Disorders of the posterior segment of the eye are traditionally one of the most important medical and social problem. The rapid development in the ophthalmology field in the 20th and 21st centuries has led to a significant improvement in the knowledge on the physiology and pathology of the light-perceiving eye structures, revolutionary achievements in the diagnosis and treatment of a wide range of retinal diseases, optic nerve, choroid and vitreous body pathology. The need for highly qualified physicians with a modern understanding of this problem led to the emergence of an ophthalmological specialization called “retinology”. Modern retinology includes various areas of diagnostics (including visualization of eye structures, electrophysiological and genetic methods), as well as drug, laser and microsurgical treatment and rehabilitation of the patients. In the rapidly developing medicine, sociological research is extremely important, allowing health care organizers to assess existing trends and make decisions determining the development direction in the field, and specialists to exchange opinions and analyze their professional activities. Retinology is no exception. Surveys of professional organizations of retinologists that have great scientific and practical significance are successfully conducted abroad, the most famous of which are the EURETINA Clinical Trends Survey and the ASRS Preferences and Trends (PAT) Survey. In Russia, such surveys have not been conducted to date. At the same time, the opportunity to learn the opinions of Russian specialists, as well as to compare domestic and foreign data is of undoubted interest. In 2024, we organized and conducted the first independent Russian survey of retinologists “SETCHAtochkaRU”, in which 585 ophthalmologists from all federal districts of the Russian Federation took part, as well as our colleagues from Belarus, Kazakhstan, Kyrgyzstan, Latvia, Lebanon, Tajikistan, Turkmenistan, Turkey and Uzbekistan. The main results of the survey are presented in this publication.

Purpose the study — to evaluate the effectiveness of a personalized approach to femtosecond laser fragmentation of the lens nucleus based on densitometry, as well as to analyze the effect of a combination drug (ketorolac + levofloxacin) on perioperative patient management. Material and methods. The study included 64 patients (64 eyes) aged 52 ± 10 with ametropia of various degrees and types, as well as with cataracts of I–III degrees of lens nucleus density according to the PNS and Buratto classification. Preoperative densitometry was performed on Pentacam and Galilei G6. The data were used for personalized selection of femtosecond laser energy and nuclear fragmentation pattern. Patients of group 1 (n = 33) received a combination drug (non-steroidal anti-inflammatory drug (NSAID) and antibiotic), in group 2 (n = 31) — NSAID and antibiotic separately. Results. Personalized femtolaser parameters provided effective fragmentation of the nucleus in all cases. Combined therapy showed advantages over separate therapy in terms of mydriasis stability, inflammation prevention, and treatment adherence. Conclusion. The study confirms the importance of densitometric assessment of lens density and combined drug therapy to improve the efficacy and safety of femtolaser-assisted refractive lens surgery.

Purpose. To evaluate the efficacy and safety of our proposed method for treating keratoconus (Pirogov protocol), including patients with a corneal thickness of less than 450 mm, providing for corneal collagen UV crosslinking in combination with personalized transepithelial photorefractive keratectomy (PRK). Material and methods. Sixty patients (60 eyes) aged 30,6 ± 9,5 with progressive keratoconus stages I–II were divided into two groups: group 1 (30 patients, 30 eyes) received the standard Dresden UV crosslinking protocol, while group 2 (30 patients, 30 eyes) received the Pirogov protocol (one-time corneal UV crosslinking and personalized PRK on the Microscan Visum excimer laser). All patients underwent visometry, refractometry, keratometry, keratopachymetry, keratotopography and optical coherence tomography of the cornea before, immediately after treatment and after 1, 3, 6, 12 and 24 months. Results. In the group of patients operated on according to the Pirogov protocol, after 1 month there was a significant (p < 0.05) increase in uncorrected and best-corrected visual acuity relative to baseline values (before surgery 0.11±0.1 and 0.53 ± 0.22; after 1 month 0.48 ± 0.27 and 0.75 ± 0.2, respectively), improvement in refractive indices (spherical equivalent of refraction decreased from –5.08 ± 0.20 D to –1.04 ± 1.56 D) and keratotopographic corneal indices (KCI, KSI, ESI of the anterior corneal surface, SAI, SRI), the values of which remained stable during 2 years of observation. Similar parameters of the control group did not change significantly during the entire observation period. Conclusion. The developed Pirogov protocol for the treatment of progressive keratoconus stages I–II showed safety and high efficiency.

Purpose of the work was to study the possibility of using transpalpebral tonometry (TPT) using the Tonotest device in younger children (up to and including 5 years old) for screening control of intraocular pressure (IOP). Material and methods. As part of the screening examination, IOP was determined in 46 children (92 eyes) aged 5 months to 5 years, divided into 2 groups. In the 1st group — 21 children (42 eyes) aged 5 months to 3 years (average 1.5 ± 1.0 years) — only Tonotest was used for tonometry, and in the 2nd group — 25 children (50 eyes) aged 3.5 to 5 years (average 4.5 ± 0.6 years) — IOP measurement was performed sequentially (in random order) by two methods — using Tonotest and a pneumotonometer (Reichert 7 AutoTonometer, USA). Results. In most cases, the children tolerated the TPT procedure well and did not complain of discomfort, pain, or any other unpleasant sensations. However, in 7 children (33 %) of the 1st group and in 5 children (20 %) of the 2nd group, behavioral characteristics did not allow measuring IOP. The IOP level according to TPT in the 1st group was 16.4 ± 2.9 mm Hg. In the 2nd group, the IOP value according to Tonotest was 15.1 ± 2.0 mm Hg, according to the pneumotonometer — 16.0 ± 2.1 mm Hg (p = 0.09). Conclusion. The possibility of using TPT for screening control of IOP in younger children (0–5 years old) is shown. Comparison of the results of IOP determination in the group of children aged 3.5–5.0 years using Tonotest and pneumotonometer showed no statistically significant differences between them. TPT using Tonotest allows to expand the possibilities of IOP monitoring in pediatric practice.

Cataract in combination with sarcopenic obesity, which is formed mainly against the background of physical inactivity due to vision deficiency, potentially contributes to a decrease in vitality, however, the study of the vitality of patients with sarcopenic obesity and cataract has not been conducted. Purpose: to analysis of the resilience of patients suffering from sarcopenic obesity and cataract. Material and methods. The study involved 135 patients aged 60–74 with cataracts and 126 patients of the same age with cataract and sarcopenic obesity. All patients underwent a comprehensive clinical and instrumental ophthalmological examination. The appropriate criteria presented in the clinical guidelines were used in the diagnosis of cataract. Sarcopenia was determined by the European Working Group on Sarcopenia in older people scale, supplemented by carpal dynamometry, and obesity was determined by body mass index. Resilience was determined on the Connor — Davidson Resilience Scale-25. Results. A separate assessment of the resilience of elderly patients with cataract and sarcopenic obesity and cataract, according to the integral value of the Connor — Davidson Resilience Scale-25, indicates a more significant level of resilience among patients with cataract and sarcopenic obesity with a statistically significant difference between the compared groups. At the same time, despite the significant differences between the groups in most subdomains, in patients with cataract and sarcopenic obesity and cataract, the greatest decrease in vitality was revealed in the subscale of relationship safety and positivity of accepted changes, resistance to adverse influences and trust in personal instincts. Conclusion. The results indicate a more pronounced effect on the decrease in resiliense of sarcopenic obesity and cataracts than cataracts alone, which is confirmed by integral values of vitality having statistically significant differences between the groups.

The increasing cases of low vision and blindness have been associated with negative impact on the mental health and quality of life of the person by many researches. Rehabilitation plays a key role in making the patient learn to utilize their potential vision to readjust and function as a part of the society. There are many factors that may play a vital role in causing depression among the visually impaired and this pilot study tries to understand and describe the role of these factors to enable the practitioners to device an appropriate rehabilitation plan for the patient. The purpose of this pilot study was to understand depression in visually impaired people, as well as the function of rehabilitation in mitigating its consequences to structure further research in this field. Material and methods. The Hospital Anxiety and Depression (HAD) questionnaire was administered to 30 visually impaired patients (17 females and 13 males of age 18 and above) diagnosed with blindness (VA < 3/60) or low vision (VA < than 6/18 in the better eye and/or visual field up to 20 degrees in better eye) after obtaining their consent. The study evaluated the relationship between depression and a variety of parameters such as the type and onset of visual impairment, rehabilitation services, type and duration of visual rehabilitation and psychological counselling. Mean depression scores were calculated and compared for each category using SPSS. Results. According to some of the major findings of this study, multimodal rehabilitation surely has an important impact in lowering depression among visually impaired people. The group that received services involving the use of low visual aids had a mean depression score of 12.00 ± 3.381 while the group that received multidisciplinary rehabilitation services had a mean depression score of 7.20 ± 6.861 (p-value 0.074). Furthermore, psychological counselling was proven to be effective in treating depression in this population. The mean depression score of the group that didn’t receive any psychological counselling was significantly higher with a value of 12.60 ± 5.835 in comparison to the group that received psychological counselling having a mean depression score of 5 ± 3.33 (p-value 0.001). Conclusion. This pilot study concludes that visual impairment is associated with depression and rehabilitation can play an important role in lowering its incidence. Moreover, a multimodal approach can prove beneficial and should be adopted by the eye care practitioners. Psychological counselling should be made mandatory for the patients with visual impairment at the time of receiving a diagnosis and well as throughout the course of treatment and rehabilitation.

Purpose of the work was to study the features of biomechanical properties of the fibrous capsule of the eye in pigment dispersion syndrome (PDS) and pigment glaucoma (PG), and to evaluate the effect of peripheral iridectomy (PIE) in these conditions on the biomechanics of the eye. Material and methods. Biomechanical parameters of 45 eyes of 23 patients with PDS (26 eyes) and PG (19 eyes) aged 33.6 ± 1.5 years were compared. Keratorefractive surgery (Femto Super LASIK) was performed on 5 eyes of patients in this group. PIE was performed on 34 eyes with PDS and PG. The examination also included 30 eyes with myopia without PDS and PG aged 40.2 ± 1.8 years (comparison group) and 18 eyes of patients with emmetropia without glaucoma aged 37.00 ± 1.93 years (control group). Biomechanical parameters and biomechanically corrected IOP (bIOP) were determined using Pentacam (Oculus) and CorVis ST. Results. Eyes with SPD and PG did not significantly differ in biomechanical parameters from myopic eyes without SPD and PG. At the same time, the biomechanical glaucoma factor (BGF) in SPD and PG was lower than in myopia (p = 0.025 and p = 0.015), which indirectly characterizes the fibrous membrane of the eyes with SPD and PG as more rigid. SSI (an indicator of internal corneal rigidity) of the eyes with SPD, PG and myopia was reduced in comparison with healthy emmetropic eyes (p = 0.000, p = 0.019, p = 0.005, respectively). After the PIE, the bIOP level decreased (p = 0.015), the values of corneal rigidity characteristics changed: Integr. Radius increased (p = 0.002) and the SP-A1 index decreased (p = 0.022), which indicates a decrease in corneal tissue rigidity. At the same time, BGF increased (p = 0.026) and reached the corresponding values of myopic eyes without SPD and PG. Conclusion. Taking into account the reduced SSI index, keratorefractive intervention in SPD and PG should be performed with caution. PIE in SPD and PG can be recommended not only to reduce IOP, but also to normalize biomechanics indicators and bring their values closer to the parameters of a myopic eyes without SPD and PG.

Purpose: a comparative study of the effect of various optical correction methods on the dynamics of refraction in children with progressive myopia after minimally invasive scleroplasty (MIS). Material and methods. A total of 58 patients (58 eyes) aged 8 to 14 years (mean 12.0 ± 0.2 years) with moderate and high progressive myopia — from 4 to 11.5 D (mean 7.7 ± 0.3 D) with the year progression gradient (YPG) from 0.5 to 1.75 D (mean 1.25 ± 0.06 D) were operated on. In all patients, visual acuity, clinical refraction, axial length of the eye and the state of the fundus were determined. For MIS, the biologically active transplant (BAT) Hitex-HG was used. Patients were divided into groups depending on the optical correction prescribed after the operation. In group 1 (17 patients), monofocal (MF) glasses used before the operation were replaced with perifocal (Perifocal-MS, PMS) or progressive glasses. In group 2 (18 patients), children used PMS or progressive glasses before and after MSP. In group 3 (16 patients), MF or soft contact lenses were used before and after the operation. In group 4 (7 patients), MF, PMS or progressive glasses used before the operation were replaced with orthokeratology lenses. The follow-up period was 1 year. Results. Comparative analysis of YPG in groups with different optical correction showed different decrease of this parameter in the postoperative period: in group 1 — 4.7 times; in group 2 — 4 times; in group 3 — 2.3 times; in group 4 — 5 times. Conclusion. The most effective treatment is a combination of MIS and optical correction with accommodation support and/or impact on peripheral retinal defocus. This approach to managing pediatric patients with progressive myopia should be a priority.

Retinal detachment (RD) is a severe ophthalmologic disease that requires urgent surgical intervention. However, the choice of a tamponade agent for filling the vitreous cavity after surgery has been debatable to date. Purpose of the study was to evaluate the efficacy of air and gas-air tamponade of the vitreous cavity in surgical treatment of RD with tears in the inferior quadrants of the fundus. Material and methods. The study included 21 patients with primary rhegmatogenous RD caused by peripheral tear flaps in the inferior quadrants. A study was conducted of 21 patients with primary rhegmatogenous retinal detachment, the cause of which was peripheral breaks in the lower quadrants. The patients were divided into 2 groups depending on the type of vitreous cavity tamponade. In group 1 (10 patients), the best corrected visual acuity (BCVA) before surgery was 0.01–0.7 (±0.04). The surgery was completed by tamponade of the vitreous cavity with a gas-air mixture of sulfur hexafluoride (SF6). In the 2nd group (11 patients), the preoperative BCVA was 0.01–0.8 (±0.07). Surgical treatment in patients of this group was completed with tamponade of the vitreous cavity with sterile air. Results. In the early postoperative period, reactive ophthalmic hypertension was observed in patients of the 1st group, intraocular pressure in the 2nd group was within normal limits. After 6 months, according to B-scan data, the membranes were adjacent in both groups, and no recurrence of RD was registered. BCVA was 0.5–1.0 (±0.04) and 0.6–1.0 (±0.046) in the 1st and 2nd groups, respectively. Conclusion. Considering comparable anatomical, functional and clinical postoperative results, the use of air tamponade of the vitreous cavity is the preferred method in the surgical treatment of rhegmatogenous RD associated with inferior tears.

In visual rehabilitation, the search for methods based on the activation of neuroplasticity is relevant, which includes the technology of fractal photostimulation (FP). Previously, a positive effect of FP courses on the function and structure of the retina was demonstrated on animals with a model of retinal pigment epithelium atrophy. On the other hand, the advantages of virtual reality (VR) technologies for visual training in a game format that increases patient compliance are known. The purpose of this work was to evaluate the effect of a FP course in VR on objective electroretinography parameters in patients with dry age-related macular degeneration (AMD). Material and methods. In 20 patients with dry AMD, intermediate and late stages, an ERG complex was recorded according to ISCEV standards before and in dynamics after a 2-week FP course. Results. A positive effect of FP on the activity of photoreceptors, as well as (to a slightly lesser extent) bipolar cells of the scotopic and photopic systems with a greater response to phototherapy of cone-related neurons were shown. The activating effect of FP on the outer retina was greatest in the early stages after the course of visual training. The positive effect of FP on the activity of retinal ganglion cells increased after the completion of the course for at least 1 month. The dynamics of multifocal ERG indicates a generalized activating effect of FP on the macula. Conclusion. The results of the study substantiate the prospects of fractal phototherapy as a method of visual rehabilitation that improves the functionality of the retinal neural network. It can also serve as a factor slowing down the progression of the degenerative process in the outer and inner retina.

Purpose: to study and compare the results of primary penetrating keratoplasty (PKP) in young children with Peters’ anomaly and sclerocornea. Material and methods. The survival rates of the graft after primary PKP were studied in 58 children (67 eyes) under 5 years of age with congenital corneal opacity in Peters’ anomaly (43 patients) and sclerocornea (15 patients). The biological result of the surgery was assessed by the Kaplan — Meier method, which was used to determine the “survival” of the graft. The functional result (taking into account the child’s age) was estimated approximately: by the child's tracking of toys from a certain distance and by the preferred gaze method. The corneal discs removed during the surgery were subjected to histological examination. Results. The overall survival rate of the grafts was 68%. Ultimately, 2 years after surgery, graft survival in children with Peters anomaly was 68%, while in children with sclerocornea it was only 20%; after 5 years, it was 56% and 7%, respectively. The mean survival time and survival rate differed significantly in patients with Peters anomaly and in patients with sclerocornea: survival time 125.3 ± 13.9 versus 36.4 ± 15.1 months (p = 0.014), survival — 82.5% versus 20.0% (p = 0.02). The presence of vascularization in the limbus and on the periphery of the cornea, as well as the diameter of the recipient’s cornea, significantly correlated with the development of graft rejection. Conclusion. After PKP, high graft survival was observed in patients aged 5 years and younger with Peters anomaly, whereas graft survival was low in patients with sclerocornea.

Purpose of the work: to evaluate the effect of combined use of bifocal soft contact lenses (BSCL) and the combined drug Midrimax (Phenylephrine 5.0%; Tropicamide 0.8%) on peripheral refraction and wavefront aberrations of the eye. Material and methods. Prima BIO Bi-focal BSCL was prescribed to 43 children aged 10.42 ± 0.26 years with myopia of 3.43 ± 0.19 D. After 1 month, 23 children (group 1) were additionally prescribed Midrimax instillations. Results. The wavefront of the eye in BSCL undergoes significant changes: RMS HOAs increases by 4 times, tilt, vertical coma, horizontal trefoil by 1.5–2 times; positive spherical aberration (SA) increases on average by 20 times. In the BMCL, myopic defocus is formed in all zones of the near periphery of the retina, except for the N5° zone (instead of the hypermetropic defocus that existed without correction); in the N5° zone, hyperopic defocus is formed, which was absent without correction. The formation of myopic defocus is completely consistent with the multiple increase in positive SA and is explained by the design of the lens with a paracentral add zone. Continuous wearing of the BMCL for 6–12 months is accompanied by a decrease in hyperopic defocus of uncorrected eyes, and when combined with instillations of Midrimax — the formation of weakly myopic defocus in the N5° zone. After a month of continuous wearing of the BMCL, a decrease in the level of positive SA by 1.7–1.8 times was noted, which is consistent with an increase in manifest refraction and an increase in the tone of accommodation. Further instillations of the Midrimax resulted in a 3-fold increase in positive SA, indicating the elimination of excess tone. Conclusion. The identified changes in the wave front and peripheral defocus in the BMCL obviously explain the stabilizing effect of this optical and optical-pharmacological method of myopia control.

Beta-thalassemia is a hereditary blood disorder which occurs due to defective beta-globin gene synthesis. It is characterized by blood deficiency caused by ineffective erythropoiesis, hemolysis, and iron overload due to repeated transfusions. The purpose of the is study to find out the changes in retinal nerve fiber layer (RNFL) thickness as a result of Beta-thalassemia major and to compare the values with healthy individuals. Material and methods. This cross-sectional study was performed on a total of 56 beta-thalassemia major cases and 64 healthy controls from December 2023 to June 2024. The mean age of the cases (18.42 ± 4.05 years) and controls (17.45 ± 4.02 years) was significantly similar (p = 0.190). All the subjects undergone standard ophthalmological examination followed by RNFL thickness measurement using Heidelberg Spectralis OCT (Optical Coherence Tomography). Results. The RNFL thickness showed significant difference between the case and control groups. The p-value for global, inferior, nasal, and temporal RNFL thickness was < 0.001, while for superior RNFL p-value was 0.006. A significant correlation of global, inferior, and nasal RNFL measurements was found with the duration of thalassemia (p = 0.01, p = 0.01, p < 0.001), however, the global and nasal RNFL were found to be thinner in the cases receiving iron chelation monotherapy (p = 0.048, p = 0.006). Conclusion. The study concludes that the RNFL was significantly thinner in beta-thalassemia major cases in comparison to healthy controls. Moreover, only global, inferior, and nasal RNFL revealed to have a significant correlation with the thalassemia duration and iron chelation therapy.

Purpose: to study the dynamics of the structure and regional profile of eye injuries in children for 2018—2022 based on materials from the Tashkent Medical Institute pediatric ophthalmology department. Material and methods. A retrospective analysis of the situational reporting documentation was carried out according to the leading diagnosis according to the ICD 10 classifier. Results. The analysis showed that every fourth child (27.2%) was h ospitalized with eye injury or its complications. Most often, children aged 5 to 14years (61.0—64.5%) sought help, with boys predominating (62.6%). Children applied from all regions of the republic, most often from Tashkent (47.9—60.1%) and Kashkadarya (10.3—13.3%) regions. The structure of eye injuries and their complications has not changed over 5 years: the leading positions were occupied by penetrating wounds of the eyeball and contusions. Complications included scars and corneal opacities, cataracts, endophthalmitis, and secondary glaucoma. Conclusion. Currently, all age groups of children are vulnerable to injury. This dictates the need for widespread activation of injury prevention, accessible emergency high-tech care, taking into account the identified dynamics of the structure and regional profile of eye injuries in children.

Purpose of the work is a comparative study of the effect of different concentrations of the excipient carbomer on the local bioavailability and local irritant effect of brinzolamide and timolol in an experimental model of dry eye syndrome (DES). Material and methods. The study was performed on 35 sexually mature male rabbits of the Soviet Chinchilla breed. The effect of Brinarga eye drops (INN brinzolamide + timolol) containing carbomer 4.2 mg as an excipient (Sentiss Pharma Pvt. Ltd., India) and the comparison drugs — Preparation 1 (original) and Preparation 2 (generic, European manufacturer), containing INN brinzolamide + timolol and carbomer 4.0 mg, when instilled into the conjunctival sac every 12 hours for 14 days was studied. The local irritant effect of eye drops on the cornea of the eye and the bioavailability of the active substances included in all the studied drops were assessed on an experimental model of dry eye syndrome, which was reproduced by daily instillation of 1 drop of 1 % atropine sulfate into experimental animals 3 times a day for 5 days. Results. It was found that Brinarga eye drops containing 4.2 mg/ml carbomer 974P do not aggravate the course of DES and do not have a local irritant effect. On the contrary, their use is accompanied by a partial correction of the pathological condition (although it does not lead to complete restoration of corneal moisture to the values of the intact eye), unlike the existing analogs — Preparation 1 and Preparation 2, containing carbomer 974P at a concentration of 4.0 mg/ml. At the same time, Preparation 2 (generic, European manufacturer) caused a pronounced local irritant effect (total score 7.2 ± 1.2), which led to its early exclusion from the experiment. At 60 min, the maximum measured concentration of brinzolamide and timolol (Brinarga) in the aqueous humor of the anterior chamber during DES significantly exceeded that of Preparation 1 and Preparation 2. Conclusion. Increasing the concentration of carbomer to 4.2 mg/ml facilitates the passage of brinzolamide/timolol (Brinarga) through the tissue barrier of the eye and prevents presystemic elimination due to imparting optimal viscometric characteristics to the dosage form.

Purpose of the work is to analyze the features of a reproducible model of a penetrating gunshot wound of the eyeball without an intraocular foreign body (type B open eye injury). Material and methods. A comprehensive examination of 36 rabbits (71 eyes) was conducted with a previously developed reproducible model of a penetrating gunshot wound of the eye without an intraocular foreign body. To study the features of the experimental model and their dynamics, an examination was carried out at control periods, including biomicroscopy, reverse ophthalmoscopy and tonometry. Results. High reproducibility of the characteristic indicators (77.0–100 %) was shown, confirming the standardization of the developed model. The studied features of the model made it possible to register pathological changes in most structures of the eyeball, including proliferative changes. This justifies the need and legitimacy of using the term “intraocular mutual burden syndrome”. Conclusion. The described “syndrome of intraocular mutual burdening” is one of the reasons for low functional and anatomical outcomes of open gunshot eye trauma. The high frequency of occurrence of this pathology during combat operations and in peacetime justifies the need to continue its study. The developed standardized model of penetrating gunshot wound of the eye without an intraocular foreign body using modern ophthalmological and general clinical research methods can be used as a basis for the experiment.

Purpose: analysis of a clinical case: removal of IOFB in combination with retinal detachment. This report presents and describes a clinical case of removing an intraocular foreign body (IOFB) diascloerally, with the elimination of retinal detachment. Under our observation was a young patient who suffered domestic trauma to the left eye. A magnetic foreign body, presumably a “nail gun staple”, entered and injured the left eye 3 days before hospitalization at the Kazakhstan Scientific Research Institute of Eye Diseases in Almaty, Kazakhstan. The patient had previously undergone primary surgical treatment of corneal wound + traumatic cataract phacoaspiration at the place of residence. The consensus decision recommended surgical treatment with the choice of transvitreal access as the main approach to IOFB extraction. However, during the operation, considering the localization of the foreign body under the retina and its length, it became clear that it was impossible to remove the foreign body with transvitreal access, as this would lead to significant retinal trauma. Recommended: remove the foreign body diascloerally according to its localization and location. The choice of access, tactics, and the extent of surgical intervention is finally decided intraoperatively and should be aimed at reducing eye trauma, especially the retina, during IOFB removal.

Diabetic retinopathy (DR) is a severe late neuromicrovascular complication of diabetes mellitus. Panretinal laser photocoagulation is a method of choice of DR treatment; antiangiogenic therapy applies if necessary. The traction development, hemophthalmos, and retinal detachment are the most common complications of proliferative DR and needs vitreal surgery. Ultrasound examination with blood flow assessment and laser speckle flowography (LSFG) are very useful methods in retinal blood flow detecting. Purpose of the study: to conduct blood flow parameters using ultrasound dopplerography with assessment of blood flow and LSFG in 67-year-old patient with bilateral severe proliferative DR after panretinal photocoagulation, avitria, pseudophakia and stable ophthalmological status. Patient observed a significant decrease in retinal blood flow and normal values of choroidal blood flow, combined with rather high visual acuity. Conclusion. Choroidal blood flow plays a significant role in maintenance of visual functions. Study of eye hemodynamic status by ultrasound dopplerography and LSFG is effective in DR patients. Quantitative and qualitative blood flow control proved usefulness in clinical practice and requires further study.

We present a clinical case of untimely recognized and inadequately treated iris melanoma, which led to the development of secondary hypertension and secondary cataract in the absence of extrabulbar growth and the presence of bleb ossification during 6 months after trabeculectomy against the background of uveal melanoma. Ossification was not accompanied by an inflammatory reaction and allowed the surgically created a well function filtering bleb. The case confirms the need for a full examination of patients and for increasing the specialists level of oncological alertness.

The review is devoted to the problem of surgical treatment (based on vitrectomy, VE) of rhegmatogenous retinal detachment (RRD) from the position of performing/not performing one-stage cataract phacoemulsification. The literature analysis was performed using the RSCI and PubMed databases. The obtained results indicate approximately similar (88.7–100.0%) levels of probability of achieving anatomically complete retinal reattachment during phacovitrectomy (FVE) and during isolated vitrectomy (VE). Along with this, a tendency towards some myopization of the eye after FVE is noted compared to VE, which may be associated with the multifactorial nature (calculation formulas, IOL type) of the effect of FVE on postoperative refraction. In addition, the literature data show a similar nature and frequency of complications in the above surgical approaches to the treatment of RRD. At present, there are no clear recommendations whether VE without lens surgery should be performed first or whether combined FVE may be a better strategy. In the long term, it is necessary to note the development of alternative criteria for the safety and effectiveness of surgical intervention related to expert assessment of the fundus condition and determination of indications for FVE (stage of proliferative vitreoretinopathy, duration of the disease, localization of retinal breaks and proliferative process), as well as a study of the dynamics of the patient's “quality of life”.

Study of factors preventing excessive scarring in antiglaucoma surgery creates a foundation for developing methods of influencing these processes in the postoperative period in order to increase the effectiveness of the intervention. Analysis of the literature showed that a systematic approach to preparing for successful surgical treatment of glaucoma should include a rational choice of previous hypotensive therapy with preservative-free drugs, prevention of damage to the ocular surface using tear substitute and immunosuppressive therapy, as well as preoperative anti-inflammatory prophylaxis with steroid and non-steroid agents with proven ophthalmic hypertension safety.

Bacterial conjunctivitis is the main reason for patients to visit ophthalmologists, and the incidence is high among both children and adults. In the current version of the Clinical Guidelines for the section “Conjunctivitis”, approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation, antibacterial and antiseptic agents are recommended as etiotropic therapy for the treatment of infectious conjunctivitis (bacterial, chlamydial) or in case of suspicion/prevention of secondary bacterial infection in conjunctivitis of other etiologies with antibacterial purposes. Antibacterial agents in the dosage form of eye drops are represented by the following International Nonproprietary Names (INN): ofloxacin, ciprofloxacin, levofloxacin, moxifloxacin, netilmicin, tobramycin, chloramphenicol, in the dosage form of eye ointments: INN tetracycline, erythromycin, tetracycline + chloramphenicol. Of the antiseptic agents, eye drops are presented with the INN picloxidine and benzyldimethyl-myristoylamino-propylammonium. Thе review presents the comparative efficacy and safety of ciprofloxacin eye drops and ointment, as well as on the assessment of their clinical significance in the treatment of bacterial eye infections.

The conjunctiva is a thin mucous, richly vascularized tissue lining the inner surface of the eyelids and the eyeball to the limbus and forming the space between the eyelids and the eyeball — the conjunctival sac. Performing important physiological functions, the conjunctiva is a structure necessary for maintaining the normal anatomy and physiology of the eye. Conjunctival damage due to the impact of various factors can lead to the occurrence of significant functional disorders of the eye, which must be eliminated exclusively by surgery. Surgical treatment of conditions accompanied by conjunctival deficiency is currently considered one of the urgent and difficult tasks of ophthalmic surgery. There are many treatment tactics and modifications of operations to eliminate conjunctival defects, as well as local and total symblepharon, which are united by the need to use various replacement materials after moving the patient's own tissues. At the same time, the requirements for replacement tissues are quite high: they must be clinically compatible with the body's tissues, have the necessary elasticity, and be accessible for surgical transplantation. The ideal approach is to use one's own conjunctiva, but, unfortunately, it is not always feasible. The review presents experimental and clinical results of using modern surgical tactics: transplantation of autologous and allogeneic conjunctiva, oral mucosa, amniotic membrane, Alloplant biomaterial, autologous cultured epithelial cells of the oral mucosa.

Habitual excessive accommodation tension (HEAT) in children is associated with ciliary muscle spasm, reduced distance visual acuity, and asthenopic symptoms. Studies highlight the role of the autonomic nervous system (ANS) in accommodation regulation, while an imbalance between sympathetic and parasympathetic activity, triggered by stress and visual load, may contribute to the development of HEAT. Modern diagnostic methods, such as heart rate variability and pupillometry, enable the study of ANS influence on accommodation. Various correction approaches are considered, including pharmacological and physiotherapeutic methods, as well as restoring autonomic balance. Further research is needed to explore the impact of the ANS on accommodation in children.