Glaucoma is worldwide the most common cause of irreversible blindness. Its prevalence in the population older than 40 years is about 3.5 %, and correlates with age. The most common type is primary open-angle glaucoma (POAG). The global prevalence of POAG is expected to grow from 76.0 million in 2020 to 111.8 million by 2040. In 2022, a total of 1,250,558 patients with glaucoma were registered in the Russian Federation, of which 110,680 had newly diagnosed glaucoma. The overall glaucoma incidence rate in Russia shows a steady growth: in 2022, it increased by 30 % as compared to 2013. In order to meet the challenge, medical care of glaucomatous patients is on the rise: the contingent receiving dispensary observation increased by 6.8 % over the last 10 years,  whilst surgical treatment involved 28.1 % more patients.

Purpose: to assess the clinical course of metastatic orbital tumors (MOT) and the results of instrumental examination of patients. Material and methods. 50 MOT patients aged 5–84 years (ave. 56.9 ± 14.3), including 41 women (82 %) and 9 men (18 %), were examined for the clinical signs, the laterality of the lesion, the size and shape of the tumor, the presence of oncology in the clinical history and its duration. All patients underwent ultrasound examination with color Doppler imaging (CDI), plus computer tomography (CT) or magnetic resonance imaging (MRI) of the orbits. In all cases, the diagnosis of MOT was confirmed morphologically. Results. 32 (64 %) patients had an oncology history, which lasted from 9 months to 23 years (median 5 years). The most frequently observed metastases were those of breast cancer (27 cases, 54 %), while other types occurred much less frequently: metastases of kidney cancer (4 cases) and stomach (3 cases), cancers of the reproductive systems (2 cases), melanoma (3 cases), thyroid cancer (1 case), and sarcomas (4 cases). The primary focus could not be detected in 3 patients (6 %). OD/OS orbit damages were observed in 23 patients (46 %)/ 21 patients (42 %), while 6 patients (12 %) had bilateral damages. Clinical symptoms included exophthalmos (35 cases, 70 %), enophthalmos (6 cases, 12 %), eye movement impairment (35 cases, 70 %), ptosis (35 cases, 70 %), eyelid edema (24 cases, 68 %), pain in the orbit (7 cases, 14 %), chemosis (12 cases, 24 %), difficulty in eye repositioning (32 cases, 64 %). Decreased visual acuity was noted in 13 cases (26 %). CT symptoms included infiltrative nature of the lesion (43 patients, 86 %), and solid tumors with clear and even contours (7 patients, 14 %). Bone wall changes were detected in 7 patients (14 %). Ultrasound data revealed a heterogeneous structure and an increased acoustic density of MOT. CDI detected own vessels in the projection of the tumor (15 patients). Conclusion. Orbital metastases present a multidisciplinary problem, which requires mandatory monitoring by physicians of various specialties, as only 36% of patients have no oncology in their clinical histories. Specific history features, the patient’s complaints, typical clinical symptoms, CT (MRI) and ultrasound data should alert the ophthalmologist about a possible MOT. A mandatory examination of patients with malignant neoplasms by an ophthalmologist is necessary to exclude ocular metastases.

Purpose. To evaluate the effectiveness and safety of direct current cornea fulguration in the treatment of drug-resistant keratitis. Material and methods. 20 patients (20 eyes) diagnosed with drug-resistant infectious keratitis (bacterial, acanthamoeba, fungal), underwent fulguration of the infiltration zone with plasma electrocautery. In addition to a standard ophthalmological examination, all patients were tested for corneal thickness and lesion depth before surgery and 1 day, 1 month, and 3 months after surgery by anterior segment optical coherence tomography (OCT). After photofixation of the cornea, OCT data were used to dynamically assess the lesion area and deepithelialization. Results. In 95 % of cases (19 eyes), the infectious inflammatory process could be stopped in 3 to 7 weeks, with the opacification onset in the stromal layers of the cornea 2–3 weeks after the procedure. In these cases, after 2 weeks, the infiltrated or corneal ulcer area was completely epithelialized. Over a long postprocedural period (3 months), the corneal thickness in the inflammation area varied from 285 µm to 791 µm. During the entire observation period, the integrity of the cornea was maintained and transparency improved. 3 months after surgery, the average visual acuity corrected by spectacle lenses increased from 0.42 ± 0.35 to 0.54 ± 0.33. Conclusion. Direct current fulguration can be an effective and relatively safe urgent treatment for drug-resistant infectious keratitis.

Currently, endothelial vascular dysfunction, leading to ischemia of the optic disc and compression of the optic nerve axons, is considered to be one of the main mechanisms underlying the development of primary open-angle glaucoma (POAG). Purpose: to assess the severity of endothelial dysfunction (ED) in patients with different stages of POAG receiving complex therapy. Material and methods. 94 POAG patients were divided into three groups depending on the type of treatment. Group 1 (29 patients, control) received traditional therapy: 1 % emoxypine parabular injections, 5 % pyridoxine hydrochloride and 5 % ascorbic acid intramuscularly, and piracetam tablets.  Group 2 (34 patients) additionally received combined therapy: Clexan 4000 iu, 0.5 mg lymphotropically and Omega-3 capsules. Group 3 (31 patients) received, in addition to traditional therapy, Clexan 4000 iu, 0.5 mg lymphotropically, intravenous injections of 10 ml Cytoflavin dissolved in 200 ml of 5 % glucose solution (later to be replaced by tablets), and 1 capsule of Omega-3 three times a day for one month. Before and after the course of treatment, levels of endothelin-1, VEGF and Willebrand factor in blood serum were measured by immunoenzymatic assays using Human test systems (Germany). Results. Traditional treatment of the patients’ cohort provides an insignificant reduction of endothelin-1 but does not affect endothelial dysfunction. Complex therapy with the addition of Clexan and Omega-3 helped reduce the amount of endothelin-1 and the Willebrand factor. The most pronounced changes were observed when cytoflavin was added: from 42.9 ± 3.4 ng/ml to 34.9 ± 2.9 ng/ml and from 50.8 ± 4.7 ng/ml to 32.1 ± 2.4 ng/ml, respectively (p < 0.05). Conclusion. An increased level of endothelin-1 and Willebrand factor, as well as a low VEGF level in POAG patients indicate the role of these pathogenetic factors in the formation of endothelial dysfunction. The correction of ED marker levels in patients with different POAG stages using the proposed compound therapy confirm its effectiveness.

Ocular allergies are a group of diseases that affect the surface of the eye and are usually accompanied by type 1 hypersensitivity reactions. Purpose: to evaluate the clinical manifestations of allergic conjunctivitis and compare the effectiveness and comfort of using epinastine 0.05 % and olopatadine 0.2 % in its treatment. Material and methods. The comparative study involved 106 people: 45 female students (42.4 %) and 61 male students (57.5 %), divided into 2 groups. Group I (64 people, 128 eyes) with seasonal allergic conjunctivitis (SAC) received olopatadine 0.2 %, 1 drop twice a day for 30 days, Group II (42 people, 84 eyes) with atopic keratoconjunctivitis (AKC) received epinastine 0.05 % (Epinepta®) 1 drop twice a day for 8 weeks. The condition of the ocular surface was assessed using the OSDI (Ocular Surface Disease Index), and the severity of allergic symptoms was assessed in points using the SCORAD index (scoring atopic dermatitis). The control group III consisted of 20 students with dry eye syndrome (DES) of mild severity (according to the OSDI index) caused by visual work on a computer, who used no medications at the time of the study. Results. After treatment, the decrease in mean OSDI and SCORAD scores was more pronounced in group II. Patients receiving epinastine 0.05 % reported significantly less ocular discomfort and itching than patients receiving the alternative drug (olopatadine 0.2 %). In both experimental groups, the Schirmer test showed a statistically significant increase in the volume of total tear production (p < 0.05) after the treatment, which was more pronounced in group II (Epinepta®). Conclusion. Epinastine 0.0 5% (Epinepta®) can effectively relieve the main symptoms of the disease due to its high affinity for histamine receptors, minimizing the risk of developing dry eye syndrome.

Purpose: to analyze the effectiveness of transferring open-angle glaucoma patients to therapy with a preservative-free fixed combination of a carbonic anhydrase inhibitor and a prostaglandin analogue. Material and methods. The study involved 58 people (24 men and 34 women), averagely aged 61.2 ± 7.1, diagnosed with stages II–III POAG and degree of compensation a-b (according to the Nesterov-Bunin classification). The patients were divided into three groups. Initally, Group 1 (22 people, 30 eyes) had received monotherapy with a beta-blocker (timolol), Group 2 (20 people, 27 eyes) had received monotherapy with the original prostaglandin analogue drug (latanoprost), and Group 3 (16 person, 19 eyes) had had therapy with the original drug, namely a fixed combination of a beta-blocker (timolol) and a prostaglandin analogue (latanoprost)). All patients were prescribed antihypertensive therapy with a fixed combination of a carbonic anhydrase inhibitor (dorzolamide) and a prostaglandin analogue (latanoprost) — the drug Dorzoprost, which was administered according to the standard regimen. We assessed the dynamics of intraocular pressure (IOP), perimetric indices, morphometric indicators of the optic nerve, tolerability of the drug regarding the effect on the ocular surface and safety regarding potential systemic side effects. Results. After 1 month of therapy, IOP significant decreased by 7.5 mm Hg (32 % of the initial value) in Group 1, by 3.7 mm Hg (19 %) in Group 2, and by 1 mm Hg (5 %) in Group 3. At month 3 and month 6, the hypotensive effect stabilized with respect to the previous control measurements (taken at 1 month) in all three groups. The morphometry of the optic nerve and the dynamics of perimetric indices showed no progression of glaucomatous optic neural opticopathy and no local or systemic undesirable effects of the therapy that could affect the compliance of the treatment. Conclusion. The Dorzoprost drug has demonstrated a high hypotensive efficiency when transferring patients from various basic therapy regimens and can be considered the drug of choice for patients with symptoms of keratoconjunctival xerosis and concomitant organ pathology requiring the use of systemic β-blockers.

Purpose: to evaluate the clinical effectiveness of using green lens glasses to reduce IOP in healthy people during psychoemotional stress. Materials and methods. IOP variation was estimated for 23 students, who alternatively wore green lens glasses for 1 hour and did not wear them. The research was done during classwork so the students experienced intense mental load. Results. With no chromatic optical correction, the average IOP which initially was 15.45 ± 2.37 mm Hg (95% CI: 13.75–17.15), increased after one hour up to 16.85 ± 2.40 mm Hg (95% CI: 15.13–18.57), which was statistically significant (p = 0.029). In the chromatic correction experiment, the initial average IOP was 16.15 ± 2.73 mm Hg (95% CI: 14.87–17.43), and only slightly increased after one hour to reach 16.48 ± 3.0 mm Hg (95% CI: 15.04–17.91), and the change was statistically insignificant (p = 0.526). Side effects of green lens glasses, specifically a change in colour perception, were registered in 96% of the students observed. Conclusion. Green lens glasses reduce the rate of IOP elevation under psychological stress. However, we have not received any information about an IOP decrease achievable by such glasses.

Purpose: to analyze the frequency of GNAQ/GNA11 mutations in circulating tumor DNA and tumor tissue, and the frequency of genotypes of polymorphic marker C3435T of ABCB1 gene in patients with iris melanoma. Material and methods. The study included 139 patients with uveal melanoma (UM) followed in 2011–2023. The experimental group included 46 patients with iris melanoma (n = 20, group I) and ciliary body involvement (n = 26, group II), who underwent a molecular genetic study. The comparison group III consisted of 30 UM patients managed in 2012. Morphologically, uveal melanoma was verified in all cases. Results. No mutations in the GNAQ/GNA11 genes were identified in group I. In group II, one heterozygous mutation in the GNAQ/GNA11 genes was detected in 2 patients (7.7 %). No significant associations with clinical or pathomorphological features were found (p > 0.1). In the comparison group III, mutations in the GNAQ/ GNA11 genes were detected in 27 patients (90 %). When comparing the frequency of heterozygous mutations in the GNAQ/ GNA11 genes significant differences between the experimental groups and the comparison group were revealed (F = 0.0000001, χ² = 56.45). The CC genotype of the C3435T polymorphic marker of the ABCB1 gene was found in 90 % (F = 0.026418, χ² = 5.36, significantly more frequently than in group III), in group II — in 92.3 % (F = 0.006183, χ² = 7.75, significantly more frequently than in group III), in group III it was found in 60 %. The TT genotype was not detected in any group. Conclusion. This study has shown that the frequency of mutations in GNAQ and GNA11 genes, the frequency of CT genotype of ABCB1 polymorphic marker C3435T gene in iris melanoma is significantly lower than that in choroid melanoma, indicating a relatively favorable tumor behaviour.

Purpose. To evaluate the effectiveness and safety of monotherapy and combination therapy with Moxifloxacin-Optik and Mitraseptin-OphthalmoLOR drugs for the treatment of infectious complications after reconstructive operations on the accessory apparatus of the eye performed for congenital, post-traumatic, and senile pathology. Material and methods. 90 patients aged 18 to 75 years (M = 58.46 ± 7.31) with various pathologies of the auxiliary apparatus of the eye — 21 men (23.3 %) and 69 women (76.7 %) were included in the study. At the screening stage, 31 patients who showed signs of bacterial conjunctivitis were given a 7-day mono- or combined antimicrobial therapy, followed by an efficacy control according to bacteriological testing data. After 1 month, all 90 patients were divided into three groups depending on the therapy regimen. Group 1 (n = 30) had monotherapy with Moxifloxacin-Optik which started after the surgery and lasted up to 14 days. Group 2 (n = 30) had sequential therapy with Mitraseptin-OphthalmoLOR for 3 days before surgery and with Moxifloxacin-Optik for up to 14 days after surgery. Group 3 (n = 30) received combination therapy: Mitraseptin-OphthalmoLOR for 3 days before surgery and Mitraseptin-OphthalmoLOR + Moxifloxacin-Optician for up to 14 days after surgery. All patients had reconstructive plastic surgery on the auxiliary apparatus of the eye and underwent a standard ophthalmological examination before surgery and 3, 7 and 15 days after it. Results. All antimicrobial treatment plans showed high clinical effectiveness in the operated patients. The combined therapy with the antiseptic Mitraseptin-OphthalmoLOR and the antibiotic Moxifloxacin-Optik which brought about the greatest degree of eradication of conjunctival microorganisms (up to 100 %), has a pronounced antimicrobial effect, effectively controls the inflammation and reduces the therapy duration by 36 %, ensuring the best clinical tolerability. Conclusion. The use of various methods of antibiotic prophylaxis reduced the amount of bacterial microflora of the conjunctiva. The most effective method of preventing postoperative infectious complications is combined therapy with an antiseptic and an antibacterial drug.

Ultraviolet cross-linking (UVCL) of corneal collagen is one of the leading methods for treating primary progressive keratectasia. Purpose: to evaluate the effectiveness and safety of a new Russian-produced device for UVCL, KERATOLINK, in treating patients with stage I–II keratoconus and pellucid marginal corneal degeneration (PMCD). Material and methods. UVCL was performed in 36 patients (46 eyes) aged 18 to 35 years, including 22 patients (30 eyes) with stage I–II keratoconus and 14 patients (16 eyes) with PMCD. Three programs were used: 1 — standard UVCL with radiation intensity from 2.5 to 3.0 mW/cm2 and 30-minute exposure time (8 patients, 10 eyes); 2 — accelerated UVCL 1: from 8.0 to 9.0 mW/cm2 and exposure time 10 min (20 patients, 25 eyes); 3 — accelerated UVCL 2 with radiation intensity from 16.0 to 18.0 mW/cm2 and 5-minute exposure time (8 patients, 11 eyes). The patients were examined before UVCL, then a week, 1, 3, 6 months after it. The examination included vision acuity, autorefkeratometry, biomicroscopy, Scheimpflug analysis on a Galilei G6 device (Ziemer, Switzerland), optical coherence tomography of the cornea (Anterion, Heidelberg Engineering, Germany), aberrometry (OPD-scan III, Nidek, Japan), confocal biomicroscopy (ConfoScan 4, Nidek, Japan), and determination of biomechanical parameters of the cornea - corneal resistance factor (CRF) and corneal hysteresis (CH) on an ORA device (Reichert Inc., USA). Results. 6 months after UVCL, an increase in visual acuity from 0.56 ± 0.16 to 0.68 ± 0.13 was noted in stage I-II keratoconus, and from 0.66 ± 0.17 to 0.75 ± 0.14 (p < 0.05) in PMCD. Flattening of the cornea at the steepest point increased from 54.46 ± 4.39 to 52.87 ± 4.26 D and from 52.64 ± 2.88 to 51.53 ± 2.84 D, while the rigidity increased in CRF from 6.93 ± 1.00 to 8.38 ± 1.00 mm Hg and from 8.02 ± 0.68 to 9.13 ± 0.97 mm Hg. (p < 0.03), and CH increased from 7.64 ± 0.47 to 8.61 ± 0.73 mm Hg and from 6.89 ± 1.20 to 8.17 ± 0.90 mm Hg (p < 0.05). The analysis of various UVCL programs revealed no difference in the recovery period and showed comparable clinical and functional results. Conclusion. The new KERATOLINK device is shown to be effective and safe in the treatment of stage I–II keratoconus and PMCD. A decrease in ophthalmometry indicators, and an increase in corneal rigidity and visual acuity indicate an improvement in the optical and biomechanical properties of the patients’ cornea and stabilization of the pathological process. The use of local UVCL and accelerated algorithms with a significant reduced exposure time improves the comfort and tolerability of the procedure, and also reduces the risk of complications. The KERATOLINK device provides a personalized approach to the treatment of patients due manual and stationary use options, the availability of standard and accelerated UVCL programs, providing for the choice of power and duration of the procedure, with smooth adjustment and fixation of the size and the area of treatment. The laser focal length control system ensures the maintenance of the required UVCL intensity regardless of the size of the impact spot. It has good prospects for clinical practice.

Purpose. The aim of the work is to compare the time of epithelization and the change in the thickness of the cornea in the treatment of erosions after corneal burns of 2–3 degrees and ulcers after keratitis with preserved amnion and amnion saturated with autologous PRP lysate. Materials and methods. To compare the effectiveness of preserved amnion and lysate-soaked PRP, 2 groups of patients were identified: the main group (amnion saturated with lysate PRP) and the comparison group (amnion without lysate PRP). Each group included patients with erosions after recent burns with an average area of 60 % of the cornea and ulcers after keratitis with a corneal thickness at the bottom of the ulcer of 382 microns in the experimental group and 393 microns in the comparison group. In the comparison group, ulcers were treated by covering the cornea with an amniotic membrane for 7–14 days, after which the amnion was removed and the condition of the cornea was monitored. An amniotic membrane saturated with PRP lysate was used in the experimental group. PRP lysate was made from autologous blood of patients in the laboratory of cell transplantation and immunotyping of the N.V. Sklifosovsky Research Institute of Emergency Medicine using a patented technology. To do this, platelet-rich plasma (PRP) with a platelet content of over 1000 thousand/ml was isolated from the blood of donors, which was then frozen at -80 °C and thawed at 0–4 °C in order to destroy cell membranes. Assessment of the condition of the cornea was carried out using clinical and instrumental studies, including biomicroscopy with fluorescein staining, photoregistration and OCT on the Heidelberg Engineering “OCT Spectralis” apparatus. Results. The use of an amniotic membrane saturated with PRP lysate led to epithelialization of erosions after recent burns in 1.3 months and a decrease in corneal edema by 247 microns, epithelialization of ulcers after keratitis in 1.3 months and an increase in the thickness of the cornea at the bottom of the ulcer by 62.5 microns. Treatment with conventional preserved amnion took 1.8 months before complete epithelization in recent burns with a decrease in corneal stroma edema by 193 microns, and epithelization of ulcers after keratitis required 1.6 months and ended with an increase in the thickness of the cornea at the site of the ulcer by 42 microns. Conclusion. The study showed that the presented method of treating erosions and ulcers of the cornea of various genesis using an amniotic membrane saturated with autologous PRP lysate allows achieving complete and persistent epithelialization in a shorter time and with fewer amnion coatings, unlike the comparison group. At the same time, patients do not need additional conservative treatment of epitheliopathies.

A new method of adaptive control of infusion during phacoemulsification (PE) based on the Optimed Profi (Optimedservice) surgical system was developed, allowing calculation of the predicted volume of post-occlusion surge (POS) by monitoring aspiration and infusion flow rates. Purpose. To compare POS amplitude, predicted and actual volumes of POS during experimental ex vivo PE on cadaveric porcine eyes, between Optimed Profi and Centurion Vision surgical systems. Material and methods. For two experimental PE series of 10 operations on porcine eyes, the mean POS amplitude (mm Hg) was measured using a pressure sensor in the anterior eye chamber. Predicted and actual POS volumes were assessed using a non-contact aspiration-line flowmeter sensor by varying aspiration flow rate depending on the phaco needle patency. The parameters were compared between the series using the Student t-test. Results. The mean POS amplitude during PE by Optimed Profi and Centurion Vision System was 12.10 ± 0.21 and 13.3 ± 0.3 mm Hg, respectively (p < 0.001). The mean value of the predicted POS volume during PE by Optimed Profi and Centurion Centurion Vision System was 136.80 ± 9.59 and 146.00 ± 9.46 μm, respectively (p > 0.01). The mean value of the actual POS volume during PE by Optimed Profi and Centurion Vision System was 135.30 ± 4.97 and 158.50 ± 8.63 μm, respectively (p < 0.01). Conclusion. The lower values of POS amplitude and predicted and actual volumes of POS in the series using the new method of adaptive infusion control may indicate a better hydrodynamic stability in experimental PE.

Purpose: the article presents arguments for changing the traditional operation name “micropulse cyclophotocoagulation”. In accordance with the potential mechanisms involved, a new name is proposed — “micropulse transscleral laser cycloplasty”.

A clinical case of a severe toxic lesion of the cornea in the form of an extensive ulcer in the only seeing eye (left) due to a prolonged use of the local anesthetic oxybuprocaine is presented. The patient (who had lost the object vision in the right eye after a penetrating injury of the eyeball) started using the drug for the first time on his own accord, without informing the attending physician, 2 months before referring himself to the Ufa Research Institute of Eye Diseases due to the development of recurrent keratoconjunctivitis, accompanied by severe pain. The patient combined oxybuprocaine instillations 4–6 times a day with the prescribed anti-inflammatory therapy, including local application of steroid drops. This led to the development of a corneal ulcer, complicated by a toxic allergic reaction. The fact of a long-term unauthorized use of oxybuprocaine was discovered in a confidential talk with the patient. Subsequent in-patient and long-term out-patient treatment involving reparative, anti-inflammatory, antibacterial and antiviral therapy, helped achieve gradual epithelialization of an extensive corneal defect resulting in vascularized opacification and an increase in visual acuity of the only seeing eye to 0.5 with correction. The case demonstrates the need to increase the awareness of ophthalmologists, who should not disregard possible corneotoxic lesions in their differential diagnosis. In addition, the patients should be informed about severe complications and their consequences associated with self-administration and prolonged use of local anesthetics.

Vasculitis of the retina and the optic nerve is one of the most complex, rare and challenging issues in clinical ophthalmology. Managing patients with this diagnosis is difficult because practical ophthalmologists lack sufficient experience, clinical manifestations and courses of the disease are versatile and technical means of full-scale diagnostics and observation, including fluorescein angiography are limited. The report illustrates a particular case of optic nerve vasculitis in a young female patient. We assumed that an infectious mononucleosis that she had experienced led to immune dysfunction and the development of autoimmune vasculitis of the optic nerve. An immunosuppressive therapy was prescribed, which allowed achieving a good clinical result.

Purpose. To evaluate the clinical efficacy of IOL implantation with a wavefront formation mechanism as part of cataract surgery of patients who underwent penetrating keratoplasty. Material and methods. 4 patients – one man and three women (4 eyes) (1 man, 3 women) aged 24 to 58 underwent phacoemulsification after penetrating keratoplasty (PKP) (performed in all patients more than 1.5 years ago, in 3 cases for keratoconus IV, in 1 case due to herpetic keratitis). The corneal sutures were removed 1 year after the PKP in all patients. All patients received cataract phacoemulsification through a 2.2 mm corneal tunnel. In one case, Alcon AcrySof IQ Vivity was implanted, in three cases, who had had corneal astigmatism, the same model was used but with a toric component. The IOL calculation was based on current optical biometrics data (IOL-Master 700, Carl Zeiss, Germany) and Scheimpflug-keratotopographic measurements (Oculyzer, Alcon, USA). The optical power of the IOL was calculated by the formulas of Barrett True K, Kane, Barrett Universal II, Hoffer Q, and Haigis. Results. It all cases, surgeries had no complications. Visual acuity, both with (BCVA) and without correction (UCVA), increased with respect to preoperative values in all cases (before surgery, mean BCVA values were 0.05; after surgery, 0.55; mean UCVA values before surgery, 0.34; after surgery, 0.68). The average observed cylindrical component of refraction before the opening operation was 2.25 D; the implantation of a toric IOL reduced it to 1.13 D. In all cases, a smooth transition of the defocusing curve from +0.5 D to -1.5 D (corresponding to 66 cm) was observed. The most effective formulas achieving target refraction were those by Kane and Barrett True K. Conclusion. The paper presents Russia’s first clinical experience of using IOL with a wavefront formation mechanism Alcon IQ Vivity и Vivity Toric in patients who underewent penetrating keratoplasty. In all cases, these IOLs were calculated and implanted taking account of the initial corneal astigmatism, which made it possible to significantly improve both BCVA and UCVA with a smooth transition to the middle distance. Despite the high values of higher order aberrations, none of the operated patients complained of undesirable photopic phenomena, such as halos and glare, which are inherent in intraocular lenses with diffractive technology.

With the development of strabismology, the issues of using Botox in various eye movement pathologies are gaining relevance. The literature analysis shows that the data concerning the effectiveness of Botox are ambivalent and as a rule, are based on short-term results. The review presents the data on the efficiency of the botulinum toxin in the treatment of various oculomotor system diseases in comparison with traditional surgical interventions. Indications for such therapy, application techniques, doses and complications are discussed. The generalized modern data on the functional features of the onset of various pathologies in strabismology help assess the potentials of optimizing strabismus treatment with type A botulinum toxin. To search for the data published between 1973 and 2022, select and summarize them we used Google Scholar, PubMed and eLibrary databases.

The review discusses the current state of affairs and prospects for the use of virtual reality (VR) technologies in visual rehabilitation strategies based on neuroplasticity activation. Vision training in VR has a number of advantages compared to traditional rehabilitation activities. Play-based VR exercises, practices in a safe and controlled environment, attract the users and encourage them to actively participate in therapy and comply with the treatment plan. VR systems have options that enable the creation of individual treatment programs tailored to the specific needs and abilities of each patient. VR systems are only beginning to be used in the rehabilitation of visually impaired but on the whole show promising results already. Yet, more careful evaluation of the results and additional research are required to overcome the existing limitations of the approach, such as a small size of the sample and lack of control groups. Objective diagnostic methods are needed to create a solid and high-quality evidence base. It seems promising to expand the potentials of VR technologies for visual rehabilitation of diverse retinal pathology patients by combining visual training in the virtual world with rhythmic photostimulation using optimal parameters of optical signals.

This article presents a literature review on visual impairments in COVID-19 and post-COVID syndrome and their possible pathogenesis. The data on possible cellular targets of SARS-CoV-2 in various damaged eye structures are discussed. The proposed approaches to the treatment of eye disorders in COVID-19 are reviewed. The main attention is given to the recently discovered family of cation channels — the channels with a transient receptor potential, or TRP channels, as possible targets of SARS-CoV-2 action on eye cells. The structure and properties of TRP channels, in particular their ability to act as receptors for temperature, pain and inflammation, and to participate in phototransduction, are examined. TRP channels are shown to be present in the anterior and posterior segments of the eye. The relationships are explored between TRP subfamilies, in particular TRPV1 channels, and various pathologies, such as dry eye syndrome, glaucoma, eye trauma, retinopathy, etc. Evidence is provided for a direct involvement of TRP channels in the pathogenesis of pulmonary pathology in COVID-19, and their role in the pathogenesis of many other diseases, including neuropathic and inflammatory pain, stroke, migraine, neurodegenerative disorders. The currently known pharmacological approaches targeting TRP channels are discussed. The paper highlights the importance of closely monitoring TRP channels activity, particularly TRPV1 ones, in assessing various COVID-19 manifestations, including eye infections.

In 1908, George Coats published a paper about a rare form of outer retinopathy with massive exudation. Until today, the causes of the Coats’ disease (CD) has not been revealed and there is no generally accepted model of its pathogenesis. It was hypothesized that the condition could be caused by an infectious process or an inflammatory reaction, but there is no consensus about that. Genetic determinants of CD have not been identified, either. A histological examination of CD revealed “cholesterol fissures”, subretinal exudate, massive gliosis, retinal disorganization, vasodilation and hyalinization, diffuse thickening of retinal capillaries and areas of complete absence of pericytes and vascular endothelium, as well as inflammatory infiltrates. The main component of subretinal exudate is intense cell reaction of the macrophages. A study of the cytokine profile showed an increased concentration of VEGF in the subretinal fluid, the level of IL-6 was significantly higher in adult patients and correlated with the degree of exudative retinal detachment. In the eye fundus of CD patients, vascular telangiectasias followed by exudate deposition in these areas have been revealed. Complications of CD include vasoproliferative tumors, neovascular glaucoma, intraretinal and intraocular hemorrhages, vitreous fibrosis, traction retinal detachment, anterior chamber cholesterolosis. CD treatment includes laser coagulation, cryotherapy, intravitreal administration of glucocorticosteroids and angiogenesis inhibitors. In severe forms and advanced stages of CD, vitreoretinal surgery is resorted to. Enucleation may be necessary in some cases.

Searching for methods of treating primary rhegmatogenous retinal detachment (RRD) is a highly relevant issue, since this disease often leads to disability in people of young working age. The history of surgical treatment of retinal detachment began more than 200 years ago and has undergone many changes due to the evolution of knowledge of this disease. In the early 20th century, sealing of retinal breaks was first shown to be a key principle in the treatment of RRD. The two most commonly used surgical techniques today are pars plana vitrectomy and scleral buckling. Over the years, various materials have been studied as possible buckling means. At present, soft silicone fine-pored tape is the gold standard for scleral sealing. Modern laser technologies open up new vistas for extrascleral surgery in the treatment of primary RRD. The advantages of specific individual approaches or combinations thereof are under active discussion.

Diabetic retinopathy (DR) and diabetic macular edema (DME) present a serious medical and social issue of modern society. DME is one of the most common complications of DR and a frequent cause of a sudden decrease in visual acuity and the onset of disability. The review describes the main links of DME pathogenesis, including the participation of inflammatory cytokines, glycation products, reactive oxygen species, vascular endothelial growth factor and various cellular damages. The existing classifications of the disease, instrumental methods of diagnosis and treatment are presented, primarily those using angiogenesis inhibitors alone or in combination with laser treatment and intravitreal injection of an implant with dexamethasone. Various methods of surgical treatment of DR, which can impact the course of DME, are analyzed, including vitreoretinal surgery using vitrectomy with or without membrane peeling of the internal limiting and epiretinal membranes. Factors predicting the effectiveness of these surgical interventions are listed: these can be based on the general somatic condition of the patient and on the results of optical coherence tomography.

Cataract is one of the leading causes of blindness worldwide; its prevalence increases with age, ranging from 3.9 % among 55–64 years old to 92.6 % among those aged 80 years or more. Intraocular lenses (IOLs) are used in cataract surgery to replace the natural human lens and/or correct refractive errors. In recent years, a wide range of IOLs have been developed for the correction of presbyopia, which have surpassed traditional monofocal intraocular lenses. With an increased life duration and lifestyle changes, an increasing number of patients are not content with excellent distant vision alone but wish to have adequate near- and intermediate-distance vision. The review presents modern approaches to the correction of presbyopia by IOLs produced with the help of various technologies. The mechanisms of presbyopia correction, the general principles of multifocal IOL use, extended depth of focus (EDOF) technology, the advantages and drawbacks of individual IOL categories such as multifocal IOLs, improved monofocal IOLs, and deep focus IOLs are discussed. Special attention is given to terminology. Specifically, the concepts of EDOF and multifocal IOLs are distinguished, which however are not mutually exclusive as bifocal IOL, aspherical monofocal IOL, diffraction or refraction trifocal IOL can have EDOF characteristics (with partial range limitation at near distance in order to minimize dysphotoptic complaints). Taking into account the active marketing strategies of IOL manufacturers, the presented data can be useful in clinical practice, facilitating and structuring the relevant information for the ophthalmologist. Innovative solutions in the development of materials, optical platforms and the design of intraocular lenses for intraocular presbyopia correction provide a differentiated approach to achieving high functional results depending on the individual needs of patients.