Vol 12, No 1 (2017)

Aim. The objective of the present study was to evaluate the results of lensectomy in the combination with intraocular lens implantation including various types of their fixation in the children presenting with Marfan’s syndrome. Materials and methods. The study included 16 children presenting with Marfan’s syndrome and congenital cataract (31 eyes) at the age from 3 to 16 (mean 9.8+-4.1) years treated in the Excimer Eye Centre during a period from 2003 to 2015. The best corrected visual acuity (BCVA) prior to the surgical treatment was estimated at 0.1-0.4 (0.32+-0.16). All the patients underwent early phacoemulsification of the cataract in the combination with the intraocular lens implantation after the standard ophthalmological examination. Various types of intraocular lens implants were applied, namely AcrySof SN 60AT (n=2), SN60WF (n=3), MA60AC (n=19), MA60BM (n=2), and toric SN60T5 (n=3). The choice of the method for the intraocular Implant fixation depended on the degree of lens ectopia, the capsule characteristics, and the age of the patient. Results. Three main types of lens fixation were identified, viz. the mixed type (n-5), intracapsular (n-15) and intrascleral (n= 11) types. The BCVA measured within 12-36 months after the surgical intervention: was 0.4-1.0 (0.78+-0.26). The dislocation of the implanted intraocular lens was documented in 10 children, including all the three cases in the group with the mixed type of fixation without suturing and two cases of membranous cataract. Lens dislocation developed in 6 eyes of the patients with the Intracapsular localization of the intraocular lens and in 7 other eyes of the children comprising this group. Secondary lens reposition was required in a single patient who had undergone intrascleral lens fixation. No cases of uveitis, retinal detachment, macular oedema, and other complications were documented. Conclusion. In all the cases of lensectomy in the combination with the intraocular lens implantation in the children presenting with Marfan’s syndrome, the well apparent improvement of the visual functions and reduction of the severity of ambliopathy have been achieved. The lowest frequency of postoperative complications and the best functional outcome of the surgical treatment were documented in the group of the children with the intrascleral fixation of the intraocular lens implants. However, further studies involving a large sample of the patients are needed to obtain the statistically significant data for the evaluation of the long-term outcomes of the surgical treatment of the children presenting with Marfan’s syndrome and the choice of the optimal method for the fixation of the intraocular lens implants.

Aim. The objective of the present study was the comparative evaluation of the morphological characteristics of the reaction of the ocular tissues following experimental scleroplasty with the application of the xenografts from UV-irradiated and non-irradiated pericardium. Materials and methods. To elucidate the morphological characteristics of the reaction of the eye tissues to experimental scleroplasty, we used histological sections of the 16 eyes of 8 rabbits. The animals were allocated to two groups. Those in group 1 underwent sclera-strengthening operations as described by Khatminsky with the use of UV cross-linked xenotransplants from the pericardium. Part of them was preliminarily subjected either to UV-irradiation at a wavelength of 370 nm and an irradiation power of 5 mW/cm2 for 20 minutes or to the treatment with a 0.5% aqueous solution of riboflavin during 30 minutes (the right eyes from 4 animals). The remaining rabbits comprised group 2 and were operated using the same procedure with the application of the xenotransplants from the non-irradiated pericardium. The left eyes of all the animals remained intact and serves as the controls. The enucleated eyes were subjected to the microscopic and histological examination within 2 weeks (two rabbits from each group) and 1 month after surgery. Results. The morphological study of the enucleated eyes obtained within 2 weeks after the surgical intervention gave evidence of only the mild aseptic inflammatory reaction in the form of a lean rim composed from lymphocyte-like cells buried deep in the sclera close to the transplants from the UV-irradiated pericardium. The histological studies carried out within 1 month after the operation have demonstrated the signs of formation of a connective tissue capsule. The sections through the sclera of the enucleated eyes with the use of the biological materials from the non-irradiated pericardium obtained 2 weeks after the operation at the borderline with the transplants exhibited the clearly visualized signs of aseptic inflammation with massive lympho-macrophage infiltration and the presence of a large amount of fibroblasts. Only isolated areas of the granulation tissue were identified within 1 month after the intervention. Conclusion. The histological study of the enucleated rabbit eyes conducted within 2 weeks after experimental scleroplasty has demonstrated the less pronounced reaction of the ocular tissues to the introduction of the UV-irradiated xenografts in comparison with that of the non-irradiated ones. One month after the surgical intervention with the application of the xenotransplants from the UV cross-linked pericardium, the histological signs of the formation of the capsules from the connective tissue were well apparent in the association with the mild inflammatory reaction of the ocular tissues. The animals operated with the use of the non-irradiated biological materials from the pericardium experienced massive inflammatory lympho-macrophage infiltration and exhibited only isolated areas of the developing granulation tissue.

Optical biometry is based on the laser interferometry technique for the measurement of the biometric characteristics of the eyes, such as the antero-posterior axial length, anterior chamber depth, lens and retina thickness, corneal diameter and parameters of keratometry. The present article was designed to overview the basic principles of this method, its advantages and disadvantages, indications and contraindications for its application. The comparative analysis of the characteristics of the following optical biometric devices was undertaken: IOL-Master 500, Lenstar LS 900, Aladdin, OA-1000, OA-2000, Al-3000, Al-Scan, Galilei G6, IOL-Master 700.