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Objective: to identify the features of biomechanical parameters of the fibrous capsule of the eye in patients after radial keratotomy (RK). Materials and methods. 87 eyes were examined after radial keratotomy, the average age was 59.8 ± 0.83 years. With glaucoma 47 eyes, without — in 40 eyes. Patients were divided into three groups: 17 eyes with a central corneal thickness (CCT) of less than 530 microns; 30 eyes with a CCT of 530–580 microns; 40 eyes with a CCT of more than 580 microns. The control group consists of myopic patients without glaucoma, without PES, over 45 years old. Corneal tomography and biomechanical parameters were measured using Pentacam (Oculus) and CorVis ST, respectively. Results. in the eyes after RK, the corneal stiffness (DA ratio, R) is higher in comparison with the control and increases with an increase in CCT. The stiffness of the fibrous capsule of the eye (SP-A1) after RK is reduced in comparison with the control and increases with an increase in CCT. The SSI analysis showed a higher stiffness of the eyeball than in the control, regardless of the CCT. BGF is higher in the eyes after RK compared to the control with the maximum value for thin corneas. Hyperopic shift (HS) after RK is distinctive for eyes with glaucoma. With a CCT of more than 580 microns, HS is a clinical glaucoma detector, with thin corneas, it is not. Conclusion. The eye after RC is characterized by an increase in the stiffness of the cornea, a decrease in the stiffness of the fibrous capsule of the eye, a general increase in the stiffness of the eyeball and HS.

Objective: to analyze the tonometric data, obtained with standard contactless tonometry and corneal-compensated tonometry, examined by the Oculus CorVis ST device in different groups of patients of the Tri-Z Krasnodar Clinic.Patients and Methods. The study included 42 eyes of patients, with glaucoma — 55 %, with suspected glaucoma — 45 %, mean age — 63.19 ± 1.7 years, men were 20 (47.5 %), women — 22 (52.5 %), the central corneal thickness was 554.43 ± 5.28 microns. Corneal tomography and biomechanical parameters were measured using Pentacam (Oculus) and Corvus ST, respectively.Results. IOP in people aged over 60 years was lower according to CorVis ST (Po 22.07 = 2.25, Pcс 18.63 ± 1.30, p = 0.007). IOP differed only in patients with a CCT of more than 580 µm (Po 22.4 ± 2.9, Pcc 18.21 ± 2.16, p = 0.012). IOP in patients with glaucoma was Ро 26.19 ± 3.5 and Рсс 21.3 ± 2.0, p = 0.008, without glaucoma — Ро 17.83 ± 9.60; Pсс 16.1 ± 5.5; p = 0.063. IOP in patients with compensated glaucoma Ро 17.34 ± 1.10, Pсс 16.6 ± 1.1, p = 0.354, with decompensated Ро 42.78 ± 6.8, Pсс 30.08 ± 4.10, p = 0.005. In the initial stage of glaucoma, Рo 22.5 ± 2.3, Рсс 20.0 ± 1.0, p = 0.297, in the advanced stage — Рo 20.7 ± 2.7, Рсс 17.6 ± 1.9, p = 0.027.Conclusion. Standard non-contact tonometry can be used in persons aged under 60 years, persons without glaucoma and with initial compensated glaucoma. In all other cases, the Oculus CorVis ST values are more accurate.

Objective: to analyze the biomechanical parameters of the eye fibrous membrane and the biomechanical glaucoma factor (screening index for low-pressure glaucoma) studied by the Oculus Corvis ST device in various clinical situations.Patients and Methods: the study included 382 eyes, 181 eyes with glaucoma (47 %), 201 eyes without glaucoma (53 %). Patients were divided into groups: without glaucoma, with glaucoma (POAG, NTG, PEG), with keratotomy, depending on the CCT and axial length. Corneal tomography and biomechanical parameters were measured using Pentacam (Oculus) and Corvus ST, respectively.Results in patients without glaucoma, the stiffness of the eye increases with age (increasing SSI). Even higher SSI in the PEX group. Higher BGF values compared to the control. With PEG, the CCT is thinner, p = 0.005, bIOP is higher than p = 0.038, SSI is higher than p = 0.00 than in the control. With NTG, the CCT is thinner, p = 0.002, bIOP is lower than p = 0.000, DA ratio, R is higher (p = 0.000) than in the control. In all groups, BGF is higher than in the control (POAG p = 0.016, PEG and NTG p = 0.000). With ketatotomy, DA ratio, R and SP-A1 p = 0.000, lower than with myopia, and SST is higher, p = 0.000, BGF is almost twice as high. With a thin cornea, the DA ratio, R, SP-A1 (p = 0.000) and SSI p = 0.044 are lower than in the control, BGF is higher than p = 0.000. With a axial length of more than 24.00 mm below the DA ratio p = 0.034, BGF above p = 0.000.Conclusion: with age, with different CCT, with increasing axial length, with different forms of glaucoma and keratotomy, the indicators of the fibrous membrane of the eye change.

Purpose: to study the state and dynamics of changes in primary ocular disability in the period 2016–2018 by nosological forms. A complete retrospective study was made based on the data of the MSE (medical and social expertise) Bureau’s reporting documents. The following indicators of primary disability (per 10 thousand population) were registered from 2016 till 2018: among the adult population (18 years and older) 69,0–70,7–68,6 respectively; among the able-bodied population 42,8–44,1–41,1 respectively; among the population of retirement age — 125,1–126,4–124,6 accordingly. In the structure of primary disability of the adult population by severity for the period 2016–2018, the dynamics recorded an increase in the proportion of 1 group and 3 group with a decrease in the share of disability of 2 group. In the nosological structure of primary disability of the adult population in 2016–2017–2018, eye diseases account for 3 %, 3 % and 3.2 %, respectively, of all first recognized as disabled. There has been an increase in first-time applicants to the MSE Bureau. In the nosological structure of primary disability, the percentage of glaucoma patients over the past period is 47–33–32.5 % of the total number of primary disability for eye diseases, which determines the 1st rank. There is a progressive increase in the number of people with disabilities due to glaucoma of group 1 and group 2 throughout the study period. In the nosological structure of primary disability for 2016–2018 the percentage of patients with retinal diseases is 25–23–23.8 % of the total number of primary disability for eye diseases, which corresponds to the 2nd rank. There is a progressive increase in the number of disabled people in group 2. A low proportion of persons of working age in the structure of primary ocular disability was noted. A consistently high share of primary disability and a progressive increase in severe disability combined with an increase in persons of retirement age in the Krasnodar region forms an unfavorable forecast for an increase in the number of blind and visually impaired residents of the region.

The study included patients with a verified diagnosis of “Traction retinal detachment” (RD) in pediatric (50 patients, mean age 13.8 ± 1.1 years, age range from 11 to 18 years) and adults (50 patients, mean age 54, 6 ± 2.2 years, age range 19 to 72 years). The control groups included 25 children (mean age 13.1 ± 1.2 years) and 25 adults (mean age 52.8 ± 1.6 years) patients without pathology of the organ of vision. A comprehensive examination of the functional state of the visual analyzer was performed, including the assessment of clinical (maximum corrected distance visual acuity, BCVA), subjective (Quality of Life, QOL), hemodynamic (pulsation index in the central retinal artery, PI), electrophysiological (threshold of electrical sensitivity of the retina (PESR); threshold of electrical lability of the retina; critical frequency of fusion and flashing (presentation of a red object); photostress test) and biochemical (antioxidant activity in the lacrimal fluid, AOA; superoxide dismutase indicator, PS in the lacrimal fluid) indicators of the visual system. The data obtained indicate some differences in the studied parameters in patients with OS in pediatric and adult practice. In particular, a higher level of BCVA in adults was found (by 18.8 %, p < 0.001). Along with this, it was determined that RD in children is accompanied by more pronounced disorders of hemodynamic and antioxidant parameters, which is associated with a more pronounced degree of proliferative vitreoretinopathy and preservation of antioxidant defense mechanisms. The results of stepwise discriminant analysis of the statistical characteristic F, which determines the weighting coefficient of the relationship in the regression equation of the basic AOA parameter with each indicator in the general array, determined the following most informative indicators (F > 3.0) of the visual system of patients with OS associated with antioxidant protection: in an adult practice — BCVA, QOL, PI, PESR, PS; in pediatric practice — BCVA, PI, PESR, PS. The obtained similar results of statistical analysis for children and adults are actualized by research in pediatric practice aimed at increasing the clinical effectiveness of vitrectomy for RD based on antioxidant protection methods tested in adult practice.

Рurpose. A comparative analysis of clinical and morphological features of retinal detachment (RD) in pediatric and adult practice.Materials and methods. A retrospective analysis of 100 case histories of patients with a confirmed diagnosis of RD in children aged 7 to 18 (mean age 12.6 ± 1.2 years) and adults aged 19 to 80 (mean age 56.8 ± 2.4 years) was performed prior to standard surgery (subtotal vitrectomy with endolaser coagulation and filling of the vitreous cavity with tamponade substances) and 6 months after it. The main parameters for the comparative analysis were gender, age, RD type, cause (risk factor), stage of development of proliferative vitreoretinopathy (PVR), best corrected distance visual acuity, intraocular pressure, presence of postoperative complications, anatomical adherence of the retina after surgery, the fact of reoperation. Statistical analysis was carried out according to two criteria — chi-square and Fisher's test.Results. Statistically significant differences in the type and cause (risk factors) of RD, were found. In children, rhegmatogenous RD was less common than in adults (69 % of cases compared with 80 % of cases), while traction RD was more common in children (29 % of cases compared to 19 % of adult cases). The C stage of PVR development in children were found to be almost twice as common as in adults. Postsurgical outcomes were found to be significantly higher in adults compared with children.Conclusion. RD type, causes and outcomes are statistically different in pediatric and adult practice. Significantly less successful functional and anatomical results of RD surgery in children reflect differences in etiology, pathogenetic features (PVR stage) of the disease, as well as an increased risk of postoperative complications.

The purpose: to evaluate the effectiveness of the Delfanto® in the complex therapy of patients with dry eye syndrome of various etiologies and severity of the clinical course.Patients and methods. 114 patients (228 eyes) with dry eye syndrome of various etiologies were examined: 72 patients with chronic meibomian blepharitis and dysfunction of the meibomian glands (xerosis due to increased evaporation of the tear film), 33 women with perimenopause (a mixed form of xerosis with a predominant decrease in the production of components of the tear film) and 9 persons with Syegren syndrome (xerosis due to a pronounced decrease in tear production). All patients received individually selected tear replacement therapy over the past weeks and the drug was not replaced throughout the study. At the same time, patients with mild and moderate clinical course of SSG for 30 days received Delfanto® at a dosage of 60 mg, and with severe course — 120 mg per day.Results. All patients on the background of complex therapy showed a significant decrease in the severity of subjective manifestations of the dry eye syndrome, an increase in the of the tear film stability and indicators of tear production. At the same time, the dynamics of changes in these parameters of the course of the xerotic process increased as the therapy continued, reaching a maximum by the 30th day. The maximum effect of Delfanto® in the complex therapy of patients with dry eye syndrome was observed in patients with chronic meibomian blepharitis. Moreover, patients with a mild clinical course of cornealconjunctival xerosis were the most susceptible to the therapy.Conclusion. The effectiveness of the complex therapy for patients with dry eye syndrome can be significantly increased by prescribing Delfanto® in a daily dose of 60 mg for mild and moderate xerosis and 120 mg — for severe disease. Delfante® can be recommended for widespread clinical use in complex treatment of patients with various clinical and pathogenetic forms of dry eye syndrome.

Purpose: to analyze the monitoring of patients with primary and advanced stages of glaucoma, who applied to the private clinic “Tri-Z” (Krasnodar).Patients and Methods. A total of 3 524 patients underwent screening with a diagnosis of glaucoma for all over 2018 at the clinic, of which 55.6 % were diagnosed with primary and advanced glaucoma. The criterion for inclusion in the study was primary glaucoma of the initial and advanced stages, elimination criteria: high degree of refraction errors, retinal detachment in anamnesis, proliferative diabetic retinopathy, AMD exudative forms, congenital forms of glaucoma, secondary types of glaucoma.Results: The average age of patients was 68.44 ± 8.142 years, women were 71 %, men — 29 %. The average duration of glaucomatous history was 3.48 ± 3.525 years. POAG was found in 85.3 % of cases, PACG in 14.7 % of cases. Glaucoma without concomitant PEX was observed in 44.7 % cases, with signs of PEX in 55.3 % cases. In stage I of glaucoma, the majority of patients (42.7 %) received APG and in 27.1 % cases a fixed combination of ICA + BB. In stage II glaucoma, the majority of patients (26.5 %) received a fixed combination of ICA + BB, in 18.8 % of cases, the combination of APG + ICA + BB and in 17.7 % — APG. The share of laser interventions: LTP — 14.7 %, SLT — 4.1 %, peripheral iridectomy — 10 %, YAG-GP — 0.8 %, SLT + YAG-GP — 0.8 %, peripheral iridectomy + SLT — 0.5 %. The share of surgical interventions: at glaucoma stage I non-penetrating deep sclerectomy (NPDS) — 3.4 %; at stage II NPDS — 10.9 %, repeated NPDS — 0.5 %, deepsclerectomy — 2.2 %; phacoemulsification + IOL — 21.9 % of cases.Conclusion: In the study, we noted the following features: use, including as a starting therapy, effective drugs or their combinations; the preferred use of fixed combinations; prioritization of non-preservative therapy; high frequency of laser interventions in the anterior eye segment; use of peripheral laser iridectomy in the overwhelming majority of cases when PACG is detected; early transition to surgical treatment.

Objective: To compare corneal endothelial indexes in eyes with pseudoexfoliation syndrome (PEX) and without it, and identify the dependence of corneal endothelial cell density (CD) on the age and stage of glaucoma.Patients and Methods: The study included 55 people (96 eyes). There were 53 eyes with PEX and 43 eyes without it. Patients were divided into 2 age groups: 40–60 years (41 eyes) and 61–80 years (55 eyes). The groups were homogeneous with respect to the level of IOP, Central corneal thickness, anteposterior axis of the eye and the stages of glaucoma. Endothelial microscopy was performed on a SP-3000P (Topcon). Statistical processing was made with "SPSS 16.0 for Windows"(methods of variation statistics, discriminant analysis).Results: There were significant difference in eyes with PEX and without PEX in CD in ages of 40–60 years (2309,57±87,77 cells/mm2 and 2642,39±64,81 cells/mm2, p=0.005) and 61–80 years (2247,02±59,5 (cells/mm2 and 2590,18±93,39 cells/mm2, p=0.004), as well as in the average surface area of endothelial cell (434,08±17,43 µm2 and 385,17±9,57 µm2, p=0,024; 461,14±15,23 µm2 and of 395.00±13,21 µm2, p=0.002, respectively).There was age difference of CD reduction: the highest CD was at 40–50 years (2722.75±63.05 cells/mm2), and at 81–90 years if fells to 1872.67±417.29 cells/mm2 (at a given age are found only patients with PEX). Revealed that the CD is dependent on the stage of glaucoma: the density was highest in the absence of glaucoma (2603.00±162.61 cells/mm2) and at an initial stage of glaucoma (2480.65±48.88 cells/mm2), while the density was lowest at stage 3 of glaucoma (2118.73±150.51 cells/mm2). Here reducing of the CD was due to patients with PEX, while in patients without PEX the differences were not statistically significant in different stages of glaucoma.Conclusion: Our study showed that the eyes with PEX are characterized by a more pronounced damage to the corneal endothelium, than eyes without it. The condition of endothelium cells worsens in eyes with PEX, depending on the age and stage of glaucoma. Thus, the performing of endothelial microscopy can be seen as a necessary tool in the monitoring of patients with PEG for the solution of a question on tactics of treatment and timely phacoemulsification.

Aim. Comparative study of choroidea, retina ganglion cell complex (GCC) and regional hemodynamics in primary open angle (POAG) and pseudoexfoliative glaucoma (PEG) patients.Materials and methods. 40 POAG patients and 36 PEG patients with the same disease stage were observed. MD –1.52±0.27 in POAG group and –2.38±0.35 in PEG group (p = 0. 069). Subjects were age-matched (ranged from 60 to 70 years: 69.41±1.207 66.32±0.75 in PEG group;p = 0.32) and comparable for axial eye length (24.08±0.38 in POAG group, 23.48±0.27 in PEG group; p = 0.208).Results. Significant difference in focal loss of retinal ganglion cells (FLV) between POAG and PEG groups was revealed (1.875±0.399 and 3.535±0.684, respectively; p = 0.035). Choroidea thickness decrease was discovered in PEG patients as compared with POAG patients: 219.55±17.81 and 266.93±15.9, respectively, at the fovea (p = 0.048);and 117.1±10.1 and 158.3±14.8, respectively, at the peripapillary area (p = 0.026). The reduction of blood flow velocity in ophthalmic artery (29.08±2.38 cm / sec), central retinal vein (5.22±0.29 cm / sec) and superior ophthalmic vein (5.22±0.29 cm / sec) were observed in PEG group as compared with POAG group (34.10±1.47, 7.54±0.53 and6.47±0.33 cm / sec, respectively). The significance of these differences is confirmed by the following data: p = 0.05 (for Vsyst in ophthalmic artery), р = 0.012 (for Vsyst in central retinal vein) and p = 0.007 (for Vmean in superior ophthalmic vein).Conclusion. At the same disease stage, PEG is characterized by greater choroidea thinning, GCC damage and reduced blood flow in large retrobulbar vessels as compared with POAG.