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Kuban Scientific Medical Bulletin № 2 (137) 2013
GLAUCOMA
S. V. BALALIN, V. P. FOKIN
RISK FACTORS AND TARGET INTRAOCULAR PRESSURE IN PATIENTS WITH PRIMARY OPEN-ANGLE
GLAUCOMA
A study of target intraocular pressure was performed basing on values of tolerant pressure in 1310 patients (1638 eyes)
with primary open-angle glaucoma. It was established that level of tolerant and target intraocular pressure tends to
decrease with age increment, elongation of anterior-posterior eye globe dimension, aggravation of glaucoma stage.
Increase of diastolic blood pressure in brachial artery is characterized by growth of tolerant and target values of
intraocular pressure.
Key words: glaucoma stage, target pressure, age, anterior-posterior eye globe dimension.
O. I. LYSENKO, A. V. MALYSHEV
RESULTS OF DEFINITION OF THE INITIAL VEGETATIVE TONE AT PATIENTS WITH OPEN-ANGLE NOT
STABILISED GLAUCOMA
To patients with open-angle not stabilised glaucoma the initial vegetative tone and presence of a syndrome of vegetative
dysfunction were prescribed. As a result of the conducted research it has been positioned that the raised tone of
parasympathetic excitatory system and a syndrome of vegetative dysfunction had the majority of patients.
Key words: a glaucoma, vegetative excitatory system.
L. P. CHEREDNICHENKO, L. Y. BARYCHEVA, A. A. BERNOVSKAYA
THE ROLE OF PRO- AND ANTI-INFLAMMATORY CYTOKINES IN DEVELOPMENT OF PRYMARY OPEN-ANGLE
GLAUCOMA
A total of 70 patients: 25 – with suspected glaucoma, 25 – with an initial stage of glaucoma, 20 – with advanced stages of
glaucoma. The increase of IFN-γ, IL-1β, TNF-α in the lakrimal fl uid and blood serum, depending on the severity of
glaucoma. Indicators of IL-17 in the lakrimal fl uid is increased in patients with advanced stages of glaucoma. In patients
with glaucoma predominant Th-1 variant of the immune response. Switching to a Th-2 type immune response occurs in
the later stages of the glaucomatous process.
Key words: primary open-angle glaucoma, a suspicion of glaucoma, interleukins, dacryops, blood serum.
G. V. SHKREBETS, V. G. OVSINNIKOV
NEW RESULTS OF RHEOLOGICAL STUDIES IN THE PATHOGENESIS OF PRIMARY JUVENILE GLAUCOMA WITH
HIGH MYOPIA
A survey of 32 patients with primary juvenile glaucoma (PYUG) in combination with high myopia (main group) aged 18–
32 years: 1st subgroup (n = 18) – with ischemic variant of PYUG, 2nd subgroup (n = 14) – with dyscirculatory variant of
similar age, – found in patients with PYUG in combination with high myopia violations of general homeostasis. Increased
concentration of fi brinogen in the background amplifi cation of platelet aggregation indicating the predominance of
plasma viscosity in patients with ischemic variant of PYUG. Increase blood fl ow index in the shear rate 10 sec-1 and 20
sec-1, increased platelet aggregation coupled with a decrease in fi brinogen concentration and fi brinolytic activity of
plasma is characteristic for of increased blood viscosity and is one of the pathogenetic mechanisms of development of
neovascularization and retinal hemorrhages in patients with PYUG discirculatory variant with high myopia.
Key words: glaucoma, myopia, hemostasis, blood plasma.
CATARACT SURGERY AND INTRA OCULAR LENS IMPLANTATION
A. G. ZABOLOTNIY, K. S. MISAKYAN
PHARMACOPREVENTION OF PROGRESSING LEVEL OF AMD FOR CATARACT EXTRACTION AT PATIENTS WITH
COMBINED OPTHALMOPATHY
Prospective comparative analysis of combined administration nonsteroidal antiinfl ammatory drugs (NAD) and antioxidant
action drugs (AAD) long-term administration late results (>1,5 years) for prevention and lowering of progressing level of
age macular dystrophy for cataract extraction with ultrasound phacoemulsifi cation at patients with combined
opthalmopathy. It is determined that combination NAD (indocallyre®) and AAD (ocuvait® lutein) are effective
pharmacological parts in prevention and lowering of progressing level of age macular dystrophy at patients of this group;
AAD administration, ocuvait® lutein is effi cient 2–3 months before cataract phacoemulsifi cation with prolongation period
after surgery.
Key words: pharmacoprevention AMD, cataract, ocuvait® lutein.
V. A. RUDENKO, E. L. SOROKIN
THE MORPHOMETRIC PECULIARITIES OF THE EYES WITH TRACTIONAL MACULAR EDEMA AFTER
PHACOEMULSIFICATION OF AGE-RELATED CATARACT
2far-eastern state medical university, Russia, 680000, Khabarovsk, Muraviev-Amurskii str., 35
72 patients (72 eyes) with macular edema (ME) after phacoemulsifi cation of age-related cataract were observed. The
measurement of the axial length and horizontal diameter of the eyeball and the analysis of the initial thickness of the lens
were made in all eyes. The postoperative ME appears more often (in 65,3% of cases) in the eyes with short axial length
(less than 23,5 mm). The characteristic shape of the eyes with postoperative ME is compressed ellipse (51,4%). The
eyes with increased thickness of lens (more than 4,8 mm) were in the majority cases of the observed eyes (59,7%).
These points may become the base of the prognosis of high risk of ME appearance after phacoemulsifi cation of agerelated cataract.
Key words: macular edema, phacoemulsifi cation, axial length, shape of the eye, thickness of the lens.
E. L. SOROKIN, V. V. EGOROV, N. V. POSTUPAEVA, A. V. POSTUPAEV, A. N. MARCHENKO
ASSESSMENT OF FREQUENCY OF THE INITIAL FACTORS COMPLICATING PHACOEMULSIFICATION
PERFORMANCE AND WAY OF INTRAOCULAR PRESSURE NORMALIZATION IN PATIENTS WITH COMBINATION
OF AN AGE CATARACT AND PRIMARY OPEN ANGLE GLAUCOMA
Frequency of existence of accompanying primary open angle glaucoma (POUG) at 300 patients with an age cataract was
found out, risk degree of intra- and postoperational complications for cataract phacoemulsifi cation was studied. Existence
of accompanying POUG with fi rmness normalized intraocular pressure (IOP) was noted in 61 eyes (20%). In their
structure 86% of eyes had various adverse features for phacoemulsifi cation. It was not taped accurate patterns of
development of complicating factors depending on surgical or medicamental hypotensive ways of permanent
normalization of IOP level.
Key words: cataract, phacoemulsifi cation. glaucoma, risk factors.
REFRACTION ABNORMALITY
A. V. DOGA, N. V. MAYCHUK, N. KH. TAKHCHIDI, E. S. BRANCHEVSKAYA
THE VISUAL QUALITY AFTER LASIK AND FEMTO-LASIK
To evaluate the recovery rate of the quality of vision after femtosecond laser – Femto LDV («Ziemmer», Switzerland)
corneal fl ap forming, and to assess and compare ophthalmo-ergonomic data after femtosecond laser-assisted LASIK
(Femto-LASIK) and microkeratome-assisted LASIK with «Moria-3 SBK OUP» («Moria», France) fl ap forming. LASIK –
MK group, 125 patients (250 eyes) FemtoLASIK – FS group, 121 patients (242 eyes). Ophthalmo-ergonomic data «Optec
6500» («Stereo Optical company», USA) were analyzed pre – and postoperatively (1–6 month) in both groups. Our study
demonstrates that Femto-LASIK provides better clinical and functional results and faster recovery of the «delicate visual
functions» comparing to microkeratome-assisted LASIK.
Key words: LASIK, Femto-LASIK, myopia ,visual functions contrast sensitivity.
G. F. KACHALINA, N. V. MAYCHUK, N. KH. TAKHCHIDI
COMPARATIVE ANALYSIS OF HIGHER ORDER ABERRATIONS AFTER CONVENTIONAL AND Q-VALUE GUIDED
FEMTOLASIK WITH THE MICROSKAN VISUM
To compare the results of the Q-value guided FemtoLASIK with the conventional FemtoLASIK for the correction of
myopia with the microskan visum. We conducted a retrospective study on 22 myopic patients who underwent Q-value
guided femtosecond laser: 11 patients, 22 eyes SE – 4,11±0,32 D or femtosecond laser: 11 patients, 22 eyes SE –
4,29±0,27. For aberrometry OPD-Scan ARK-10000 (Nidek, Japan) was used. The total root mean square (RMS), as well
as the higher-order aberrations (RMS-HO), spherical aberration, coma were analyzed. The aberrations changed slightly
after Q-value guided FemtoLASIK from preoperatively and from conventional FemtoLASIK.
Key words: myopia, visual quality, aberrations, Q-value, FemtoLasik.
PATHOLOGY OF EYE CONNECTIVE TISSUE MEMBRANE. KERATOCONUS
L. N. BORISKINA, E. G. SOLODKOVA
CORNEAL COLLAGEN CROSSLINKING SAFETY EVALUATION IN TREATMENT OF PROGRESSIVE
KERATOCONUS BASING ON REMOTE POSTOPERATIVE RESULTS
Safety and effi ciency of two corneal collagen crosslinking (CXL) techniques was brought to comparative analysis. CXL
was performed in 25 patients with progressive keratoconus: 9 patients (9 eyes) underwent a conventional CXL; 16
patients (16 eyes) had a modifi ed CXL which novelty consisted of a depth-metered deepithelialization performed by
excimer laser with on-line pachymetry Schwind Amaris (Germany). UV-A exposure was made by means of «UV-X»
device (version 1000) (IROC Inc., Switzerland). All patients were prescribed to wear silicon-hydrogel soft contact lenses
until a complete epithelial recovery. Improvement of NCVA, BCVA, topographic parameters, pachymetric values along
with integrity of endothelial cell density was registered in all the cases which allows concluding that both CXL methods
are safe.
Key words: corneal collagen crosslinking, keratoconus.
N. A. POZDEEVA, O. V. SHLENSKAYA
DRY EYE SYNDROME AFTER SURGICAL INTERVENTIONS IN PATIENTS WITH CONGENITAL ANIRIDIA
13 patients (26 eyes) aged 7–38 (mean 22,5±3,3) with congenital aniridia after iris lens diaphragm implantation were
examined. Iris lens diaphragms (ILD) produced at «REPER-NN» (Nizniy Novgorod) were implanted. Together with ILD
implantation simultaneously during surgery lacrimal points of some patients were blocked by «FCI» (France) obturators in
order to prevent dry eye syndrome development. Examination indicates that this tactics contributes to prevention of
postoperative progress of secondary «dry eye» syndrome. Nevertheless further investigation of obturation infl uence of
lacrimal channels on dynamics of development of corneal dystrophic processes in patients with congenital aniridia is
necessary.
Key words: «dry eye» syndrome, congenital aniridia, obturation of lacrimal points.
S. V. YANCHENKO, S. N. SAKHNOV, A. V. MALYSHEV, V. A. SHIPILOV, A. S. RUDASHOVA, E. V. VARLASHINA,
V. JE. HOROL’SKAJA
THE IMPACT OF TEAR-SUBSTITUTE ON THE BASIS OF HYDROXYPROPYL GUAR ON THE CONDITION OF THE
EYE SURFACE AT PATIENTS WITH THE «DRY EYE» SYNDROME
Tear-substituting therapy with drug application on a basis of hydroxypropyl guar allows to achieve a reliable reduction of
the severity of subjective symptoms (mild integral index of discomfort), functional displays (increase the time of rupture of
the tear fi lm); objective evidence (normalization index a tear of the meniscus, reduction in the rates of xerosis) changes
ocular surface on the type of «dry eye» syndrome. The use of tear-substituting therapy to reduce the integral index of the
discomfort of not less than by 1 point after the fi rst instillation, is not accompanied by discomfort in instillation, and also
does not cause the fog after instillation, the overwhelming majority of patients (96,7%).
Key words: dry eye syndrome, malfunction of meibomian glands, age-specifi c decrease of tear production,
hydroxypropyl guar.
OPTHALMOPATHOLOGY AT COMMON DISEASES
O. V. KOLENKO, E. L. SOROKIN, V. V. EGOROV
STUDYING OF PATTERNS OF DYNAMICS OF MACULAR RETINA MICROMORPHOMETRIC INDICATORS IN
PREGNANT WOMEN AT PATHOLOGICAL PREGNANCY IN INTERRELATION WITH GESTOSIS SEVERITY
Studying of morphometric parameters of macular retina of 77 pregnant women (154 eyes) in dynamics of trimesters at
physiological (30 women, 60 eyes) and pathological (47 women, 94 eyes) pregnancy was carried out. The technique of
optical coherent tomography of macular retina was used. The results taped signifi cant rising of macular retina thickness
to the 3rd trimester in group with OPG-gestosis. There were 60% of women with medium degree of gestosis and 77% of
women with severe degree of gestosis. It is shown that changes of micromorphometric parameters of retina are directly
bound to gestosis severity. In 2–4 months after the delivery the average value of fovea thickness considerably decreased,
but still signifi cantly exceeded the primary values; the macular volume of a retina remained raised in 12% of eyes, mainly
in severe gestosis.
Key words: pregnancy, OPG-gestosis, optical coherent tomography, macular retina, micromorphometric parameters.
O. I. LYSENKO, A. V. MALYSHEV
FEATURES OF THE PSYCHOLOGIC STATE OF PATIENTS LOSING SIGHT AGAINST THE VASCULAR PATHOLOGY
OF THE OPTIC NERVE
180 patients with glaucomatous and vascular optical neuropathy are surveyed by means of the paste of Luscher and H.
Ajzenka’s questionnaire. It has been positioned that the overwhelming majority of patients are owners of melancholic
temperament. Progressing falling of sight descends against a stressful state, is accompanied by penetrating experiences.
Key words: an optic nerve, stress, melancholic temperament.
V. V. MYASNIKOVA, S. N. SAKHNOV, I. V. CHERKASOVA
XENON ANESTHESIA СARDIOPROTECTIVE EFFECT IN ELDERLY AGE PATIENTS WITH OPHTHALMOSURGICAL
INTERFERENCES
The hemodynamic response features in 28 patients under general inhalation sevoran anesthesia and in 27 patients under
general xenon anesthesia with ophthalmosurgical interferences were analyzed. The signifi cant mean arterial pressure
reduction was in the group with sevoran anesthesia. The reduction degree was signifi cantly dependent on age and was
the highest in the patients older than 50 years. In xenon anesthesia terms in all age groups, the stable hemodynamics
was observed. The critical mean arterial pressure reduction in sevoran anesthesia required an active fl uid therapy
executing and and in some cases vasoconstrictors administration. Xenon cardioprotective effect is confi rmed by the
positive dynamics of changes in the myocardium metabolic state during xenon anesthesia in patients with baseline
cardiac pathology in «Cardiovisor» investigation. The achieved results allow us to recommend xenon anesthesia as the
most secure anesthesia method in elderly age patients with concomitant cardiac pathology at ophthalmosurgical
operations.
Key words: xenon anesthesia, cardioprotective effect, elderly age, ophthalmosurgery.
A. N. UZENYOVA, V. N. KANYUKOV, G. G. BAGIROVA
INNOVATIVE APPROACH IN SOMATIC PATHOLOGY CORRECTION AT TREATMENT OF PATIENTS WITH
GLAUCOMA AND ARTERIAL HYPERTENSION
Arterial hypertension at patients with glaucoma is one of paraoperative risk main factors. At present time innovative
approach
contains correction of arterial pressure in short time before glaucoma operative treatment using fi xed combination of
angiotensionconverting
enzyme inhibitor and thiazide diuretic in paraoperative period.
Key words: arterial hypertension, innovative approach, angiotension-converting enzyme inhibitors, glaucoma.
T. V. SHELKOVNIKOVA, V. G. WAVIN, J. L. KATSADZE
THE SYSTEM OF HEMOSTASIS IN PATIENTS WITH RETINAL VASCULAR PATHOLOGY
The purpose of this review was to analyze the existing data in the literature of research on some of the pathogenetic
mechanisms of venous, arterial occlusion of retinal vessels, diabetic retinopathy, proliferative eye syndrome. Considered
the most interesting changes of hemostasis in patients with vascular disease of the retina. Hematogenous, autoimmune
thrombophilia is an important link in the pathogenesis of venous and arterial occlusions of the retina, diabetic retinopathy,
proliferative eye syndrome. Recognition of the type of thrombophilia and its timely laboratory diagnosis in patients with
vascular disease of the retina in the basis of which there is a violation in the hemostatic system and hemorheology,
should help optimize the treatment and prevention of disorders in the hemostatic system in patients with vascular disease
of the retina.
Key words: hemostasis, thrombophilia, venous, arterial occlusion.
V. N. KUROCHKIN, O. A. SHELIHOVA
FRESNEL LENS USE IN CHILDREN’S AND ADULTS’ CONCOMITANT STRABISMUS TREATMENT
Fresnel elastic lens use in the complex treatment of adults’ concomitant strabismus allows to prevent any postoperative
diplopia and achieve stable orthophoria. The technique is socially adapted; it allows quick and effective strabismus
correction, promotes bifi xation mechanism and binocular vision formation.
Key words: Fresnel lens, strabismus, diplopia.
OPHTHALMIC HELP ORGANIZATION
A. G. ZABOLOTNIY, S. N. SAKHNOV
THE ANALYSIS OF MEDICAL ORGANISATIONAL SUPPORT AND STAFFING OF OPTHALMOLOGICAL HELP IN
REGIONAL LEVEL
Based on the results of researches the main problems of medical organizational support and staffi ng were determined
when the patients get proper quality ophthalmological help. It is also determined development actuality of overall strategy
and tactics of regional ophthalmological help enhancement at all stages, based on integration cooperation of medical
organizations, educational establishments and public health control agencies of RF subdivisions.
Key words: ophthalmology, quality of medical care, resources’ provision.
L. I. KASPRUK, V. N. KANYUKOV, YU. N. KOPYLOV, M. B. MUKANOVA
THE ROLE OF NURSING MEDICAL STAFF IN INNOVATIVE TECHNOLOGIES INTRODUCTION AT EYE CARE
Given the increasing demand for nursing and medical staff steady downward trend in their numbers, requires constant
monitoring of nursing and training and retraining of nursing care, including the provision of eye care.
Key words: innovative technologies, monitoring, modernization.
S. I. MAKOGON
COMPARATIVE ASSESSMENT OF LEVEL AND STRUCTURE OF INCIDENCE AND PATHOLOGICAL
PORAZHENNOSTI DISEASES OF THE EYE AND ITS ADDITIONAL DEVICE
In article the comparative characteristic of level and structure of incidence and a pathological porazhennost by diseases
of an eye and its additional device at the staff of law-enforcement bodies is carried out. It will allow to receive additional
information on risk of emergence of occasions to the request for medical care, and also about possible professional unfi
tness.
Key words: incidence, pathological porazhennost, eye diseases.
S. I. MAKOGON
OPHTHALMOLOGIC INCIDENCE IN STRUCTURE OF TEMPORARY DISABILITY AMONG THE STAFF OF
DEPARTMENT OF INTERNAL AFFAIRS
In article the analysis of ophthalmologic incidence in structure of temporary disability among the staff of department of
internal affairs and the working population of Altai territory is carried out.
Key words: ophthalmologic incidence, temporary disability.
A. M. OVSYANNIKOV
FORMATION OF TARGET INDEXES IN THE PROCESS OF INTEGRATIVE COOPERATION BETWEEN MEDICAL
ORGANIZATIONS (ON EXAMPLE OF OPHTHALMIC MEDICAL CARE)
This paper deals with problems of effi cient economic management and mechanism of cooperation between medical
organizations with different subordination degree in federal regions while rendering specialized medical care.
Key words: management, health care, health protection systems in federal regions.
EXPERIMENTAL RESEARCHES
S. V. BALALIN, V. P. FOKIN, L. N. BORISKINA, E. M. MAKOVKIN
CORNEOSCLERAL RIGIDITY AS AN CUMULATIVE BIOMETRIC PARAMETR
Examination of corneoscleral rigidity by means of dynamic differentiated tonometry was performed in 640 healthy persons
(640 eyes). Rigidity factor is a cumulative parameter, comprising various characteristics, such as age, corneal thickness,
anterior-posterior ocular globe size, clinical refraction.
Key words: rigidity, cumulative biometric parameter, differentiated tonometry.
N. P. LISITSINA, A. V. KISELEV, A. I. VISLOBOKOV, Y. D. IGNATOV, P. A. GALENKO-YAROSHEVSKY
INFLUENCE «OF INOKAIN+ VISITON-PEG» COMPOUND POSSESSEDWITH FRANK LOCAL ANAESTHETIC
ACTIVITY ON TRANSMEMBRANE ION CURRENTS OF ISOLATED NEURON
It is shown that in experiments on isolated neurons of conch the compound inokain+visiton-PEG, according to
inactiveness on Na+-fl ows, exceeds single inokain, but what concern on affecting on Ca2+-and slow K+-fl ows, cedes it.
Key words: inokain+visiton compound, inokain, isolated neurons, transmembrane ion currents.
S. N. SAKHNOV, A. V. MALYSHEV, Z. G. ALRASHID, D. V. KROL, E. A. KHACHATUROVA
CHARACTERISTICS OF THE IMPACT OF LOW-INTENSITY LASER RADIATION WITH A WAVELENGTH OF 4,33
MICRONS ON THE EYE TISSUES
Purpose of the study was to investigate the effects of low-level features of laser radiation with a wavelength of 4,33
microns on the cornea and conjunctiva of the healthy eye. Experimental study performed on 15 healthy rabbits (30 eyes).
Rabbit eyes were subjected to laser action with the following parameters: wave length – 4,33 m, power – 2 W, frequency
– 20 Hz exposure 10 minut once a day for 10 days. The experiments have shown that when using the proposed method
of radiation with a wavelength of 4,33 microns over the entire range of investigated parameters did not result in eye
tissues experimental animals irreversible morphological changes and given the wide range of therapeutic effects of lowintensity laser radiation, there is a need of the pilot study to determine the effectiveness of this type of radiation in
treatment of bacterial corneal ulcers.
Key words: low-intensity laser radiation, wavelength, rabbits.
PROBLEM ARTICLES
I. B. ZABOLOTSKIKH, N. V. TREMBACH, N. V. ZABOLOTSKIKH, A. S. BABAKOV, V. P. BABICH, E. V.
GORMAKOVA, A. P. BERDNIKOV
OPHTHALMODYNAMOMETRY OF THE CENTRAL RETINAL VEIN – NONINVASIVE ASSESSMENT OF
INTRACRANIAL PRESSURE
The article reviews the literature on the application of the ophthalmodynamometry of the central retinal vein as a noninvasive method for evaluating of intracranial pressure. The basic anatomical and physiological conditions of its use and
the works that compare this method with the conventional invasive were discussed. This paper presents a great clinical
experience with ophthalmodynamometry in anesthesiology and critical care medicine.
Key words: ophthalmodynamometry of the central retinal vein, intracranial pressure.
A. V. TERESHCHENKO, YU. A. BELYY, I. G. TRIFANENKOVA, M. S. TERESHCHENKOVA, J. A. SIDOROVA
ASSESSMENT OF EFFICIENCY OF TREATMENT OF ACTIVE STAGES OF A RETINOPATHY OF PREMATURE
The basic regulations of the complex ROP treatment are early, within fi rst 6 weeks of chronologic age, photocoagulation
to delay progression of the retinal detachment and to stabilize vascularity, and early vitrectomy if ROP progressing after
the laser treatment.
Key words: retinopathy of prematurity, aggressive posterior retinopathy of prematurity, complex treatment.
ANNIVERSARIES
S. N. SAHNOV, L. A. KALENICH
BY 135 ANNIVERSARY OF PROFESSOR STANISLAV VLADIMIROVICH OCHAPOVSKY
Honored scientist of the RSFSR, professor Stanislav Ochapovsky (1878–1945) – an ophthalmologist, MD, an organizer
for trachoma control in the North Caucasus, the creator of the Kuban research school of ophthalmologists, the founder of
works on local history medicine and ophthalmology, social activist and historian, honorary citizen of the Caucasus, village
Uchkulan and township Beslan.
Key words: Ochapovsky – person of the Kuban of the XX centure.