Vol 12, No 4 (2017)

Articles

THE SURGICAL CORRECTION OF THE ANOMALIES OF THE POSTERIOR CAPSULE OF THE LENS

Babadzhanova L.D., Turakulova D.M., Kariev A.V., Berdaliev A.F.

Abstract

Aim. The objective of the present work was to describe the surgical strategy used for the correction of congenital cataract in the children presenting with the anomalies in the posterior capsule of the lens making possible intracapsular implantation of the IOL. Material and methods. The analysis of the surgical strategy for the removal of congenital cataract in the children presenting with the anomalies in the posterior capsule of the lens was performed based on the results of objective examination of its clinical and anatomical features in 40 patients (71 eyes) with the use of biomicroscopy, ophthalmoscopy, and ultrasound study. Results. The intact transparent posterior capsule of the lens was found in 28% of the examined children while 72% of them exhibited changes in the capsule in the form of thinning (33%), lenticone (25%), fibrous degeneration with the presence of calcificates (14%). The choice of the differential surgical treatment of the above anomalies was made on an individual basis. Implantation into the capsular bag proved successful in 81% of all the cases and into the ciliary furrow in 15%. Implantation of IOL was found impossible in $% of the patients. Due to a major defect of the capsular bag. Conclusion. The surgical treatment of congenital cataract with concomitant changes in the shape and transparency of the posterior capsule of the lens requires a differential approach in order to carry out intracapsular implantation of IOL even in the case of manifest posterior lenticone and avoid the development of intra- and postoperative complications.
Russian Pediatric Ophthalmology. 2017;12(4):182-186
pages 182-186 views

THE ROLE OF ULTRASOUND BIOMICROSCOPY IN DIAGNOSTICS OF POST-UVEAL GLAUCOMA AND THE CHOICE OF THE TREATMENT SURGERY FOR ITS CORRECTION IN THE CHILDREN

Katargina L.A., Denisova E.V., Ibeaid B.N.

Abstract

Introduction. At present, trabeculectomy is the method of choice for the treatment of uveitic glaucoma with the pre- and trabecular retention of the outflow. However, the effectiveness of such intervention decreases over time due to the scarring of the newly formed outflow pathways. Ultrasound biomicroscopy is the method allowing for the objective evaluation of the state of the anterior segment of the eye. Aim. The objective of the present study was to estimate the condition of the filtration zone after trabeculectomy in the children presenting with uveitic glaucoma with the use of ultrasound biomicroscopy for the elucidation of the parameters characterizing the compensation of the processes underlying the development of glaucoma and the signs of enhancement of the proliferative changes responsible for the elevation of intraocular pressure (IOP). Material and methods. A total of 32 children at the age from 6 to17 years presenting with uveitic glaucoma were examined with the use of ultrasound biomicroscopy during the period from 1 month to 7 years (mean 23.5 ± 2.6 months)after the trabeculectomy. Results. It was shown that the maximum height, area, volume, and frequency of detection of the microcavities in the filtration bleb as well as the area and volume of the intrascleral cavity could be observed in the cases of IOP compensation in the absence of medication therapy (28 eyes). These parameters were lower in the children with compensated glaucoma given the antihypertensive treatment and fell down to the minimal values in the children with uncompensated IOP (2 eyes). The study has demonstrated the association between the drug-free compensation of glaucoma and the height of the filtration bleb in excess of 0.9 mm and its volume over 14 cub. m. The absence of IOP compensation was associated with a more than 30% decrease in the height, area, and volume of the filtration bleb and with a more than 10% increase of filtration bleb as well as with the decrease and/or disappearance of the microcavities. These findings give evidence that the above characteristics can be used for the comprehensive evaluation of the quality of compensation of post-uveal glaucoma and the choice of the optimal surgical strategy for the treatment of this condition. Conclusion. The present study has demonstrated the relationship between the success of compensation of post-uveal glaucoma following trabeculectomy and the parameters of bth the filtration bleb and the intrascleral cavity as determined by means of ultrasound biomicroscopy. The expediency of the application of the ultrasound biomicroscopic studies of the filtration zone within one month after trabeculectomy is substantiated. These studies should be continued during the follow-up of the patients showing the tendency toward the further elevation of the intraocular pressure and the decrease of the filtration bleb. The examination should be repeated once every year in the case od persistent compensation of uveitic glaucoma.
Russian Pediatric Ophthalmology. 2017;12(4):187-192
pages 187-192 views

PROTEOMIC DIAGNOSTIC TECHNOLOGIES AND THEIR APPLICATION FOR THE REFRACTIVE CORRECTION OF AMETROPIA

Kovalevskaya M.A., Chernikova I.V., Podoprigora V.S., Sergeeva M.I.

Abstract

Aim. The objective of the present study was the analysis of the tear fluid proteomic status and the eye surface of the patients presenting with ametropia before and after laser-assisted in situ keratomileusis (LASIK). Material and methods. The study included 163 patients (326 eyes) divided into three groups. Group 1 was comprised of 51 adult patients (102 eyes)at the age from 35 to 54 years suffering from high-degree myopia and astigmatism. Group 2 was composed of 26 adult patients (52 eyes) at the age from 35 to 55 years suffering from moderate or high-degree hyperopia and astigmatism. Group 3 consisted of 86 younger patients (172 eyes) at the age from 18 to 54 years suffering from high-degree myopia and astigmatism. The dry eye syndrome and the state pf the cornea were diagnosed with the use of the Lipkof’s test, Schirmer’s test, TBUT test, and corneal fluorescence staining. The antioxidant activity of the tears was estimated based on the results of measurements of peroxyredoxin-6 (PEDX6) expression. Results. The level of PEDX6 expression after LASIK increased in the patients presenting with myopia by 1.4 times and in those with hyperopia by 1.07 times, that is it changed but slightly after the operation and was 6.2 times less pronounced in comparison was the myopes. Conclusion. The study has demonstrated that two methods proved reliable for the evaluation of the tear fluid proteomic status, viz. the Lipkof’s test (1.82 ± 0.2mm, stage 3) and the TBUT test (8.0 ± 1.46 seconds), suggesting the presence of grade 2 dry eye syndrome. Te same refers to the patients of group 2: the results of the Lipkof’s test (1.31 ± 0.2mm) and the TBUT test (8.23 ± 0.87 seconds). The level of antioxidant protection of the ocular surface (PEDX6 expression) depended on the type of the refractive error: in the patients of group 1 before and after LASIK, PEDX6 expression was 4.7 times (13.57 ± 0.83) and 6.2 (19.31 ± 0.71) higher 2.88 ± 0.38 and 3.09 ± 0.47) than in those of group 2, respectively. In addition, it was shown that the level of antioxidant protection of the ocular surface (PEDX6 expression) depended on the age of the patients prior to LASIK: it was 1.3 lower in group 1 than in group 3 (1.35 ± 0.83 and 17.77 ± 1.03 respectively). The clinical significance of the tests for the tear fluid production and proteomic status changed appreciably after LASIK. The TBUT test for diagnostics of dry eye syndrome remained reliable in all the groups.
Russian Pediatric Ophthalmology. 2017;12(4):193-199
pages 193-199 views

THE EXPERIENCE WITH THE COMBINED TREATMENT OF KERATOCONUS (FEMTOLASER IMPLANTATION OF INTRASTROMAL SEGMENTS WITH THE SUBSEQUENT CROSS-LINKING OF CORNEAL COLLAGEN) IN THE CHILDREN

Pershin K.B., Gurmizov E.P., Pashinova N.F., Burenina E.V., Semenova L.A., Tsygankov A.Y.

Abstract

Aim. The objective of the present study was the analysis of the results of the combined treatment of keratoconus in the adolescent patients (2 clinical cases). Results. In both cases, the combined treatment was carried out with the use of femtolaser implantation of intrastromal segments with the subsequent cross-linking of corneal collagen. Conclusion. The described combined treatment resulted in the significant improvement of the functional indicators of both patients/ It is concluded that the proposed method can be used to treat the children and adolescents presenting with keratoconus.
Russian Pediatric Ophthalmology. 2017;12(4):200-203
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THE ROLE OF NEURORETINOPROTECTION IN THE PEDIATRIC OPHTHALMOLOGICAL PRACTICE

Saidasheva E.I.

Abstract

This article presents the author’s many year experience with the use of domestic medications of peptide structure for the combined treatment of various diseases of the optic nerve and the retina in the children. In addition it summarizes the results of the relevant investigations. The clinical effectiveness of retinalamin used as a neuroprotector for the treatment of the disabling conditions, such as atrophy of the optic nerve, retinopathy of prematurity, and degenerative myopia and post-therapy rehabilitation, is demonstrated.
Russian Pediatric Ophthalmology. 2017;12(4):204-209
pages 204-209 views

THE MODIFIED METHOD FOR EVISCERATION IN THE CASE OF BUPHTHALMOS WITH THE USE OF A COMBINATION OF ORBITAL IMPLANTS

Filatova I.A., Mokhammad I.M.

Abstract

Aim. The objective of the present study was to evaluate the effectiveness of the modified technique for for evisceration in the case of buphthalmos with the use of a combination of orbital implants. Material and methods. The clinical material collected during 3 years was analyzed. The removal of the eye was performed in 385 patients of whom32 (8.1%) of the total) needed the removal because of of buphthalmos as the consequence of congenital, secondary post-traumatic glaucoma. The age of the patients ranged from 7-75 (mean 39.3 ± 5.7) years. 19 of them were males and 13 females. Nine patients presented with pronounced staphyloma of the sclera. The visual function was absent in all the cases. The modified method for evisceration included radiowave surgery with the use of a Surgitron device operated at a frequency of 3.8 Mg (Ellman, USA) and a combination of orbital implants (both intrascleral and intraconal) in order to obtain an additional volume for the stump. The Karbotextim carbon felt and polytetrafluoroethylene (PTFE) were applied as orbital implants. The surgical intervention is described in many detail. The duration of the follow-up ranged from 6 months to 3 years (mean 21 ± 6.17 months). The groups of comparison were two groups of the patients who had undergone the eye removal for buphthalmos: one of them was comprised of 14 patients treated by means of enucleation with plastic formation of the stump, the other consisted of 21 treated by traditional evisceration. Results. Wound healing in the early postoperative period occurred during normal time, without oedema and reactions to the presence of the additional implant in the orbit. Evaluation of the long-term results of the treatment was made based on the following criteria: retraction of the prosthesis and the upper eyelid into the orbit, asymmetry of the palpebral fissure, motility of the stump and the prosthesis. The best functional and cosmetic results (in comparison with enucleation and standard evisceration) were obtained in the patients treated with the use of the modified evisceration procedure and the application of the additional orbital implant. Conclusion. The modified method for evisceration in the case of buphthalmos with the use of a combination of orbital implants allows to compensate not only the volume of the eviscerated eye but also the volume of the atrophic orbital tissue. Moreover, it yields an additional stump volume of 0.5-0.7 cub. cm and permits to spare the fascial links between the orbital tissues and thereby prevent the development of stump and prosthesis hypophthalmos in the late postoperative period. The modified evisceration technique is more effective than both enucleation and standard evisceration in the patients with buphthalmos.
Russian Pediatric Ophthalmology. 2017;12(4):210-215
pages 210-215 views

ORGANIZATION OF OPHTHALMOLOGICAL CARE FOR THE CHILDREN PRESENTING WITH RETINOPATHY OF PREMATURITY IN THE REPUBLIC OF CRIMEA

Birkun E.Y., Sorokina S.A., Berezovskaya T.A., Saidasheva E.I.

Abstract

Aim. The objective of the present study was to identify the main stages of the organization and the results of the ophthalmological care for the children presenting with retinopathy of prematurity (ROP) in the Republic of Crimea. Material and methods. This retrospective analysis of the results of ophthalmological screening of 2105 prematurely born children, monitoring of 281 children with the early stages of ROP, the laser-assisted treatment of 64 babies undergoing the progression of the disease to its threshold stages and the follow up of the children with ROP in the Crimea during the period from 1999 to 2016 years. All the above patients were nursed and treated in the clinical hospital over the territory of the Crimea and in the perinatal centre of Simferopol. Results. ROP was diagnosed in 281 (26%) of the 2105 prematurely born children. The progression of the disease to the threshold stage was documented in 64 (22.8%) patients within 1 to 12 (mean 3-4) weeks after the identification of the initial stages of active ROP. ROP of the posterior aggressive type developed in 15 children. The duly-timed laser-assisted treatment permitted to prevent the appearance of blindness among the prematurely born children attributable to retinopathy of prematurity. As a results of the implementation of the program for the modernization of the ophthalmological care for the retinopathy of prematurity in the Republic of Crimea it is currently organized and provided in conformity with the relevant normative acts of the Ministry of Health of the Russian Federation. The ophthalmological Department of the Republic of Crimea Children’s Clinical Hospital is equipped with the necessary modern medical and diagnostic instruments and techniques; training of the Crimean ophthalmologists in retinopathy of prematurity and laser-assisted treatment of active retinopathy of prematurity.
Russian Pediatric Ophthalmology. 2017;12(4):216-218
pages 216-218 views

THE USE OF THE BOTULINUM TOXIN A FOR THE TREATMENT OF OCULOMOTOR PATHOLOGY

Apaev A.V., Gubkina G.L., Tarutta E.P.

Abstract

The use of the botulinum toxin A can be the method of choice for the treatment of oculomotor pathology. In certain cases of strabismus, this technique provides the sole correct and justified tool for the management of this condition. There are numerous publication concerning this issue in the foreign literature, but they do not permit to develop the well defined criteria for the application of the botulinum toxin A in the ophthalmological practice Specifically, such issues as the timing and dosages of botulinum toxin A administration remain to be addressed and solved. Of special interest is the application of the botulinum toxin A for the treatment of nystagmus. The expediency of the application of the botulinum toxin A for the treatment of oculomotor pathology should be estimated on an individual basis.
Russian Pediatric Ophthalmology. 2017;12(4):219-224
pages 219-224 views

OCULAR MANIFESTATIONS OF ECHINOCOCCOSIS IN A CHILD (A CASE FROM THE CLINICAL PRACTICE)

Saakyan S.V., Sudovskaya T.V., Makarova A.A., Kokoeva N.S., Tatskov R.A., Maibogin A.M.

Abstract

This article was designed to report the clinical case of ocular echinococcosis in a child. The patient was characterized by ptosis, oedema of the periorbital tissues, exophthalmos, displacement of the eye bulb, its abnormal movements in all directions, strabismus, pain, and orbital cysts. Rehabilitation of the child with ocular echinococcosis included transcutaneous orbitotomy with the excision of the echinococcal cyst from the orbit.
Russian Pediatric Ophthalmology. 2017;12(4):225-227
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X RUSSIAN NATIONAL OPHTHALMOLOGICAL FORUM-2017 MOSCOW, 03-05 OKTOBER 2017

Pleskova A.V., Kogoleva L.V.
Russian Pediatric Ophthalmology. 2017;12(4):230-231
pages 230-231 views
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