDR/XDR) pathogen to anti-TB drugs has the source of infection and the patient himself. The urgency of the problem determines: increase in the adult population of the M. tuberculosis with the specified allocation stability, the need for the drug susceptibility test of the source of infection to choose a starting chemotherapy regimen is determined by the negative M. tuberculosis status in the diagnostic material of the majority of children and adolescents. Patient-specific approach to chemotherapy is necessary subject to age limitations when choosing antituberculous drugs. Particular attention is paid to chemotherapy after surgical treatment. The results of scientific research carried out in accordance with WHO guidelines; indicate the possibility to shorten the duration of chemotherapy and to reduce the number of drugs in the treatment regimen without decreasing treatment efficacy.

The paper presents the results of the possibility of applications of modern methods of bronchodilator therapy in patients with different forms of pulmonary tuberculosis, combined with COPD and asthma. On a large contingent of patients, the clinical efficacy of bronchodilator therapy has been demonstrated. In this case, the positive effect of bronchodilator therapy was distributed in three main areas: the general condition of patients, the course of tuberculosis and the course of COPD and asthma. In all three directions, positive results were obtained: the general condition of patients improved, the terms of bacilli were reduced and the rate of regression of the tuberculosis process increased, and the effectiveness of control of COPD and asthma increased. These data are a reliable indicator of the feasibility of cooperation between phthisiology and pulmonology.

The aim of the current article is to report the case of a patient with posttraumatic glaucoma who underwent a successful a draining auto valve limbosclerectomy (DALS) 6 months ago. A 65-year-old patient admitted on April 2017 with history of blunt left eye trauma. The diagnosis of severe eye contusion, Ectopia lentis and ocular hypertension was made. A subtotal vitrectomy, lensectomy and iris fixation of posterior chamber intraocular lense were performed the next day. A laser trabeculoplasty was performed 10 days after surgery for lowering IOP. During a follow-up examination, the patient was found high IOP in the left eye despite maximum IOP-lowering topical treatment. A draining auto valve limbosclerectomy (DALS) was performed in the left eye. The reduction in IOP has subsequently been maintained over six months of follow-up. This patient’s experience is a single case, yet it contributes to the evidence that a draining auto valve limbosclerectomy (DALS) may be high efficient in posttraumatic glaucoma treatment.