scholarly journals Innovative approach to barrier amnioplasty in surgical treatment of primary progressive pterygium

2020 ◽  
Vol 12 (4) ◽  
pp. 13-21
Author(s):  
Anna N. Bochkareva ◽  
Victor V. Egorov ◽  
Galina P. Smoliakova ◽  
Alexey D. Pilipenko ◽  
Pavel A. Banshchikov
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Early Postoperative Period ◽  
Corneal Astigmatism ◽  
Control Group ◽  
Inflammatory Reactions ◽  
Primary Progressive ◽  
Limbal Area ◽  
Conjunctival Inflammation ◽  
Special Examination

The aim is to evaluate the efficacy of new method of barrier amnioplasty in surgical treatment of primary progressive pterygium. Materials and methods. 40 patients (40 eyes) with primary progressive pterygium, divided into two groups depending on surgical features of barrier amnionoplasty: in the main group (20 patients), plastic surgery was carried out in the semilunar fold area; in the control group (20 patients) in the limbal area. All patients underwent special examination: tear pH measurement and cytological evaluation of the cellular composition from the wound surface. The treatment efficacy was evaluated: in the early postoperative period by the timing of conjunctival inflammation disappearance, corneal epithelialization and vitalization of the amnion; after 1 year according to the state of the limbus, cornea, visual acuity, degree of corneal astigmatism. Results and conclusions. The use of amnioplasty method in the area of semilunar fold developed and implemented by us in clinical practice showed high efficacy: time reduction in local cellular inflammatory reactions in the cytological composition of swabs and scrapings and postoperative inflammation of ocular surface, which led to shortening of periods of corneal epithelization by 1.7 times and vitalization of the amnion by 1.5 times. Uncomplicated postoperative course of inflammatory-regenerative reactions allows avoiding the pterygium recurrence and causes reduction of the degree of corneal astigmatism and visual acuity increase.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

Efficacy of surgical treatment of traumatic cataract with simultaneous intraocular lens implantation in children

2013 ◽  
Vol 4 (1) ◽  
pp. 37-40
Author(s):  
Diloram Asrarovna Zakirkhodzhayeva
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Early Postoperative Period ◽  
Eye Injury ◽  
Traumatic Cataract ◽  
Iol Implantation ◽  
Intraocular Injection ◽  
Lens Implantation ◽  
One Year

Background: eye injury is often accompanied by lens damage. Aim: To evaluate the efficacy of surgical treatment of traumatic cataract with simultaneous IOL implantation in children. Material and methods: The results of surgical treatment of traumatic cataract with simultaneous IOL implantation in 62 children were analyzed: in 48 boys (77.4%) and 14 girls (22.6%) with a mean age 8.1 years. Results: visual acuity after surgery gradually increased from 0.09 to 0.22 by the end of the first month, 0.43 in 6 months and 0.47 in one year of follow-up. In 85.5% of the operated children visual acuity in the late post-op period was accounted 0.3–1.0, and in 82.2% of cases binocular vision was recovered. In the early postoperative period following complications were observed: exudative iridocyclitis — 16.1%; deposits of fibrin in the pupil — 8%; pigment deposits on surface of the IOL — 19%; secondary cataract — 12%; IOL or its haptics dislocation — 3% cases. Conclusions: Early IOL implantation during traumatic cataract surgery in children is suitable. Use of viscoelastics allows minimizing the severity of postoperative inflammation and reducing a risk of complications. Intraocular injection of Gemasa during surgery is effective to resolve hyphema, intraocular hemorrhages and fibrinoid exudate.

scholarly journals Correction of High Corneal Astigmatism during Cataract Surgery

2019 ◽  
Vol 15 (4) ◽  
pp. 405-410 ◽  
Author(s):  
K. B. Pershin ◽  
N. F. Pashinova ◽  
M. E. Konovalov ◽  
E. P. Gurmizov ◽  
O. Yu. Zubenko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Clinical Experience ◽  
Intraocular Lens ◽  
Surgical Intervention ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Intraocular Lens ◽  
Surgical Interventions ◽  
Uncorrected Visual Acuity

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

New Potentialities in Surgical Treatment of Proximal Humerus

2011 ◽  
Vol 18 (1) ◽  
pp. 21-27
Author(s):  
Eduard Ivanovich Solod ◽  
A F Lazarev ◽  
Ya G Gudushauri ◽  
M G Kakabadze ◽  
A S Roskidaylo ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Surgical Treatment ◽  
General Condition ◽  
Postoperative Period ◽  
Proximal Humerus ◽  
Original Method ◽  
Early Postoperative Period ◽  
Early Rehabilitation ◽  
Control Group ◽  
Stable Fixation

Original method of stressed osteosynthesis for the treatment of proximal humerus is proposed. Primary tension of Y-shaped pin fixative and secondary tension that is created at its intramedullar insertion and blocking enable to achieve stable fixation of fragments without inflicting additional intraoperative injury in patients of any age and independently of their general condition. Preservation of blood supple in fragments, low traumatic osteosynthesis, and possibility of patients' early rehabilitation define the prospective of this technique for the treatment of patients with fractures on the background of osteoporosis. The importance of drug therapy for osteoporosis in the early postoperative period is shown. Experience in treatment of 62 patients aged from 23 to 78 years is presented. Control group included 30 patients with similar fractures who were treated using osteosynthesis. In the main group good results were achieved in 82.3% of patients, satisfactory - in 17.7%, no poor results were observed. In control group good results made up 40%, satisfactory - 56.7%, poor 0 3.3%.

scholarly journals Autologous Plasma Enriched with Platelet Lysate for the Treatment of Idiopathic Age-Related Macular Degeneration: A Prospective Study

2018 ◽  
Vol 73 (1) ◽  
pp. 40-48
Author(s):  
A. P. Lykov ◽  
O. V. Poveshchenk ◽  
M. A. Surovtseva ◽  
O. M. Stanishevskaya ◽  
D. V. Chernykh ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Growth Factors ◽  
Surgical Treatment ◽  
Macular Degeneration ◽  
Clinical Efficacy ◽  
Early Postoperative Period ◽  
Platelet Lysate ◽  
Age Related Macular Degeneration ◽  
Autologous Plasma ◽  
Age Related

Background: Plasma enriched in growth factors is widely used in medical practice. However, the clinical efficacy of its application in the treatment of age-related retinal integrity violations is investigated insufficiently. Aims: The aim of the study was to evaluate the clinical efficacy of autologous plasma enriched with platelet lysate for treating age-related macular degeneration. Materials and methods: A three-port subtotal transconjunctival vitrectomy was performed and administration of the autologous plasma enriched with platelet lysate was indicated. Autologous plasma enriched with platelet lysate was received from the peripheral blood. We assessed visual acuity, intraocular pressure; conducted optical coherent tomography examination of the eye on the side of the pathological process. Results: The study demonstrated that the combination of a standard 3-port transconjunctival subtotal vitrectomy followed by tamponade of the gap using the autologous plasma enriched with platelet lysate with the injections of the autologous plasma enriched with platelet lysate in the area of pterygopalatine fossa on the side of the operated eyes statistically significantly promoted recovery of the visual acuity in the early postoperative period (15 days) and late period (90 days) if compared with patients who received only surgical treatment (p≤0.05). Use of the autologous plasma enriched with platelet lysate in the treatment increased the closing rate of the tearing of the retina in the macular region up to 62,5%, while only surgical treatment leads to the closure of the defect of the retina in 37.5% of cases. The study showed that autologous plasma enriched with platelet lysate contains cytokines, growth factors, and nitric oxide which are involved in the regeneration/reparation of the retina. Conclusions: Additional administration of the autologous plasma enriched with platelet lysate in the scheme of treatment patients with age-related macular degeneration is accelerating the closure of retinal tears of the eye and improves visual acuity.

scholarly journals Outcomes of Application Two-Piece Microkeratome-Assisted Mushroom Keratoplasty

2021 ◽  
Vol 18 (1) ◽  
pp. 70-76
Author(s):  
S. V. Trufanov ◽  
E. A. Budnikova ◽  
V. N. Rozinova
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Surgical Treatment ◽  
Anterior Chamber ◽  
Cell Density ◽  
Endothelial Cell Density ◽  
Corneal Astigmatism ◽  
Descemet Membrane ◽  
Donor Material ◽  
Specific Complication

Purpose: to evaluate outcomes and to expose possible specific complications of two-piece mushroom keratoplasty.Patients and methods. A total of 9 patients (9 eyes) with corneal perforations and deep stromal opacities involving the Descemet membrane were undergone surgery. In all cases, preserved hypothermic corneoscleral buttons (in Borzenok– Moroz medium) for up to 5 days were used as donor material. The two-piece mushroom keratoplasty was performed using a microkeratome and vacuum trephines set in the variant proposed by M. Busin.Results. Success survival was obtained in 78 % of patients (7 out of 9 cases). Best spectaclecorrected visual acuity (BSCVA) 1 year after surgery averaged 0.54 ± 0.20. The average of corneal astigmatism was 3.41 ± 1.89 D. Endothelial cell density in 6 months after surgery was on average 2364 ± 236/mm2, and in 1 year — 2082 ± 228/mm2. A false chamber formation between separate parts of the graft as a specific complication was detected in 2 patients on 1 day after surgery. In one case it was eliminated by air re-injecting into the ocular anterior chamber. The second patient underwent conventional PKP due to the lack of graft adaptation. In addition, 1 patient also underwent conventional PKP as a result of postoperative crystalline infectious keratopathy, which is the non-specific complication of mushroom keratoplasty.Conclusion. The two-piece microkeratome-assisted mushroom keratoplasty is an effective method of surgical treatment of corneal perforations and deep stromal opacities involving the Descemet membrane.

scholarly journals Optimization of surgical treatment of cataract in patients with diabetes mellitus

2010 ◽  
Vol 13 (2) ◽  
pp. 91-93
Author(s):  
Dmitriy Valentinovich Lipatov ◽  
Timofey Alexandrovich Chistyakov ◽  
Anatoliy Gennad'evich Kuz'min
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Combined Treatment ◽  
Functional Results ◽  
Early Postoperative Period ◽  
Lens Opacity ◽  
Research Centre ◽  
Diabetic Cataract ◽  
Ocular Tissues ◽  
Patients With Diabetes

Aim. To compare different methods for surgical treatment of cataract in patients with diabetes melli-tus (DM) and substantiate the choice of its optimalmodality. Materials and methods. Analysis included data on 209 patients (221 eyes) treated from January 2008 to December 2009 in the Department ofRetinopathy and Ophthalmosurgey, Endocrinological Research Centre. Diabetic cataract was managed using UNIVERSAL-II, LEGACY EVEREST,and INFINITI phacoemulsifiers. Parameters studied included time of ultrasound (US) ex-posure, US power, and retinal characteristics in the earlypostoperative period. In addition, analysis included data on the location of lens opacity in 1047 patients (1897 eyes) with diabetic cataract. Results. Relatively low corrected and uncorrected visual acuity in the early postoperative period was attributable to concomitant DM-related retinalpathology. Analysis of lenticular opacity showed that it in the first place affected collagen fibers beneath the posterior capsule. The use of torsional USin INFINITI for cataract phacoemulsification produced almost 4-fold reduction in the exposure time of ocular tissues. As a result, the postoperativeoedema was significantly smaller than in patients undergoing combined treatment (AQUALASE hydromonitoring and OZIL ultrasound system). Conclusion. Combination of ultrasound and hydromonitoring phacoemulsification for the treatment of cataract in DM patients reduces exposure timeof ocular tissues and postoperative oedema which creates prerequisites for faster recovery of visual acuity after surgery. Functional results of surgicaltreatment of diabetic cataract can be further improved by early diagnosis of lens opacity and the use of US and hydromonitoring phacoemulsificationtechniques.

New approach to surgical treatment of primary progressive pterygium

2021 ◽  
pp. 13-17
Author(s):  
A.N. Bochkareva ◽  
◽  
O.V. Kolenko ◽  
V.V. Egorov ◽  
G.P. Smoliakova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Disease Index ◽  
Tear Fluid ◽  
Control Group ◽  
Initial Growth ◽  
Ocular Surface Disease Index ◽  
New Approach ◽  
Primary Progressive ◽  
Recurrent Pterygium

Purpose. To evaluate effectiveness of new method of barrier amnioplasty in surgical treatment of primary progressive pterygium. Material and methods. The study included 64 patients (64 eyes) with primary progressive pterygium. All patients were divided into two groups depending on method of barrier amnioplasty. The main group consisted of 32 people (32 eyes) who underwent barrier amnioplasty in the area of initial growth of pterygium. The control group consisted of 32 patients (32 eyes) who underwent barrier amnioplasty in the limbus area. The main criterions for clinical efficacy of surgical treatment of pterygium was dynamics of the wound process, the Ocular Surface Disease Index (OSDI) and the osmolarity of the tear fluid in the compared groups. Also, after 1 year, the frequency of pterygium recurrence was assessed. In addition to standard ophthalmological examinations, special methods were used in the work: determination of the osmolarity of the tear fluid, pH of tears, cytological assessment of the wound process, and also assessed the OSDI. Results. The results of pH-metric, osmometric, cytological studies have provided evidence of the ability of the anatomical and topographic approach described by us to positively influence the course of inflammatory and reparative processes in the operation area, preventing the development of recurrent pterygium and cicatricial deformities. Conclusion. A new effective method of surgical treatment of primary progressive pterygium, including moving the area of the barrier amnioplasty from the limbus area to the area of initial growth of blood vessels of pterygium - the area of the lunate fold, has been developed and introduced into clinical practice. Key words: pterygium, inflammatory and reparative processes, recurrence.

Evaluation of effectiveness of a new combined method of treatment of primary progressive pterygium

2021 ◽  
pp. 221-225
Author(s):  
A.N. Bochkareva ◽  
◽  
V.V. Egorov ◽  
O.V. Kolenko ◽  
G.P. Smoliakova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Ultraviolet Irradiation ◽  
Combined Treatment ◽  
Disease Recurrence ◽  
Surgical Removal ◽  
Initial Growth ◽  
Ophthalmological Examination ◽  
Combined Method ◽  
Primary Progressive

Purpose. Evaluation of the effectiveness of the combined method in the surgical treatment of pterygium. Material and methods. There were 30 patients (30 eyes) under observation for primary progressive pterygium. To assess the condition of the ocular surface and the functional effectiveness of the new combined method of treating pterygium, the patients were divided into two groups. The main group consisted of 15 patients (15 eyes) who underwent surgical treatment of the pterygium according to the developed method. The comparison group consisted of 15 patients (15 eyes), who underwent pterygium removal using standard technology. Standard ophthalmological examination included: visometry, autorefractokeratometry, biomicroscopy with fluorescence test. The criteria for evaluating the effectiveness of treatment were: maximally corrected visual acuity; the degree of corneal astigmatism; the presence and degree of turbidity in the operation area; the frequency of relapse. Results. The use of the proposed method of combined treatment of pterygium, including surgical removal with plasty of the amnion in the zone of initial growth in combination with ultraviolet irradiation of the de-epithelialized corneal bed in the postoperative period, leads to the restoration of transparency and the correct shape of the cornea, therefore, and minimization of induced astigmatism, which is accompanied by an increase in functional parameters eyes. Conclusion. The results obtained, the simplicity and availability of the method developed by us allow us to recommend it for wider use in the surgical treatment of pterygium in order to increase the functional, cosmetic effect, surgical rehabilitation and prevention of disease recurrence. Key words: pterygium, combined treatment, visual acuity, ultraviolet irradiation.

scholarly journals Transorbital Endoscopic Medial Orbitotomy and Decompression of the Optic Nerve in Patients with Endocrine Ophthalmopathy Complicated by Optical Neuropathy

2020 ◽  
Vol 9 (1) ◽  
pp. 167-172
Author(s):  
O. V. Levchenko ◽  
A. A. Kalandari ◽  
N. Y. Kutrovskaya ◽  
K. V. Revazyan
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Satisfactory Result ◽  
Postoperative Period ◽  
Conservative Therapy ◽  
Early Postoperative Period ◽  
Medial Wall ◽  
Endocrine Ophthalmopathy

AIM OF STUDY: to improve the results of surgical treatment of patients with endocrine ophthalmopathy complicated by optical neuropathy. For this, medial orbitotomy and decompression of the optic nerve were performed for a patient with endocrine ophthalmopathy, CAS<3, OD=18 mm, OS=23 mm and visual acuity OD=1.0 OS=0.2, using transorbital transconjunctival endoscopic access. The first step was a retro caruncular incision. After that, we defined an access to the medial wall of the orbit with its subsequent resection. Then, we performed ethmoidectomy and approach to the optic nerve canal. Upon completion of bone decompression, we opened periorbitis.RESULTS. The postoperative period was uneventful. In the early postoperative period, regression of exophthalmos was observed OD=18 mm, OS=20 mm, improvement in visual acuity OD=1.0 OS=0.5 . No complications were recorded. A satisfactory result was obtained.CONCLUSION. Transorbital endoscopic medial orbitotomy and optic decompression can be effectively used in the treatment of patients with endocrine ophthalmopathy complicated by optic neuropathy, refractory to conservative therapy. The technique is promising and requires further randomized studies.

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