Vol 8, No 2 (2013)

The results of 163 YAG-laser interventions for the elimination of the papillary block following the extraction of congenital, traumatic, complicated, and secondary cataracts are reported. Basal colomba was present in all treated eyes after YAG-laser iridectomy and iris bombe was eliminated in 93,9% of the children. The papillary block was eliminated with the complete restoration of normal anatomical features in 65,5% of the patients in the immediate postoperative period (within 3 months after surgery) and in 54,9% during the follow-up period from6 months to 17 years in duration with the partial restoration of anatomical and morphological relationships in the affected region in one third of the children (32,5% and 35,3% respectively). The hypotensive effect was documented in 96,6% and 85,3% of the children in the early and late postoperative periods respectively. It was shown that indications for the elimination of the papillary block include any variants of clinical manifestations of this pathology, such as seclusion of the pupil, iris bombe (both with ophthalmic hypertension (requiring emergency intervention) and without it (threatening iridocorneal adhesions)), and preangular block (planned treatment). The strategy for the choice of the laser-assisted treatment is recommended with special reference to various clinical manifestations of the papillary block in the children. The most persistent anatomical effect characterized by the reduced frequency of hemorrhagic complications at lower energy consumption was achieved with the use of the combined Ar-YAG-laser iridectomy (in comparison with YAG-laser iridectomy) in the case of laser colomba over 1 mm in diameter. The importance of maintaining the minimal energy regime is emphasized in conjunction with taking into consideration the degree of child’s communicativeness, the possibility of surgical intervention without narcosis (usually by performing surgery in several steps), and the reduction of the number of narcotization procedures. It is concluded that YAG-laser iridectomy provides an effective and safe tool for the elimination of the pupillary block as an alternative to surgical iridectomy; moreover, it does not require repeated capsulotomy and can not infrequently be performed possible without narcosis.

Dacryocystitis in the newborn babies is one of the commonest diseases in the structure of eye pathology in the children. The etiological structure of pathogenic agents of neonatal dacryocystitis has changed during the past decades. We have distinguished 3 clinical forms of this pathology (catarrhal, suppurative, and phlegmonous) differing in both etiological structure of the pathogens and their susceptibility to antibacterial medications. The treatment of the patients presenting with neonatal dacryocystitis taking into consideration the results of microbiological investigations and sensitivity of pathogenic agents to antibacterial preparations was shown to improve the clinical and functional outcomes of therapy and prevent relapses of the disease that require repeated probing of the lacrimal canals.

Ophthalmopathology in the patients suffering from diabetes mellitus is one of the main causes of impaired vision and blindness all over the world. The present study included 89 patients with type 1 diabetes mellitus (DM1). The traditional research methods were supplemented by microperimetry with the use of a MAIA apparatus. The study has demonstrated a significant ( p < 0,0001) 2 dB reduction of light sensitivity in the central retinal region compared with that in the age-matched healthy subjects in the absence of clinical signs of diabetic retinopathy (controls). The significant reduction of average photosensitivity in the central retinal region and K-index was documented in the case of progressive diabetic retinopathy ( p < 0,001). ROC analysis showed that K values in excess of 3 U and/or mean light sensitivity (≤ 25,8 dB) may be regarded as the threshold values for the chosen parameters of microperimetry; also, they can be used for the purpose of screening for diabetic retinopathy.

The results of investigations into clinical polymorphism and genetic heterogeneity of hereditary diseases of the cornea are presented with special reference to the algorithms for differential diagnostics of this group of pathologies. The practical significance of molecular genetic research is discussed.

The totality of evidence of the role of the blood flow in the eye in pathogenesis of glaucoma account for the ever increasing interest in the investigations of the influence of anti-glaucoma medications on various eye vessels. The effect of anti-glaucoma preparations on various eye vessels was investigated in a clinical study with the use of a variety of different methods. The present review was designed to summarize the results of the most important experimental and clinical research on the influence of hypotensive agents, such as M-cholinomimetics, beta-blockers, carboanhydrase inhibitors, and prostaglandins, on the blood circulation in different eye compartments in experiment, in healthy subjects, and patients with ocular hypertension and glaucoma.

Coffin-Siris syndrome is a very rare hereditary disease (OMIM, 135900) that was described for the first time by G. Coffin and E. Siris in 1970. Only 50 reports of this condition have thus far been published in the medical literature. The authors report a case of clinically confirmed Coffin-Siris syndrome in a boy aged 3 years and 4 months with the results of ophthalmological, neurological, orthopedic, and cardiological examination as well as the data of the instrumental studies including computed tomography and evaluation of visual evoked potentials. It is argued that Coffin-Siris syndrome involves multiple systemic pathology. The clinical manifestations of the disturbed visual function include megalocornea and partial atrophy of optic nerve confirmed by VEP.