Objective: To evaluate the efficacy and safety of a combined surgical approach in patients with primary open-angle glaucoma and cataract complicated by grade I–II lens subluxation in the setting of pseudoexfoliation syndrome.

Materials and methods: The study included 40 patients (40 eyes) with POAG stages II–III, cataract, and grade I–II lens subluxation associated with PEX. All patients underwent simultaneous combined surgery: phacoemulsification with IOL implantation using the optic capture technique and non-penetrating deep sclerectomy with implantation of a Healaflow collagen drain.

Results: At 12 months after surgery, a significant improvement in uncorrected visual acuity (UCVA) was observed: from 0.12±0.04 to 0.38±0.06 in stage II glaucoma and from 0.04±0.02 to 0.40±0.08 in stage III glaucoma (p<0.001). Intraocular pressure (IOP) decreased to 16.4±2.1 mmHg and 17.0±1.9 mmHg, respectively (p<0.001). Antihypertensive therapy was discontinued in 85% of patients with stage II and 80% with stage III glaucoma.

Conclusion: Combined surgical treatment demonstrated high efficacy and safety in patients with this complex ocular pathology.

This review summarizes current techniques of episcleral buckling (EB) for uncomplicated rhegmatogenous retinal detachment (RRD). Historical aspects, effectiveness, and modern modifications of the procedure are discussed. Based on an analysis of recent publications, the advantages of EB compared to vitrectomy, its indications and limitations, and emerging trends aimed at minimizing complications and improving surgical outcomes are highlighted. EB remains relevant in uncomplicated RRD, particularly in phakic patients, providing high anatomical and functional success with a low risk of complications.

The prevalence of myopia, particularly high myopia, continues to increase and can lead to irreversible blindness.  

Objective. To evaluate the dynamics of axial length and choroidal thickness in eyes with different degrees of myopia and their impact on visual function.

Materials and Methods. Sixty patients (120 eyes) aged 25.3 ± 4.5 years were examined. Patients were divided into four groups based on the degree of myopia and axial length: mild myopia (axial length 24.1–24.9 mm), moderate myopia (25.0–26.5 mm), high myopia (≥27.0 mm), and a control group with emmetropic eyes (22.1–24.0 mm). Measurements were taken twice-at baseline and after 12 months.

Results. Axial length increased over one year: by ±0.014 mm in mild myopia, ±0.023 mm in moderate myopia, and ±0.038 mm in high myopia. Choroidal thickness decreased in all sectors of the eye (nasal, temporal, and foveal) over the year. The most pronounced thinning was observed in patients with high myopia, especially in the foveal and temporal zones, while the nasal sector changed the least. Correlation analysis revealed a strong negative relationship between axial length and choroidal thickness (foveal zone r = –0.90, nasal sector r = –0.88, temporal sector r = –0.85; p<0.05). Best-corrected visual acuity decreased proportionally to the degree of myopia.

Conclusion. Optical coherence tomography allows for early detection of structural changes. Progressive axial elongation and choroidal thinning are associated with reduced visual function, particularly in high myopia.

Background. Transscleral laser coagulation in retinal pathology have important advantages in cases of reduced transparency of optical media and the need for treatment on the periphery of the fundus. However, optical media opacities make it challenging to accurately assess the severity of the burns that occur, so the development of more precise dosing methods, including automated ones, could help to make transcleral laser coagulation a more effective and safe treatment option and allow its use in routine clinical practice.

Aim. To investigate the relationship between temperature and its variations on the scleral surface and the intensity of laser burns during transscleral laser coagulation of the retina.

Materials and methods. An experimental study was conducted on five rabbits (10 eyes). Transscleral laser exposure was performed using a diode laser (Alod-01, Alkom Medica, 810 nm) with a power of 0.2 W and a spot diameter of 300 microns on the surface of the sclera. The temperature was measured remotely using a thermal camera (Guide MobIRAir, China) on the surface of the sclera at the point of exposure. The severity of coagulation injury was characterized as barely visible, mild, moderate and intense burns, and for each level, the duration of exposure, temperature, and temperature difference on the surface of the sclera at the point of exposure were taken into consideration.

Results. The formation of barely visible burns occurs when the temperature on the surface of the sclera rises by 2.10 ± 0.320 °C, mild burns gradient on the surface of the sclera in the laser exposure zone and the time of burn formation at all intensities considered (r>0.45, p<0.05).

Conclusion. During transscleral laser coagulation of the retina, the temperature on the surface of the sclera at the point of exposure increases and correlates with the time and intensity of burns formed on the fundus.

Objective. To analyse and evaluate the results and effectiveness of ocular prosthetics in patients with congenital anophthalmia and microphthalmia based on four years of observation data.

Materials and methods. The clinical observation group consisted of 270 (two hundred and seventy) patients: 202 patients with congenital anophthalmia (74.8% of patients) and 68 patients with congenital microphthalmia (25.2% of patients). A retrospective study was conducted based on clinical data collected between 2020 and 2024 at the Eye Prosthetics Centre in Moscow. The age of the patients ranged from 1 month to 80 years. The ophthalmological examination included: assessment of the conjunctival cavity (condition of the arches, its configuration), external examination methods (position of the eyelids, width of the eye slit) and biomicroscopy of the conjunctiva and the surface of the ocular prosthesis. Photography was used at all stages for objective assessment of the results and monitoring of effectiveness.

Discussion. Retrospective analysis of the effectiveness of ocular prosthetics in patients with congenital anophthalmia and microphthalmia revealed that the results depended on age and management tactics. The key prognostic factors for success were: early primary prosthetics, adherence to the schedule for planned replacement of ocular prostheses, thorough hygiene and regular care of the conjunctival cavity and prosthesis, and the absence of conjunctival inflammation.

Conclusion. Stepwise ocular prosthetics is a key rehabilitation method for patients with congenital anophthalmia and microphthalmia. The best functional and cosmetic results are observed with the use of custom-made prostheses that compensate for the missing volume and accurately imitate the appearance of a healthy eye. A comprehensive approach minimises psychological trauma and creates conditions for successful social adaptation of the patient.

Adnexal lymphoma account for about 8% of extranodal lymphomas, with the lacrimal gland involved in 7–26% of cases. Lacrimal gland lymphoma (LGL) is more commonly diagnosed in older individuals, predominantly women. B-cell subtypes predominate, with MALT lymphoma being the most frequent. Diagnosis is challenging due to clinico-radiologic mimicry; therefore, analysis of tear fluid (TF) as an accessible “liquid biopsy” has practical value.

Objective: to examine the profile of 7 key cytokines (IL-6, TNF-α, IL-2, IFN-γ, IL-17A, IL-4, IL-10) in TF of patients with LGL and assess their diagnostic informativeness.

Methods: The pathology group included 8 patients with histologically verified LGL (mean age 56,5 ± 10,6 years; 75% women; bilateral disease – 25 %; generalized involvement–12,5%): MALT lymphoma – 5, follicular – 2, mantle cell – 1. The control group comprised 10 healthy volunteers. TF was collected in the morning during preoperative preparation, ≥50 µL (both eyes in LGL; one eye in controls). Detection frequency and concentrations of cytokines were determined by multiplex immunoassay. Results were compared between groups using statistical analysis.

Results. In the affected eye of LGL patients, the detection frequency of all cytokines increased (reaching 100% for IL-6, IL-2, and IL-17A) and their levels were higher versus controls. On the contralateral, clinically healthy side, increases were evident mainly for IL-6 and IFN-γ, with a modest rise for IL-17A. Statistically significant differences from controls were observed for all cytokines on the affected side, and between sides for IL-6, TNF-α, IL-2, and IL-4 (p < 0,05).

Conclusion. Profiling TF cytokines in LGL is a promising direction not only for developing noninvasive differential diagnostic tools but also for informing targeted therapeutic approaches aimed at key mechanisms of carcinogenesis, tumor growth, and progression.

Purpose: To evaluate the anatomical and functional efficacy of autologous retinal transplantation in patients with giant macular holes.

Materials and Methods: A retrospective analysis was performed of three clinical cases of patients who underwent surgery at the Center of Ophthalmology, N.I. Pirogov National Medical and Surgical Center, in 2024–2025. All patients underwent transplantation of a peripheral neurosensory retinal flap into the area of the macular defect, followed by silicone oil tamponade of the vitreous cavity.

Results: Anatomical closure of the foveal defect was achieved in all cases. Serial OCT images demonstrated restoration of the outer retinal layers, including gradual reformation of the ellipsoid zone. Subjective improvement in visual function was noted, with best-corrected visual acuity (BCVA) increasing to 0.2–0.3.

Conclusion: Autologous neurosensory retinal transplantation is an effective method for restoring macular anatomy in cases of giant macular holes refractory to conventional surgical techniques.

Purpose:  To optimize methods of comprehensive treatment of blepharitis using photodynamic therapy (PDT).

Materials and methods. The study involved 80 patients, who were randomly assigned into two groups: a control group and a main group. Participants in the control group underwent conventional therapeutic measures, including hygienic cleansing of the eyelid margins with a 0,02% furacilin solution and topical application of 1% tetracycline ointment. In the main group, along with standard therapy, photodynamic therapy (PDT) was additionally used.

Results and discussions. Integration of photodynamic therapy into the treatment protocol significantly accelerated the resolution of the inflammatory process. By the third day of treatment, the inflammation index had decreased by 2,92 times, and by the eighth day, all patients in the main group exhibited complete regression of eyelid inflammation. Clinical manifestations such as eyelid swelling and hyperemia showed a notable reduction within 4–5 days in the PDT group, whereas in the control group these symptoms subsided only by day 6. Furthermore, pathogenic microflora was eliminated in 85.4% of patients in the main group within 4–5 days, while in the control group complete microbial clearance was achieved only after 6–7 days.

Conclusions. The inclusion of photodynamic therapy in complex treatment increases the effectiveness of blepharitis therapy. PDT ensures faster elimination of inflammatory signs, promotes eradication of pathogenic microflora in 85,4% of cases, and reduces the duration of treatment by an average of 5–6 days.

The aim of this study was to investigate the incidence and prognostic value of schisis of the retinal nerve fiber layer (sRNFL) in epiretinal membrane (ERM) surgery with internal limiting membrane (ILM) peeling.

Material and Methods. The surgical outcomes of 64 patients (66 eyes) with ERM were retrospectively evaluated. The incidence and relationship of sRNFL with surgical characteristics, various OCT biomarkers, and final best-corrected visual acuity (BCVA) were studied. The follow-up period was 1 year.

Results. The incidence of sRNFL was 37.9%. In the sRNFL group, the overwhelming majority of ERMs (96%) were classified as stage 3 and 4, subfoveal ellipsoid zone (EZ) defects were also significantly more common (64% versus 14.6%; p <0.001) and perivascular anomalies (84% vs. 9.8%; p <0.001). In addition, the group with sRNFL had a significantly higher preoperative central retinal thickness (CRT): 477.6±78.1 vs. 324.8±102.6 (p <0.001), and the incidence of intraretinal microcysts was 84% and 43.9% (p = 0.002), respectively. The “wave” symptom in the group with sRNFL occurred in 56% of cases; without sRNFL, it occurred in 19.5% (p = 0.003). In the group with sRNFL, en bloc removal of ERM with ILM occurred in 92% of cases, while in the other group - in 51.2% (p <0.001). At the end of the follow-up period, patients in the sRNFL group had a significantly higher incidence of EZ defects (52% vs. 9.8%; p <0.001) and microcystic macular edema (52% vs. 22%; p = 0.014). Visual acuity in the comparison groups, both preoperatively and 1 year after treatment, did not differ significantly (0.34±0.18 vs. 0.38±0.15; p = 0.18 and 0.74±0.28 vs. 0.84±0.17; p = 0.28, respectively).

Conclusion: sRNFL is a frequent occurrence that is accompanied by ERM and is significantly more prevalent in more severe stages of ERM (with the presence of ectopic inner foveal layers, EZ defects, and greater CRT). sRNFL is a sign of a strong connection of the ERM with the underlying retina, which is confirmed by a significantly higher frequency of the intraoperative “wave” symptom and an extremely high (92%) probability of removing the ERM en bloc with the ILM in eyes with the presence of this sign.

Target. To evaluate changes in retinal thickness according to optical coherence tomography (OCT) in patients with resistant diabetic macular edema after vitreoretinal surgery.

Materials and methods. 30 patients (30 eyes) with a diagnosis of resistant diabetic macular edema were examined. In group 1 (15 patients, 15 eyes), a standard 25G vitrectomy with membrane peeling was performed. In group 2, 15 people (15 eyes) underwent 25G vitrectomy, membrane peeling, and subretinal administration of a balanced saline solution.

Results. A week after the operation, patients in the 2nd group showed a decrease in the total thickness of the retina (Full retinal) compared to the 1st group, according to OCT. The average value was 334.1± 23.7 microns (p = 0.047), which was 1.17 times less than in patients of the 1st group. By the end of the first month, the thickness of the retina decreased to 280.7±24.1 microns (p = 0.045 compared with patients in group 1), which corresponded to a decrease of 1.25 times.

There was also a statistically significant decrease in retinal thickness in the para- and perifoveal regions, mainly in the temporal sector. In the upper sector, the dynamics was less pronounced and manifested itself later, for periods from 1 to 6 months of follow-up.

In the Inner/Outer Retinal Thick modes, it was revealed that a significant change in retinal thickness occurs due to a decrease in the outer layer.

Conclusion. The use of vitrectomy with peeling and subretinal administration of balanced saline solution in refractory diabetic macular edema contributed to a decrease in retinal thickness according to OCT. The results obtained indicate the effectiveness and potential of this surgical technique in the treatment of resistant forms of diabetic macular edema (DMO) that do not respond to standard Anti-VEGF and steroid therapy.

Backgraund. Surgical treatment methods for active ROP generally achieve relatively good anatomical results, but visual function can be poor, especially in advanced stages, despite technological advances in vitreoretinal surgery. However, there are still no standards for the choice of methods and timing of ROP surgery depending on the stage and type of disease progression.

Aim – to conduct a retrospective analysis of the results of vitreoretinal surgery in the active period of retinopathy of prematurity, followed by an assessment of the functional results in the cicatricial phase of the disease.

Materials and methods. This study was conducted in two stages. The first stage consisted of a retrospective analysis of the results of vitreoretinal surgery performed at the Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution from 2012 to 2024 in 89 children (89 eyes) with ROP in the active phase of the disease. The second stage included an assessment of the functional outcomes in the same 89 children (89 eyes) in the cicatricial phase of ROP using standard ophthalmological examination data (visometry, refractometry, perimetry, tonometry, ophthalmoscopy, B-scan).

Results. The retrospective study included a group of premature infants with a gestational age of 25-32 weeks and a birth weight of 700-1500 grams who underwent vitreoretinal surgery of varying extents depending on the severity of the pathological process. The most successful outcomes were observed in surgeries performed at stages 3 and 4a of active ROP, whereas the effectiveness of surgical treatment was significantly reduced at later stages (stages 4b and especially 5).

Analysis of data from the cicatricial period of ROP revealed significant differences in functional outcomes depending on the stage of the disease and the type of surgical intervention performed. In children over four years of age, significant visual acuity deficits were observed, especially in the groups operated on at later stages of ROP (stages 4b and 5).

Conclusions. The results of the study demonstrate that the final anatomical and functional outcome in each specific case depends on the surgical treatment method used during the active period of ROP to stabilize the pathological process, at what stage of the disease the treatment was carried out, the general condition of the child, the scope and timing of the surgical treatment, as well as the post-conceptual age at the time of its implementation.

Purpose: To examine cataractogenic risk factors in corneal laser refractive surgery and propose a scoring system for them.

Patient and Methods: Literature data on cataract development after corneal refractive surgery were analyzed.  Our own clinical material covers 20 years of clinical observations of the long-term results of various keratorefractive surgeries with an emphasis on the state of the lens and the development of cataracts in periods from 5 to 20 years or more after laser refractive surgeries on the cornea (PRK, TransPRK, LASIK, FemtoLASIK, SMIL).

Results: Literature analysis showed that after corneal laser refractive surgery, cataracts appear to be younger by an average of 10 years. The main risk factors for cataractogenesis included corneal thinning, a high degree of initial ametropia, residual lower-order aberrations, induced higher-order aberrations, patient age, accommodative disorders, and presbyopia. Clinical observations have shown that laser correction of high ametropia significantly increases the risk of cataractogenesis. This is due to the larger volume of stromal tissue removed, a more pronounced aseptic inflammatory response with the accumulation of peroxide radicals and oxidative stress in all structures of the anterior segment of the eye. Late after refractive surgery, the photoprotective function of the thinned cornea weakens, increasing UV stress on the lens, which is one of the important factors initiating cataractogenesis and the earlier development of cataracts.

Conclusion: For clinically significant early development of cataracts after laser refractive surgery on the cornea, a combination of several cataractogenic factors is necessary, such as the degree of corneal thinning, the magnitude of ametropia, the severity of the aseptic inflammatory reaction in the tissues of the anterior segment of the eye in the early postoperative period, induced higher-order aberrations, residual lower-order aberrations, weakness of accommodation and the development of presbyopia.

Rhegmatogenous retinal detachment (RRD) remains a leading cause of acute visual loss and requires timely surgical repair. Contemporary epidemiology shows rising RRD incidence worldwide among highly myopic patients [1–4]. First-line surgical management for RRD with superior breaks is debated. Pneumatic retinopexy (PR) offers minimally invasive repair with favorable functional outcomes in well-selected cases; the PIVOT randomized trial demonstrated better visual acuity and less vertical metamorphopsia versus pars plana vitrectomy (PPV), albeit with higher rates of new postoperative breaks and strong dependence on patient compliance with head positioning [6–8; 17–19]. Scleral buckling (SB) remains relevant, especially in phakic eyes due to lower cataract progression risk, while PPV is now the most commonly performed procedure, driven by improved visualization, control of proliferative vitreoretinopathy (PVR), and advances in technology (small-gauge systems, 3D heads-up viewing, intraoperative OCT) [5; 9–11; 20–22]. Choice of tamponade (air, SF6/C2F6/C3F8 gas, silicone oil) should account for break location, PVR grade, and patient positioning; air tamponade is increasingly discussed for uncomplicated superior breaks, whereas long-acting gas or silicone oil remains preferable for giant retinal tears and advanced PVR [13–16; 23–25]. This review synthesizes selection criteria and proposes a pragmatic decision algorithm considering lens status, number and extent of breaks, PVR severity, macular status, and positioning adherence.

Background. Postoperative cystoid macular edema (CME) is a complication of surgical treatment of various eye diseases and is caused by the development of an aseptic inflammatory reaction. The lack of a universal treatment regimen for CME necessitates the development of therapeutic methods for this complication. The objective of this study was to evaluate the clinical efficacy of a combination anti-inflammatory treatment regimen for postoperative CME. Material and Methods. This study presents a series of 8 clinical cases. All patients received treatment according to the developed regimen using steroidal and non-steroidal antiinflammatory drops. Results. In all cases, improvements in visual function and retinal anatomical condition were achieved. Conclusion. The proposed CME treatment regimen has demonstrated efficacy and is recommended for use and further study in a larger sample of patients

Relevance. Diagnosis and visualization of the anterior segment in IOL dislocation is fundamental in choosing the most effective method of repositioning dislocated IOL, ultrasound biomicroscopy (UBM) is practically the only highly informative method that allows non-invasive visualization of the pre-equatorial zone of the eyeball in vivo.

Goal. To evaluate the dynamic position of the IOL using the UBM method in patients with IOL dislocation.

Materials and methods. The study included 12 patients (12 eyes) with a diagnosis of grade 2.3 IOL dislocation and secondary uncompensated glaucoma. Grade 2 dislocation was detected in 41.6% of patients (5 eyes), grade 3 dislocation in 58.4% of patients (7 eyes). In order to assess the dynamic position of the IOL, all patients underwent an additional diagnostic examination, which included performing UBM axial scanning in the horizontal and vertical meridians in the “sitting” and “lying” positions of the subject. The statistical analysis was performed using the StatTech v. 4.8.11 software (developed by Stattech LLC, Russia).

Results. IOL contact with uveal structures in the “lying” position was observed in 16.7% of cases (2 eyes), while in the “sitting” position, IOL contact with uveal structures was observed in 100% of cases (12 eyes). According to the data obtained, when performing UBM in the “lying” position of the subject in comparison with the “sitting” position of the subject, there is a deepening of the anterior chamber, an increase in the CPC, and a posterior displacement of the IOL, therefore, the possibility of assessing the dynamic position of the IOL when performing UBM in the horizontal and vertical positions of the subject makes it possible to more reliably assess the nature of changes in the anterior segment of the eye.

Conclusion. The use of UBM in various positions of the patient’s body makes it possible to identify significant changes in the position of the intraocular lens and clarify the mechanisms of development of postoperative complications.

Actuality. Idiopathic epimacular fibrosis (EMF) is a fibrocellular formation on the inner boundary membrane of the retina and leads to a decrease in central visual acuity, metamorphosis and thickening of the macula. The standard of treatment is vitrectomy with EMF removal, however, the need for routine MIC peeling remains controversial. Peeling reduces the risk of EMF recurrence, while macular photosensitivity may decrease due to the phenomenon of dissociation of the nerve fiber layer (DONFL – Dissociated Optic Nerve Fiber Layer).

Goal. To determine the effect of VPM peeling on the long-term functional outcomes of vitrectomy in patients with idiopathic EMF and to identify morphological predictors of the outcome.

Materials and  methods. A retrospective cohort study included 96 patients (96 eyes) with idiopathic EMF operated on in 2018-2019. All underwent 25G vitrectomy with induction of posterior vitreous detachment, removal of epimacular fibrosis, in one group an additional circular peeling of the VPM was performed after brilliant blue dual staining (n = 48), in the second group fibrosis removal was limited (n = 48). The follow-up was at least 36 months. The ophthalmological examination included maximally corrected visual acuity (MCI), central retinal thickness, microstructural features according to spectral optical coherence tomography (OCT), and average macular photosensitivity according to microperimetry. EMF staging was performed according to the Govetto classification [3], taking into account the presence of an ectopic inner foveal layer (EIFL – Ectopic Inner Foveal Layer), ellipsoid zone defects (EZ), hyperreflective foci, and stratification of the nerve fiber layer. The main endpoints are ICOSIS and average macular photosensitivity after 36 months, the secondary endpoints are the frequency of EMF recurrence. For statistical analysis, a t-test was used, either the Mann–Whitney criterion, the Fisher exact criterion and the Pearson or Spearman correlation (p<0.05).

Results. The groups did not differ in age, initial MSCI, central retinal thickness, and EMF stage, however, hyperreflective foci (43.8% vs. 20.8%) and EZ defects (39.6% vs. 10.4%) were more common in the peeling group. After 36 months, both groups showed significant improvement compared to baseline, but the MCI was higher in the group without peeling (0.56±0.20 versus 0.45±0.20, p = 0.031), and the average photosensitivity was 28.0±0.97 dB versus 26.4±0.19 dB (p = 0.002). EMF recurrence occurred in 14.6% of patients without peeling and in 4.2% of patients with peeling (p<0.05). The initial ICOS was positively correlated with the final ICOS (r = 0.769) and photosensitivity (r = 0.402), the presence of an EZ defect was associated with worse ICOS (r = -0.223) and photosensitivity (r = -0.372), HPM peeling was associated with lower ICOS (r = -0.338) and photosensitivity (r = -0.883).

Conclusion. The rejection of VPM peeling during idiopathic EMF surgery provided better long-term functional parameters (ICOS and photosensitivity), but was accompanied by a higher recurrence rate. The predictors of the outcome were the initial visual acuity, the stage of EMF, the preservation of the ellipsoid zone, the presence of EIFL and hyperreflective foci. The decision on HPV peeling should be made individually, taking into account the morphological status of the macula and the risk of recurrence.

Macular hole (MH) is one of the most common pathologies of the vitreomacular interface. Despite significant advances in vitreoretinal surgery, there exists a subset of MHs that are refractory to standard approaches.

Purpose. To assess morphometric parameters of the central area of the retina and identify criteria of MH rigidity using optical coherence tomography (OCT).

Materials and Methods. The study included 27 patients (27 eyes). Patients were divided into two groups: Group I (n = 12) — chronic MHs (lasting more than 6 months), stage IV according to J.D. Gass, with the presence of an adhesion band between the retinal pigment epithelium (RPE) and neuroretina at the edges, as detected by OCT; Group II (n = 15) — recent MHs (from 2 weeks to 6 months), stage IV according to J.D. Gass. All patients underwent spectral-domain OCT using the RTVue device (Optovue, USA).

Results. Patients in Group I demonstrated a specific macular zone profile: 1. an adhesion band between the RPE and neuroretina, reflected by the PPhAB length; 2. flat, square edges, indicated by MHE angle <90° (p<0.05), smaller differences between MHDmax and MHDmin (p<0.05), between MHE height (p<0.05), as well as between MHE height and M height compared to Group II (p<0.05); 3. often absence of cystoid edema in the neuroretina at the MH edges (p<0.05).

Conclusion. Optical coherence tomography allows the assessment of several morphometric features that identify criteria of MH rigidity, contributing to the optimization of pathogenetically justified surgical strategies.

Lower eyelid atony is a common cause of ocular prosthetic complications in patients with anophthalmos. Decreased eyelid tone results in prosthesis instability, eyelid eversion, excessive tearing, and inflammatory changes. These manifestations greatly compromise both rehabilitation outcomes and patients’ quality of life. The condition gains particular clinical importance in individuals who have undergone oncological surgery or radiation therapy, where marked scarring and tissue fibrosis often occur in the orbit.

This review article provides an overview of current knowledge regarding the anatomy and physiology of the lower eyelid, the mechanisms underlying atony development, its clinical features, and diagnostic methods. Various surgical correction techniques are discussed — ranging from traditional canthoplasty to the application of synthetic implants and skin–mucosal grafts. The review also addresses specific aspects of ocular prosthesis fitting in patients with eyelid atony, emphasizing the need for individualized design in terms of shape and weight.

Particular attention is devoted to the challenges of ophthalmic rehabilitation in patients post-radiation therapy for retinoblastoma and other malignant tumors. The article highlights the importance of an interdisciplinary approach and underscores early detection of eyelid atony as a key factor for successful ocular prosthetic rehabilitation.

This study presents a comparative analysis of various visual acuity assessment methods, specifically traditional chart-based tests and contemporary vernier acuity tests. The primary focus is on comparing the obtained results and their practical implications for the diagnosis of potential pathologies. It was determined that vernier acuity methods, despite requiring double the testing time, exhibit increased sensitivity to macular changes. The rationale for the combined utilization of these methods is substantiated.

Introduction: Proliferative diabetic retinopathy (PDR) is a severe complication of diabetes mellitus, in whose pathogenesis chronic inflammation and pathological angiogenesis play a key role. Studying the local cytokine profile of the vitreous body allows us to identify specific mediators involved in the development of the disease.

Objective: To conduct a comparative analysis of the concentrations of a wide range of cytokines in the vitreous body of patients with PDR and in the control group to identify an imbalance of key mediators of inflammation and angiogenesis.

Methods: The study analyzed vitreous samples obtained from nine patients with PDR and seven control patients (idiopathic epiretinal membranes). Cytokine concentrations were determined using a multiplex enzyme-linked immunosorbent assay (Bio-Plex Pro Human Cytokine 27-plex Assay). Statistical data processing was performed using GraphPad Prism software. The nonparametric Mann-Whitney U test was used to compare groups. Statistical significance was established at p < 0.05.

Results: Patients with PDR showed statistically significant increases in concentrations of proinflammatory and proangiogenic mediators compared to the control group. The most pronounced increases were noted for IL-8 (6.7-fold), MCP-1 (3.2-fold), and eotaxin (2.3-fold). Levels of IL-6, IL-1β, IL-4, IL-13, IFN-γ, IL-12(p70), and the growth factors VEGF and PDGF-BB were also significantly increased.

Conclusion: These data confirm the central role of local inflammation in the pathogenesis of PDR. The vitreous cytokine profile in PDR is a complex mixture of proinflammatory, proangiogenic, and regulatory signals. The results support the development of therapeutic strategies aimed not only at inhibiting angiogenesis (anti-VEGF therapy) but also at modulating the inflammatory component of the disease.

Traditional methods for assessing postoperative visual function in patients with retinal diseases do not fully reflect current clinical requirements. Visual function is a multi-component process that includes the perception, analysis, and subsequent interpretation of visual stimuli. In ophthalmological practice today, the primary criterion for successful treatment of pathologies of the vitreoretinal interface remains best-corrected visual acuity (BCVA). However, accumulated clinical experience and numerous patient complaints about reduced quality of vision in everyday conditions indicate the need for a more in-depth and objective analysis of the visual system.

For a comprehensive assessment of the functional state of the eye, it is recommended to consider additional parameters such as contrast sensitivity (CS), microperimetry, and optical aberrations, which allow for the evaluation of visual quality under different lighting conditions and image contrast. This literature review is dedicated to summarizing and analyzing current data concerning changes in contrast sensitivity and optical aberrations in patients with diabetic retinopathy (DR) both before and after surgical intervention, depending on the extent of vitrectomy performed. The obtained information can serve as a basis for further research and contribute to the development of standards for assessing visual functions, particularly contrast sensitivity.

Background: Among the complications of episcleral buckling, rejection of buckling materials and the development of granulation polyps of the conjunctiva are particularly common. The development of polyps after scleroplastic surgery occurs due to chronic conjunctival trauma from protruding elements of the buckling material.

Objective: To analyze a clinical case of multiple granulation polyps developing after circular and localized episcleral buckling in a patient with rhegmatogenous retinal detachment.

Materials and Methods: A prospective analysis of the data, clinical presentation, and surgical outcomes of a patient who presented to the Center was conducted.

Conclusion: Granulation polyps are a late complication of retinal detachment, causing significant discomfort to patients. The development of this complication is associated with chronic trauma to the conjunctiva by protruding edges of the filling material or rough scleral sutures, which requires the surgeon to carefully and adequately suturing the filling material during surgery.

One of the important aspects in the treatment of glaucoma is obtaining target values of intraocular pressure. However, it is necessary to take into account the conditions of the anterior segment of the eye when performing surgical treatment of patients with various types of glaucomatous process. With the development of technology at this stage, optical coherence tomography can help us in performing this task, which can assess the condition of the anterior chamber angle. Optical coherence tomography images of 51 patients (51 eyes) were analyzed in order to improve the efficiency and safety of further surgical treatment.

Rationale: open eye trauma with the presence of an intraocular foreign body continues to be among the leading causes of vision loss and disability globally.

Objective: – to study the possibility of performing posterior femtocapsulorhexis in patients with open eyeball trauma and to evaluate its effectiveness in preserving the supporting function of the lens capsular bag during removal of an intraocular foreign body through the anterior chamber of the eye.

Methods: in 2023-2024, 7 patients (7 eyes) were treated at the Kaluga branch of “Eye Microsurgery” with a diagnosis of open trauma to the eyeball with an intraocular foreign body. The age of patients ranged from 20 to 66 years. All patients underwent diagnostic examination. The patients were recommended surgical treatment in the following scope: phacoaspiration of the transparent lens (or phacoemulsification of traumatic cataract) with femtosecond laser accompaniment at the stage of posterior capsulorhexis + vitrectomy + removal of intraocular foreign body by a combined method + IOL implantation.

Results: all surgical interventions were performed without intraoperative complications. In all patients, the intraocular foreign body was removed using a combined approach through the anterior chamber and corneoscleral tunnel incision. In all cases, the IOL was successfully implanted into the capsular bag.

Conclusion: the developed technique for performing posterior femtocapsulorhexis in open eye trauma with an intraocular foreign body increases the functional and anatomical effectiveness of surgical treatment of patients with eyeball trauma during removal of an intraocular foreign body from the vitreous cavity through the anterior chamber.

Retinal arterial macroaneurysm (RAM) is characterised as a saccular or fusiform dilation of retinal arterioles of the first to third order. The main diagnostic methods for RAM include ophthalmoscopy, fluorescein angiography (FA), and optical coherence tomography angiography (OCT-A). Currently, there is no established guideline for patients with RAM. There are limited number of RAM cases in available literature, which may be related to the rarity of this condition in the population. However, the following treatment options have been mentioned: focal laser photocoagulation, micropulse laser therapy, and intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors. A 58-year-old female patient with RAM complicated by macular edema with a central retinal thickness (CRT) of 398 µm underwent staged combined laser-surgical treatment. At the first step, intravitreal anti-VEGF therapy was performed. Reduction of retinal thickness allowed to progress to the second step – focal laser photocoagulation along the affected vascular arcade. Best corrected visual acuity (BCVA), central retinal sensitivity, and CRT were evaluated. After the combined treatment was carried out, BCVA improved from 0.8 to 1.0. OCT showed a decrease in CRT to 262 µm (∆136 µm). Microperimetry demonstrated an increase in central retinal sensitivity from 25.8 dB to 27.6 dB. This clinical case demonstrates that a combined approach to treatment including intravitreal anti-angiogenic therapy followed by focal laser photocoagulation is effective in the resorption macular edema height and improving visual function.

Purpose. To perform a clinical and functional evaluation of ocular tone disturbances and their consequences in patients with thyroid eye disease (TED), with an emphasis on determining the role of structural changes in Schlemm’s canal in the development of ocular hypertension.

Materials and Methods. Ninety-two patients (150 eyes) were examined and divided into four groups: TED with ocular hypertension, TED without ocular hypertension, primary open-angle glaucoma, and healthy controls. Comprehensive ophthalmological assessment included visual acuity testing, tonometry, tonography, perimetry, optical coherence tomography (OCT) of the anterior segment and optic nerve head, as well as morphometric analysis of Schlemm’s canal. The NOSPECS and CAS scales were used to assess disease activity.

Results and Discussion. Patients with TED and ocular hypertension demonstrated significantly more severe disease manifestations according to the NOSPECS scale, a decreased outflow coefficient (0,12±0,02 mm³/min/mm Hg), elevated intraocular pressure and ocular rigidity coefficient, and morphological narrowing of Schlemm’s canal. These parameters correlated with retinal nerve fiber layer (RNFL) thickness and the severity of visual field defects, closely resembling the ocular hydrodynamic profile of primary open-angle glaucoma.

Conclusion. Ocular tone disturbances in thyroid eye disease are associated with morphofunctional changes of the ocular drainage system and require early diagnosis using OCT and tonography for timely detection of ocular hypertension and prevention of glaucomatous complications.

Background. Despite the development of new surgical techniques, silicone tamponade continues to be an important part of the surgical treatment for full-thickness macular hole (FTMH). However, there has been little research into the potential effect of silicone oil in the vitreous cavity on retinal blood flow in the macular area and functional recovery after surgery.

Aim. To study changes in retinal blood flow in the postoperative period following closure of the FTMH using silicone tamponade.

Materials and methods. The study included 40 patients (40 eyes) with stage 4 idiopathic FTMH, according to the classification of D. Gass. The patients were divided into two subgroups: 20 patients with silicone tamponade and 20 with gas tamponade. The OCT angiography method was used to study the area of the foveal avascular zone (FAZ), vascular density in the superficial and deep capillary plexus (SCP and DCP) in the fovea and parafovea, as well as the apical (minimum) diameter of the macular hole, the area of cystic changes in the inner nuclear and outer plexiform layers, and changes BCVA and retinal sensitivity (RS) at the fovea and parafovea levels. The studies were conducted before surgery and 2 and 6 months afterwards.

Results. In the subgroup with silicone tamponade, two months after macular hole closure, there was a significantly lower vascular density in the SCP and the DCP in the fovea (p = 0.032 and p = 0.034, respectively), as well as a decrease in vascular density in these regions in the parafovea (p = 0.04 and p = 0.029, respectively). Additionally, there were lower mean values for the RS in both the fovea and the parafovea (p = 0.029 and p = 0.031, respectively). The change in the mean foveal and parafoveal RS correlates with changes in the vessel density in the DCP fovea and parafovea (r = 0.34 and r = 0,29 respectively, p<0.05) and with the vessel density in the SCP in the fovea (r = 0.33, p = 0.01), respectively.

Conclusion. Silicone tamponade used in the treatment of FTMH may have a negative impact on macular perfusion, potentially slowing down or reducing the functional recovery of the retina during the early postoperative period. 

Objective: To study the epidemiological history features in young patients with type 1 diabetes (T1D) and advanced diabetic proliferative retinopathy (PDR).

Materials and Methods: Retrospective analysis of medical records and surveyed of 44 young patients (18-44 years old) with advanced PDR. The study included standard ophthalmologic examination, general health assessment by therapist and endocrinologist, necessary laboratory tests, and measurement of glycated hemoglobin (HbA1c) levels.

Results: The study showed poor glycemic control in most patients of this age group, with only 36.4% having HbA1c < 8% at admission. The mean duration of type 1 diabetes was 20.9±4.03 years. Advanced PDR was diagnosed at age under 30 years in 47.7% of cases at first admission. Visual acuity less than 0.1 of the “main” eye was significantly more frequent (70.0%) among rural residents. Despite young age, most patients had severe concomitant somatic pathology.

Conclusion: Diabetic retinopathy in young adults with type 1 diabetes clinically manifests and rapidly progresses between 20–40 years, especially in patients with early diabetes onset. Regular scheduled exams, use of modern technologies such as continuous glucose monitoring sensors, and awareness of diabetic retinopathy features in young T1D patients by both ophthalmologists and patients themselves allow timely diagnosis of disease progression to the proliferative stage and prompt initiation of treatment, including surgical interventions

Relevance: Full– thickness macular hole (FTMH) is a pathology of the vitreoretinal interface, which is characterized by a full-layered defect of the neuroepithelium in the foveolar zone. With large-diameter FTMH, standard surgical tactics can achieve anatomical success in only 50-73.3% of surgical procedures. The task of developing a method for the surgical treatment of large-diameter CMP with the possibility of evaluating its closure intraoperatively is an urgent task and may be of interest for the development of ophthalmic surgery.

Purpose: to evaluate the anatomical and functional results of large FTMH surgery using the proposed technique in the long-term postoperative period.

Materials and methods. A randomized trial was conducted on two comparable groups. The patients underwent a comprehensive ophthalmological examination, including visual acuity, intraocular pressure, ophthalmoscopy, and optical coherence tomography of the retina before surgery, 1, 6, and 12 months after surgery. Surgical treatment of FTMH was performed in both groups, in the first group, the stage of closure of the FTMH was carried out according to the proposed method, in the second group, autologous conditioned plasma was applied to the rupture surface with subsequent exposure to close the FTMH.

Results and discussion: In the control group, 4 cases of FTMH recurrence were recorded in the postoperative period for up to 1 month after surgery. The U-shaped closure pattern was more often observed in the first group, while the V-shaped closure pattern was more often observed in the second group. Visual acuity 12 months after surgery was higher on average in patients in the first group (p = 0.05).

Conclusions: The developed technique for closing the FTMH has demonstrated a significant reduction in the risk of recurrence in the postoperative period. The use of this surgical approach ensures the achievement of a U–shaped closure of the FTMH, as well as the achievement of positive dynamics of functional outcomes, resulting in higher rates of BCVA. This technique is promising and requires further research.

Rationale: EDOF IOLs, while providing an extended depth of focus, are associated with fewer adverse optical phenomena, although they may limit near vision. Therefore, to expand visual capabilities, methods of mini-monovision and combined IOL implantation are used.

Objective: To analyze the effectiveness of combined implantation of a non-diffractive EDOF IOL and a multifocal intraocular lens.

Materials and Methods: This prospective study included 138 patients (276 eyes), comprising 77 women and 61 men, after bilateral or unilateral implantation of various IOL models. Group I included 40 patients (80 eyes) after combined implantation of the AcrySof IQ Vivity IOL (n = 40) in the dominant eye and the AcrySof IQ Panoptix IOL (n = 40) (Alcon, USA) in the non-dominant eye, with a mean follow-up period of 15.4±1.2 (range 12-22) months. Group II included 40 patients (80 eyes) who underwent bilateral implantation of the EDOF AcrySof IQ Vivity IOL. Group III consisted of 58 patients (116 eyes) with bilateral implantation of the trifocal AcrySof PanOptix IOL. All patients underwent a comprehensive standard and special ophthalmological examination. Phacoemulsification cataract surgery was performed using a standard technique.

Results: A significant (p<0.05) increase in UDVA, CDVA, and UNVA was observed at the maximum follow-up period compared to preoperative values in all groups. In Group III and Group I (combined implantation), a significantly greater increase in UDVA and CDVA was noted at the 3-month follow-up compared to Group II (up to 0.83±0.14; p<0.05 and 0.82±0.09 (p = 0.048), respectively) with distance correction throughout the entire follow-up period (p<0.05). Patients in Group II were characterized by an increase in UNVA from 0.29±0.09 preoperatively to 0.9±0.20 at the maximum follow-up period. A similar dynamic was noted in Group III (0.34±0.09 and 0.87±0.13, respectively). Over the same follow-up period, an increase in UNVA was observed in Group I from 0.31±0.06 to 0.86±0.14, respectively. The differences between the groups at all follow-up periods were not statistically significant (p>0.05). In the combined implantation group, a reduction in the spherical equivalent of refraction was shown from -2.50±1.3 to -0.12±0.64 at the 3-month follow-up. In Group II, 10% of patients reported complaints of ‘glare’, 10% of ‘halos’, and there were no complaints of difficulties with night driving. In Group III patients, the frequency of unwanted optical phenomena was significantly higher: 32.8% of patients complained of glare, 27.6% of halos, and 24.1% of patients reported difficulties with night driving. In Group I (combined implantation), the frequency of complaints was comparable to Group II: glare (10%), halos (10%), and difficulties with driving at dusk (5%).

Conclusion: Combined implantation of EDOF and trifocal IOLs demonstrated advantages compared to bilateral implantation of each of these lens types: it allows for achieving higher near visual acuity while simultaneously reducing the frequency of adverse optical phenomena.

The risk of recurrence INCREASED in the postoperative period varies from 3 to 30%. Among the recurrence rates after successful surgical treatment, the progression of PVR is an established cause in 60% of cases, being one of the most serious complications occurring in the postoperative period. The purpose of the study:

To evaluate the effectiveness of surgical treatment of retinal detachment using intraoperative binary contrast. Materials and methods. The study included 80 patients with retinal detachment up to 1 month. The patients were divided into two groups of 40 eyes each: The main group was using IBD. The control group underwent a standard vitrectomy without IBD. Results. At the initial stage, visual acuity indicators (MCI) were comparable in both groups. During follow–up (up to 12 months), both groups showed a significant improvement in ICOS, with more pronounced dynamics in the main group (with IBD), especially noticeable after 12 months - more than twice as much as in the control group. In a number of cases, relapses and complications such as proliferative changes, such as stellate membrane or epimacular fibrosis, as well as cases of previously undetected retinal tears, have been reported. Evaluation of the OCT data showed that the structure of the retina, including the CTS, remained stable without significant differences between the groups throughout all periods.

Backgraund: Modern uveal cataract surgery technologies allow for high functional results. Recently, refractive performance requirements have increased, and calculating the optical power of intraocular lenses (IOLs) is a pressing issue, as new technologies require different positioning.

Aim: To determine the correction value for the IOL power calculation formula in uveal cataract surgery using the developed technology.

 Materials and methods: Two groups of patients underwent cataract surgery complicated by severe adhesions using the developed technique. All patients underwent anterior segment optical coherence tomography preoperatively and three months later to assess anterior chamber depth, iris-to-IOL distance, and IOL position. IOL power was calculated using the Holladay II formula. In the study group, a correction of -0.6 diopters (D) toward the myopic side was applied to the planned spherical equivalent. Anterior segment structures, IOL position, and refractive error were assessed three months after surgery.

Results: In the study group, the refractive error was negative, amounting to -0.16+0.07 D. In 85% of cases (36 eyes), the achieved refraction was within ±0.5 D of the target, and in 97.5% of cases (39 eyes), it was within ±1.0 D. In the control group, the refractive error was 0.58+0.16 D, indicating a hyperopic shift in the target refraction compared to the planned one. In 27.5% of cases (11 eyes), the postoperative refraction deviated from the target by ±0.5 D, and in 55% of cases (22 eyes), it was within ±1.0 D.

Conclusions: The use of a developed technology for cataract surgery complicated by severe adhesions in non-infectious uveitis allows for stable anatomical and topographic results and reduces the risk of recurrent adhesions in the anterior segment. Calculating IOL power using the Holladay II formula (with adjustments) in this group of patients significantly improves refractive outcomes.

This study aimed to evaluate the impact of cataract phacoemulsification (PE) on keratometry in patients who had previously undergone non-penetrating deep sclerectomy (NPDS), using anterior segment optical segment coherence tomography (OCT). Methods: We analyzed four clinical cases of PE, two of which were performed with femtosecond laser assistance. Results: During the 12-month follow-up period after PE, no significant effect on keratometric parameters was observed, irrespective of the initial corneal status or the use of a femtosecond laser. OCT data likewise revealed no pronounced structural changes in the NPDS zone following PE.

In case of combined pathology, in particular aphakia and regmatogenic retinal detachment, an important point is the leveling of changes in the iridocrustal apparatus. When analyzing the morphoanatomic parameters of the angle and depth of the anterior chamber using optical coherence tomography, distinctive features were revealed in patients with various methods of correcting the defect of the iridohrustal barrier. Purpose. of the study was to evaluate anatomical changes in the angle and depth of the anterior chamber in patients with various types of intraocular correction of the defect of the capsule-binding apparatus under conditions of tamponade of the vitreal cavity with silicone oil. Materials and methods. Studies were conducted on 74 eyes of patients aged 56 to 75 years with various methods of correction of aphakia and silicone tamponade of the vitreal cavity. Results. There was a significant decrease in the anterior chamber angle in various sectors in patients with aphakia, in contrast to patients with anterior chamber and transclerally fixed intraocular lenses. A similar trend is observed in patients with anterocameral intraocular lenses, relative to the group of patients with artifacia. A decrease in the depth of the anterior chamber was revealed in patients with anterior chamber lenses relative to patients with transcleral fixation and articulation was revealed in the upper sector. In the temporal sector, there is a decrease in this indicator in patients with aphakia relative to patients with artifakia. Conclusion. In the conditions of silicone tamponade of the vitreal cavity, the technique of transcleral fixation of intraocular lenses provides the most physiological indicators of the anterior chamber angle comparable to single-format indicators of patients with artifacia.

Modern swipe-source OCT (SS-OCT), in particular the CASIA2 system, has become a key tool in ophthalmology for visualizing the anterior segment of the eye. Its technological advantages, including a wavelength of ~1310 nm and high scanning speed, ensure deep penetration and high image quality of the cornea, anterior chamber angle, iris and lens. This allows us to move from qualitative assessment to accurate quantitative biometrics. The method is especially important for the diagnosis and monitoring of angleclosure glaucoma, objectively assessing the degree of iridotrabecular contact using the ITC index, which helps in choosing between laser iridotomy and lens removal. Accurate measurements of the lens parameters (thickness, curvature, position) reveal its role in the pathogenesis of the disease. The use of OCT is also effective for monitoring changes after intravitreal injections and noninvasive visualization of lacrimal tracts. A promising direction is the integration of quantitative OCT data with machine learning algorithms to personalize treatment. Thus, SS-OCT significantly expands the possibilities of diagnosis, intervention planning, and outcome prediction in refractive, cataract, and glaucoma surgery.

Aim. The aim of the study is to compare changes in contrast sensitivity in patients with mild to moderate myopia after keratorefractive interventions using the SMILE, FemtoLASIK and PRK techniques.

Material and methods. The SMILE group consisted of 36 eyes with spherical refraction -3,6±1,6 dpt, the FemtoLASIK group consisted of 34 eyes with spherical refraction -3,4±1,5 dptr and the PRK group of 36 eyes with spherical refraction -3,6±1,5 dptr. The Zebra visocontrastometry program, version 3.02 (Astroinform SPE, Russia), was used to investigate spatial contrast sensitivity (CS). The study was performed before and 1 month after keratorefractive intervention.

Results. Analysis of the comparison between the preoperative CS level and the 1 month after keratorefractive intervention in SMILE group patients revealed a statistically significant CS decrease at high frequencies in the range 11,3 cycle/deg (р  =  0,01) and 16 cycle/deg (р = 0,005), in PRK group patients revealed a statistically significant CS decrease at high frequencies in the range 11,3 cycle/deg (р = 0,003), 16 cycle/deg (р = 0,002). In the FemtoLASIK group changes in spatial CS were not statistically significant (p>0.05).

Conclusion. FemtoLASIK allows us to preserve eye contrast sensitivity, i.e. does not lead to its significant decrease.

Objective: to analyze the morphofunctional parameters of the retina in submacular fracture of various areas on the background of age-related macular degeneration. A prospective study was conducted, which included 109 eyes (98 patients) divided into 3 groups of hemorrhages of different sizes.

Results: Statistical analysis revealed significant differences between groups of patients with different areas of QMS in the ICOS between all pairs of groups: when comparing groups 1 and 2 (U = 1228, p<0.001), groups 2 and 3 (U = 1254, p<0.001), and 1Groups 2 and 3 (U = 1254, p<0.001). Correlation analysis using Spearman’s r-criterion revealed a strong inverse relationship between the area of the QMS and the indicators of the ICOS (rS = -0.81), as well as a strong positive relationship between the values of the CTS and the area of the QMS (rS = 0.85).

Conclusion: The data obtained demonstrate that an increase in the area of submacular hemorrhage leads to a progressive deterioration in the functional state of the retina.

Aim: To formulate an algorithm for choosing surgical treatment for inferior recurrence of retinal detachments (RD) in eyes under silicone tamponade depending on the stage of APVR.

Materials and methods.  This study included the results of surgical treatment of 114 patients with inferior recurrence of RD under silicone tamponade of the vitreous cavity with APVR. Patients were divided into three groups depending on the stage of APVR and into six subgroups depending on the tactics of surgical treatment. The main criteria are achieving anatomical success rate and improving visual outcomes were compared postoperatively.

Results. An algorithm for choosing surgical treatment for inferior recurrences of RD under silicone tamponade has been formulated depending on the stage of PPVR: at the initial stage of PPVR – performing only scleral buckling (SB); at an advanced stage of PPVR – performing vitreoretinal surgery in combination with SB; at an advanced stage of PPVR – performing vitreoretinal surgery in combination with retinotomy and short-term postoperative tamponade of the perfluorocarbon liquids.

Conclusion. The created algorithm for choosing surgical intervention for inferior recurrences of RRD complicated by PPVR, under silicon oil tamponade depending on the stage of PPVR, allows to improve the anatomical and functional results of treatment.

The objective of the study: to study a standardized model of a gunshot penetrating wound of the eye without an intraocular foreign body (type B open globe injury).

Materials and methods. The experimental study was performed using a standardized model [1] of 36 Chinchilla rabbits (71 eyes). A gunshot penetrating wound to the eye without an intraocular foreign body, an open type B globe injury (OGI B), was simulated using an air rifle and upgraded projectiles for it. After modeling OGI B, a detailed ophthalmological analysis of the animals was performed on the control days of the study. A set of modern standard and high-tech methods for determining proliferative vitreoretinopathy (PVR) were used: ophthalmoscopy, optical coherence tomography (OCT), magnetic resonance imaging (MRI), ultrasound (USG) and histological examination of the eyeball. Nonparametric statistical methods were used.

Results. An analysis of the information content, including comparative analysis, of the used methods for diagnosing PVR proved the relevance of each of them. Additionally, the use of MRI has demonstrated for the first time a high level of information and visibility in the diagnosis of ARV.

Conclusion. The study of proliferative signs using various methods of analysis (histological, ophthalmoscopy, OCT, USG and MRI) confirmed the possibility of their use as markers of PVR. It also made it possible to replace these diagnostic methods in the diagnosis of proliferative changes after injury. MRI as a method of diagnosing PVR is noted for its high information content and visibility.

Purpose: to evaluate the efficacy and safety of our proposed method for treating keratoconus, including in patients with a corneal thickness of less than 450 microns, using corneal collagen UV crosslinking in combination with personalized transepithelial photorefractive keratectomy (Pirogov protocol).

Material and methods. A total of 60 patients (60 eyes) with progressive keratoconus stages I-II were examined. The first group consisted of 30 patients who underwent the standard Dresden UV crosslinking protocol, the second group consisted of 30 patients who underwent simultaneous personalized photorefractive keratectomy (PRK) with UV crosslinking according to the Pirogov protocol. All patients underwent visometry, refractometry, keratometry, keratopachymetry, keratotopography and optical coherence tomography (OCT) of the cornea before, 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 surgery, a reliable (p<0.05) increase in uncorrected and best-corrected visual acuity (UCVA and BCVA) was observed after 1 month. after surgery relative to the initial 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 of refractive indices (spherical equivalent of refraction decreased from -5.08±0.20 D to -1.04±1.56 D after 1 month) 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 statistically change during the entire observation period.

Conclusion. The developed method of one-stage combined surgery of UV crosslinking of the cornea with personalized PRK on the excimer laser “Microscan Visum” demonstrated high efficiency and safety in the treatment of progressive keratoconus stages I-II.

Purpose. To analyze the medical documentation of patients with diseases of the orbit according to the ophthalmology clinic named after Professor V.V. Volkov Military Medical Academy from 2015 to 2023.

Material and methods. A total of 336 patients with orbital diseases were examined. The study included 73 patients who were hospitalized for orbital tumors. Medical documentation included: electronic medical history data, conclusions of instrumental research methods and histological examination.

Results. The average age of the patient with an orbital tumor was 51±2.1 years (range 19 to 89 years) (men: 39, women: 34). As part of the provision of high-tech medical care, 35 people received treatment, 27 received treatment under benefits from the Ministry of Defense of the Russian Federation, 6 under the compulsory health insurance fund, and 5 under an individual contract. 28 patients were hospitalized on referral from St. Petersburg and the Leningrad region, and 45 were hospitalized at the clinic on referral from other regions. The patients were referred for treatment by: an ophthalmologist, a general practitioner, a neurologist, an otorhinolaryngologist and a neurosurgeon. The period from the onset of complaints to seeking medical help was: 18±3.7 months. In 85% of cases, tumors were located locally in the orbit; spread from other areas into the orbit occurred in 11%, and from the orbit in 4% of cases. Diagnostic orbitotomy was performed in 10.8%. Transconjunctival access was used in 50.7%, transcutaneous – in 38.5%, combined endoscopic transnasal – in 9.2% and transcranial – in 1.5% of cases. Compared to Russian literature data from 2002, there is a decrease in the proportion of malignant tumors of the orbit from 20% to 8.5% and neurogenic tumors – from 16% to 5.8%, with an increase in the number of lacrimal gland tumors from 7.5% to 10.2% and congenital cystic formations – from 9.5% to 14.4%.

Conclusion. The results of our study revealed significant changes in the structure of the incidence of orbital tumors in comparison with the data of domestic authors. The data we obtained can be applied not only in scientific practice, but also to optimize the work of ophthalmic surgery departments.

Antiangiogenic therapy has been used in Russian ophthalmology since 2008 and has become a key treatment for a few socially significant diseases, including neovascular age-related macular degeneration and diabetic macular edema. The angiogenesis inhibitor market in Russia is demonstrating qualitative and quantitative growth, with continued positive development trends. This review provides up-to-date information on ophthalmic anti-VEGF drugs registered in the country and discusses specific features of their use. The key factors influencing drug selection for specialists include a long-term safety profile based on real-world data, increased duration of action/reduced treatment burden, and the potential to improve and maintain visual acuity. Antiangiogenic therapy development trends in Russia are in line with global trends. Currently, the primary focus for improvement is the broader use of second-generation antiangiogenic drugs (including in patients with a suboptimal response to previous therapy). These drugs have the potential to significantly reduce the treatment burden and achieve optimal results in many cases. Along with the evolution of anti-VEGF drugs, approaches to assessing their effectiveness and strategies for rational use are also evolving.