Patient Satisfaction Based on IOL Implantation Results

Purpose: to found the relationship between the obtained postoperative visual acuity, the increase in visual acuity in the lines and the subjective satisfaction of patients with the results of the operation.Material and methods. The study included 165 patients (186 eyes) who received cataract phacoemulsification surgery with IOL implantation (n = 170) or refractive lensectomy with IOL implantation (n = 16). The average age of the subjects was 70.23 ± 10.14 years. The group included patients without concomitant systemic or ophthalmic pathology, without previous surgical interventions in the eye for any purpose. At least 1 month after the operation, patients filled out a questionnaire in order to find out the subjective satisfaction with the treatment (scale from 0 to 4 points). The results of the questionnaire were compared with postoperative BCVA, and increased vision (postoperative BCVA — preoperative BCVA). Preoperative BCVA — Me 0.4 (Q1–Q3: 0.1–0.68), postoperative BCVA — Me 1.0 (Q1–Q3: 0.95–1.0), increased vision — Me 0.6 (Q1–Q3: 0.3–0.9) according to Snellen’s table.Results. Visual acuity in satisfaction subgroups: 0 points — Me 1.0 (Q1–Q3: 0.9–1.0) / n = 5 (2.7 %); 1 point — 1 case, postoperative BCVA 1.16 (0.5 %); 2 points — Me 0.95 (Q1–Q3: 0.84–1.0) / n = 14 (7.5 %); 3 points — Me 1.0 (Q1–Q3: 0.9–1.16) / n = 57 (30.6 %); 4 points — Me 1.0 (Q1–Q3: 0.96–1.0) / n = 109 (58.6 %). Postoperative BCVA and increased in visual acuity do not have statistically significant differences depending on satisfaction with treatment (p > 0.05). The correlation between postoperative BCVA and satisfaction is not statistically significant (p = 0.65; rxy = 0.136), as well as between vision improvement and satisfaction (p = 0.55; rxy = 0.141).Conclusion. There was a lack of a statistically significant relationship between postoperative BCVA and improved vision with subjective patient satisfaction with treatment. Identification of factors affecting subjective assessment requires a deeper analysis. Practicing ophthalmologists should remember the importance of the dialogue between the doctor and the patient at the preoperative stage, informing the patient about the expected results of the operation and the possible course after the operation period.

Dynamics of interhemispheric relations as a result of functional treatment in children with non-paralytic operated strabismus

Purpose. To study the dynamics of interhemispheric interactions in children with friendly strabismus as a result of functional treatment. Material and methods. The study included 135 children aged 6 to 8 (average 6.8±0.1) years with convergent non-paralytic operated strabismus in combination with hypermetropic refraction and 96 children of the same age in the control group (average 7.1±0.1 years) without ophthalmic pathology. In children with strabismus, the leading hand and dominant eye were determined before and after functional treatment. Characteristics of spatial perception were evaluated by copying of complex geometric shapes which were Taylor's (right-handed) and Ray-Osterritz's (lefthanded). Results. After functional treatment in the group of children with non-paralytic strabismus, along with improved binocular functions and improved performance of the Taylor and Ray-Osterritz tests, there was an increase in the number of ambidextrous children and a significant decrease in the number of left-handers (p<0.001). Conclusion. The increase in the number of symmetrical lateral phenotypes against the background of improved binocular functions and spatial perception characteristics as a result of functional treatment of children with non-paralytic strabismus indicates an improvement of their interhemispheric interactions and can be an additional criterion for the ef fectiveness of treatment. Key words: lateral phenotypes, interhemispheric asymmetry, functional treatment of strabismus

PECULIARITIES OF GERIATRIC STATUS OF PATIENTS WITH AGE-AGE MACULAR DEGENERATION

В пожилом возрасте вследствие иволютивных процессов и соматической патологии происходит ухудшение гериатрического статуса и преждевременное старение. Присоединение зрительного дефицита, вызванного возрастной макулярной дегенерацией, еще в большей cтепени снижает функциональную активность пациентов. Цель исследования - изучение особенностей гериатрического статуса пациентов с возрастной макулярной дегенерацией. На базе офтальмологического центра проведено обследование свыше 200 пациентов с возрастной макулярной дегенерацией. Контролем служили пациенты с отсутствием данной офтальмологии. Всем пациентам выполнено комплексное офтальмологическое и гериатрическое обследование, включающее оценку зрительных функций и основных клинических гериатрических синдромов. В ходе исследования установлено, что возрастная макулярная дегенерация статистически значимо ухудшает гериатрический статус пациентов по таким позициям как личностная и ситуативная тревожность синдром гипомобильности, ограничения в бытовой активности по шкале Гронингена. У пациентов с возрастной макулярной дегенерацией гериатрический статус отягощен также синдромом полиморбидности, представленным преимущественно артериальной гипертензией, ишемической болезнью сердца, сопутствующий офтальмологической патологией. Среди пациентов пожилого возраста с возрастающей макулярной дегенерацией статистически значимо выше распространённость. Все это указывает на важность оценки гериатрического статуса для его корреляции In old age, due to evolutive processes and somatic pathology, there is a deterioration in geriatric status and premature aging. The addition of visual deficit caused by age-related macular degeneration further reduces the functional activity of patients. The aim of the study was to study the features of the geriatric status of patients with age-related macular degeneration. On the basis of the ophthalmological center, more than 200 patients with age-related macular degeneration were examined. Patients with the absence of this ophthalmology served as control. All patients underwent a comprehensive ophthalmological and geriatric examination, including an assessment of visual functions and the main clinical geriatric syndromes. In the course of the study, it was found that age-related macular degeneration statistically significantly worsens the geriatric status of patients in such positions as personal and situational anxiety, hypomobility syndrome, limitations in everyday activity according to the Groningen scale. In patients with age-related macular degeneration, the geriatric status is also aggravated by polymorbidity syndrome, represented mainly by arterial hypertension, ischemic heart disease, concomitant ophthalmic pathology. Among elderly patients with increasing macular degeneration, the prevalence is statistically significantly higher. All this points to the importance of assessing geriatric status for its correlation

Genetic Polymorphisms Affecting Ranibizumab Response in High Myopia Patients

High myopia is an ophthalmic pathology that affects half of the young adults in the United States and Europe and it is predicted that a third of the world’s population could be nearsighted at the end of this decade. It is characterized by at least 6 diopters or axial length > 26 mm and, choroidal neovascularization (CNV) in 5 to 11% of cases. Ranibizumab is a recombinant humanized monoclonal antibody fragment. It is an anti-vascular endothelial growth factor (anti-VEGF) drug used in the treatment of CNV. Many genetic polymorphisms have been associated with interindividual differences in the response to ranibizumab, but these associations were not yet assessed among patients with high myopia and CNV. We performed a retrospective study assessing the association of genetic polymorphisms with response to ranibizumab in patients with CNV secondary to high myopia (mCNV). We included genetic polymorphisms previously associated with the response to drugs used in CNV patients (bevacizumab, ranibizumab, aflibercept, and photodynamic therapy (PDT)). We also included genetic variants in the VEGFA gene. Based on our results, ARMS2 (rs10490924) and CFH (rs1061170) are associated with response to ranibizumab in high myopia patients; and, included VEGFA genetic polymorphisms are not associated with ranibizumab response in our population but might be related to a higher risk of CNV.

Prevention of accommodation disorders and myopia in children

Background. An important role in the structure of ophthalmic pathology is played by myopia, especially rapidly progressing in adolescence, and accommodation disorders, which are, in fact, the precursors and companions of myopia. The purpose was to prevent accommodation disorders and mild myopia in children of different age groups by using dietary supplements Doppelherz® Kinder Eye vitamins with lutein and Doppelherz® Kinder Glycine. Materials and methods. One hundred and three children of diffe-rent age groups underwent functional examination against the background of treatment: group I — primary school age, prepubertal period (6–11 years) — 24 children, group II — middle school age, pubertal period (12–18 years) — 79 children, 24 of them had problems of the neck and collar zone associated with computer load. Standard examination methods were used. Results. After the course of the proposed therapy, the Haidinger’s phenomenon decreased to 5.70 ± 0.01 conventional units (p < 0.05) in the first group; up to 4.60 ± 0.03 conventional units in 55 children of the second group without problems in the neck and collar zone and up to 5.40 ± 0.02 conventional units in 24 children who had such problems (p < 0.02). Conclusions. Using Doppelherz® Kinder Eye vitamins with lutein and Doppelherz® Kinder Glycine improves the functioning of the ciliary muscle. Under the influence of treatment, visual acuity and accommodation reserves increased, and the power of optical correction decreased. The positive influence of Doppelherz® Kinder Eye vitamins with lutein and Doppelherz® Kinder Glycine on the increase in the functional activity of the fovea-afferent system and the accommodative function of the visual analyzer in spasm of accommodation and mild myopia has been proven.

Structure of ophthalmic pathology according to S. Fyodorov Eye Microsurgery Federal State Institution and development of innovative technologies

The article discusses the structure of ophthalmic pathology. These results are based on the analysis of statistical data of a large number of patients of the S. Fyodorov Eye Microsurgery Federal State Institution in 2019 (year before COVID-19 pandemic). In 2019 – 565988 patients were registered in medical database of our institution for the first time. The distribution of ophthalmic pathology among these patients was as follows. Cataract – 25.0%, including complicated cataract 15.9 %. Glaucoma – 3.1%; Vitreoretinal pathology – 8.2%; Diabetes – 2.9%; Oculoplastic pathology – 2.7%; Oncology – 1.1%; Eye diseases in children – 12.9%; Refractive errors – 17.2%; Diseases of the eye fundus – 12.6 %; Corneal pathology – 2.2%; Inflammatory diseases – 10.3%; Other diseases – 1.8 %. The article carefully describes the innovative technologies and the main trends that determine the overall development of such areas of ophthalmic surgery as: cataract surgery, glaucoma, corneal surgery, vitreoretinal surgery, laser refractive surgery, laser surgery of the retina and vitreous body, surgical manipulations in children, oculoplasty, ophthalmooncology. Key words: structure of ophthalmic pathology, innovative technologies of ophthalmic surgery, main trends of ophthalmic surgery.

Comprehensive treatment of glaucoma (literature review)

Due to the growing incidence of such ophthalmic pathology as glaucoma, it is necessary to search for new methods of treatment of this disease. One of the non-drug methods of treating glaucoma is reflexology. This type of treatment can be an definitive and cost-effective method used to improve the overall condition. Our review of scientific papers shows that the results of acupuncture therapy in glaucoma patients are ambiguous and contradictory. Therefore, a more detailed study of the effectiveness of acupuncture therapy in glaucoma patients is necessary. Key word: acupuncture, glaucoma, paraorbital points, intraocular pressure.

Management of Acute Proliferative Diabetic Retinopathy Related Complications During the First COVID-19 Wave

Background. Routine hospital eye services (HES) and diabetic retinal screening were paused during COVID lockdown in March 2020. Alternate pathways for managing acute ophthalmic pathology were devised in NHS Grampian: Emergency eye treatment centres (EETC) manned by community optometrists were set up to treat and triage referrals to HES. Methods. Retrospective study analysing patients referred to HES with proliferative diabetic retinopathy (PDR) related complications between March and August 2020. Results. 52 eyes of 46 patients with PDR related complications were identified. HES appointment had been delayed or cancelled in 43% due to COVID. Mean age was 54.5 years (± 15.1), 46% were female, 46% had type 1 diabetes; mean HbA1c was 78 mmol/l (± 18.7). Vision ranged from 6/6 to perception of light. 36 patients had unilateral vitreous haemorrhage (VH), 6 bilateral, 2 tractional retinal detachments and 3 had neovascular glaucoma. Following assessment, 23 eyes received anti-VEGF injection within 3 days, two had PRP on the same day, 16 were rebooked for urgent PRP, 13 referred for urgent surgical review and 17 advised observation. After a mean follow-up of 6 months, 12 eyes (23%) of 11 patients progressed to have vitrectomy. Conclusion. Despite lockdown, hospital appointment cancellations and recommended footfall reduction limiting capacity due to COVID19, patients reaching out with PDR complications were promptly referred to HES and appropriate treatments carried out with COVID precautions as recommended.

A Narrative Review of the Complex Relationship between Pregnancy and Eye Changes

Pregnancy is a condition often characterized by changes that occur in different parts of the body. Generally, the eyes suffer several changes during pregnancy that are usually transient but may become permanent at times. This may occur due to the release of placental hormones and those of maternal endocrine glands and fetal adrenal glands. Due to hormonal influences, physiological ocular changes during pregnancy have been shown in Caucasian women, so corneal sensitivity, refractive status, intraocular pressure, and visual acuity may change during pregnancy. Within this review, all studies that referred to physiological aspects and to changes of ocular pathology of pregnancy, the effect of the pregnancy on pre-existing (diabetic retinopathy, neuro-ophthalmic disorders) eye disorders, postpartum ocular changes, the intraocular pressure and the effect of hypotensive ophthalmic medicine during pregnancy, the connection between pregnancy and the neuro-ophthalmic pathology, as well as the role of anesthesia were analyzed.