Ophthalmology Reports

BACKGROUND: Data on the effect of changes in retinal perfusion on retinal functional recovery at surgical treatment of full-thickness macular holes are limited.

AIM: To investigate the effect of changes in retinal perfusion on postoperative recovery of fovea function in full-thickness macular holes.

MATERIALS AND METHODS: A prospective study included data of 93 patients (93 eyes) with full-thickness macular holes. Optical coherence tomography-angiography (OCT-A), visual acuity testing, microperimetry, and multifocal electroretinography were performed before surgical treatment, after 1 and 6 months. We studied the relationship between changes in foveal avascular zone area, vessel density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) with changes in best corrected visual acuity (BCVA), retinal sensitivity (RS) at the fixation point and P1 amplitude in the fovea at different periods after treatment.

RESULTS: After surgical hole closure, a significant decrease in foveal avascular zone area, increase in vascular density in SCP and DCP was found within 1 month after treatment (p < 0.001). Significant increase in BCVA, RS and P1 amplitude was observed 1 and 6 months after hole closure (p < 0.001). The most pronounced correlation was found in the long-term postoperative period between the change in vessel density in the SCP and the change in BCVA, RS and P1 amplitude (r = 0.42, r = 0.26 and r = 0.3, p < 0.05), as well as between the change in vessel density in the DCP and the change in BCVA, RS and P1 amplitude (r = 0.41, r = 0.34 and r = 0.43, p < 0.05).

CONCLUSIONS: In the treatment of patients with full-thickness macular holes, there is a significant relationship between changes in retinal perfusion and the recovery of visual acuity, retinal sensitivity and bioelectrical activity in the foveal area, and it is more pronounced in the period from 1 to 6 months after macular hole closure. The obtained results suggest a possible prognostic role of OCTA results in the surgical treatment of full-thickness macular holes.

BACKGROUND: Glaucoma remains one of the leading causes of irreversible vision loss worldwide, due to the steadily increasing incidence with age. In recent years, minimally invasive glaucoma surgery combined with cataract extraction has gained significant popularity as an alternative to traditional filtering surgeries. Among the methods of hypotensive action included in the minimally invasive glaucoma surgery concept, endoscopic laser cyclodestruction plays a special role, allowing for effective reduction of aqueous humor production.

AIM: The aim of this study is to determine the optimal conditions for achieving maximum efficiency and safety of endoscopic laser cyclodestruction.

MATERIALS AND METHODS: The present study analyzed the results of 110 combined procedures (phacoemulsification and endoscopic laser cyclodestruction) performed in our clinic. The study included 110 patients (56 men and 54 women) aged from 56 to 89 years (mean age 73.7 years) diagnosed with stage I–IV glaucoma and initial complicated cataract. All patients underwent anterior endoscopic laser cyclodestruction using the E2 videoendoscopic laser ophthalmic device (Endo Optiks Inc., USA) after phacoemulsification and intraocular lens implantation. Dynamic follow-up included visual acuity testing, perimetry, tonometry, instillation regimen assessment, anterior segment OCT, and registration of complications over 60 months.

RESULTS: The data analysis showed no hemorrhagic complications and significant inflammatory reactions in the vast majority of patients. The average dynamics of intraocular pressure reduction over 60 months was 24.6%, indicating the high efficacy of endoscopic laser cyclodestruction in intraocular pressure lowering and in stabilizing the condition in glaucoma patients.

CONCLUSIONS: Endoscopic laser cyclodestruction demonstrates high efficacy and safety, with virtually no contraindications, except in cases of technical difficulties. The optimal efficiency of the procedure is achieved by destructing the ciliary body processes over 180–200°, significantly reducing intraocular pressure and decreasing dependence on hypotensive therapy.

BACKGROUND: Pseudoexfoliation syndrome is currently considered as a systemic disorder of the connective tissue metabolism with the accumulation in all corneal cell layers of pseudoexfoliation syndrome deposits, which disrupt corneal morphology and biomechanics.

AIM: to study the features of biomechanical parameters of the fibrous capsule of eyes in primary open-angle glaucoma (POAG) in comparison with those in pseudoexfoliative glaucoma (PEG).

MATERIALS AND METHODS: We compared 65 eyes with POAG and 77 eyes with PEG aged under 80 years. The control group consisted of 18 healthy eyes. Biomechanical indicators were compared, such as: DA Ratio, Integr. Radius, SP-A1, SSI, BGF, biomechanically corrected intraocular pressure (bIOP) obtained with Pentacam (Oculus) and CorVis ST.

RESULTS: Patients with PEG were elder (68.013 ± 0.75 years) in contrast to POAG patients (60.03 ± 1.05 years) (p = 0.001), had a thinner central retinal thickness (CRT) — 543.99 ± 3.9 µm versus 559.33 ± 4.4 µm in those with POAG (p = 0.010). The IOP level did not differ between groups, and no correlation with CRT was detected. Indicators of corneal stiffness: DA ratio Integr. Radius did not differ between POAG, PEG and control group. The SP-A1 parameter also did not differ between POAG and PEG patients, while there were differences between PEG patients and the control group (p = 0.046). Moreover, in eyes with POAG, SP-A1 directly correlates with IOP Ро (p = 0.001) and CRT (p = 0.001), in those with PEG — p = 0.001 and p = 0.001, respectively. The SSI index in PEG was higher and amounted to 1.38 ± 0.03 versus 1.27 ± 0.03 in POAG (p = 0.013), while it correlated with age only in the case of PEG (p = 0.007). A correlation between SSI and CTR was also revealed — in POAG (p = 0.018), in PEG (p = 0.001). In PEG, BGF shows higher values (25.92 ± 2.3) than in POAG (17.71 ± 2.2; p = 0.010). BGF has no correlation with age (p = 0.094 and p = 0.737 for POAG and PEG, respectively), depends on CRT (p = 0.001 and p = 0.027, respectively), on bIOP (p = 0.001 and p = 0.001, respectively), and on SP-A1 (p = 0.009 and p = 0.001, respectively). The only parameter that was higher in PEG than in POAG was SSI, which did not correlate with the BGF indicator (p = 0.642 and p = 0.327, respectively).

CONCLUSIONS: We did not find any fundamental differences in biomechanics between PEG and POAG, which could explain the significant rates of progression of PEG. Based on our data, it is obvious that the eye with PEG differs from that with POAG being more rigid, even at similar IOP values.

The article presents a description of a modified method of transplantation of the endothelium on descemet membrane and of a method of femtosecond laser-assisted posterior lamellar keratoplasty in patients with corneal endothelial dysfunction combined with severe defects of the iris-lens diaphragm integrity. During surgery, in both cases, a banded stromal flap was used. There were no complications in the early postoperative period. The air resorption in the anterior chamber in both cases lasted no more than 2 days. After air resorption, the stromal flap occupied an intermediate position between the iridolens diaphragm remnants and the endothelial graft. On day 3, the bandage stromal flap was removed in the operating room. It was shown that the use of a bandage stromal flap during surgical procedures for extensive defects of the iris-lens diaphragm allows minimizing the risk of dislocation of the endothelial graft into the vitreal cavity. Proposed technique is an universal solution for DMEK and Fs-DSAEK in patients with an abnormality of the iris-lens diaphragm. The preliminary insertion of banded stromal flap into the anterior chamber makes it possible to block the defects of the iris-lens diaphragm and provides conditions for prolonged air tamponade of the anterior chamber and primary graft adhesion.

Silicone tamponade is one of the prevailing methods used in the surgical treatment of retinal detachments. However, one of the significant disadvantages of using silicones is their emulsification and the risk of developing associated ophthalmic conditions. In this regard, the question of ways to prevent silicone emulsification remains relevant. Emulsification does not occur in all cases of tamponade, and this indicates that there are factors that could interfere with the development of this process. It is known that emulsification of silicone oil has a multifactorial etiology, and in vitro experimental models are being developed to study these mechanisms in more detail. It is the variety of factors that determine the tendency to emulsify ophthalmic silicone that formed the basis for the creation of these models. Such factors include physicochemical and mechanical effects, saccadic eye movements, adhesion of silicone oil to eye tissues, absorption of biological substances from intraocular fluids and tissues. The development of a variety of in vitro models allows, on the one hand, to obtain new fundamental knowledge, while, on the other hand, it allows us to solve practical issues related to the prevention of silicone emulsification and may provide insight into future strategies for improved intraocular tamponade.

Congenital ptosis is one of the most common eyelid abnormalities in the field of pediatric ophthalmology. This condition is characterized by drooping of the upper eyelid and can lead to functional and aesthetic problems in children in the absence of timely treatment. Various surgical methods aimed at correcting blepharoptosis are described in the literature, including levator resection, frontalis sling and tarsomullerectomy. Levator resection is the most common technique that significantly improves the position of the upper eyelid and provides lasting functional results. Frontalis sling is usually used for severe ptosis or in cases where levator resection is impractical. Tarzomullerectomy surgery is also frequently used, especially in patients with sufficient levator function. An important aspect of surgical treatment is the need for preoperative diagnosis of the degree of ptosis, levator function, and the presence of concomitant abnormalities such as amblyopia and strabismus. The results of surgical procedure show a high degree of patient satisfaction, however, they require constant monitoring to identify possible complications and the need for repeated intervention. Thus, the choice of surgical treatment method should take into account the individual anatomical and physiological characteristics of the patient.

The editorial board regret that un the published version “YAG-laser treatment of secondary cataract with silicone tamponade of the vitreous cavity” by Polina S. Ratanova, Andrei Yu. Kleimenov, Oleg A. Zykov, Nataliya S. Shuman, Anastasiya D. Arapova, Nikolai V. Strenev (Ophthalmology Reports, 2024;17(4):21–28. doi: 10.17816/OV516561) Institution (place of work) of the authors S. Fyodorov Eye Microsurgery Federal State Institution, Ekaterinburg, Russia was indicated incorrectly.

The authors’ institution is: Eye Microsurgery Yekaterinburg Center, Yekaterinburg, Russia.

The editorial board is confident that the error could not significantly affect the perception of the work and the interpretation of information by readers. The error has been corrected online, the file of the article and the issue have been updated.