Purpose. To assess the intraoperative results comparing two non-mechanical laser assisted penetrating keratoplasty approaches in keratoconus and Fuchs dystrophy. Patients and Methods. 68 patients (age 18 to 87 years) with keratoconus or Fuchs dystrophy were randomly distributed to 4 groups. 35 eyes with keratoconus and 33 eyes with Fuchs dystrophy were treated with either excimer laser ([Exc] groups I and II) or femtosecond laser-assisted ([FLAK] groups III and IV) penetrating keratoplasty. Main intraoperative outcome measures included intraoperative decentration, need for additional interrupted sutures, alignment of orientation markers, and intraocular positive pressure (vis a tergo). Results. Intraoperative recipient decentration occurred in 4 eyes of groups III/IV but in none of groups I/II. Additional interrupted sutures were not necessary in groups I/II but in 5 eyes of groups III/IV. Orientation markers were all aligned in groups I/II but were partly misaligned in 8 eyes of groups III/IV. Intraocular positive pressure grade was recognized in 12 eyes of groups I/II and in 19 eyes of groups III/IV. In particular, in group III, severe vis a tergo occurred in 8 eyes. Conclusions. Intraoperative decentration, misalignment of the donor in the recipient bed, and need for additional interrupted sutures as well as high percentage of severe intraocular positive pressure were predominantly present in the femtosecond laser in keratoconus eyes.
This article describes the realization of smart city concept in architectural and urban media spaces. Considerable attention is paid to studying the influence of some parameters of the “smart city”, such as adaptability, mobility, intellectualization, sustainability, security and some others. The article also analyses the elements of utopianism and realism in the application of high technologies in urban reality. The connection is studied between utopian models of ideal city and realized strategy of smart urban development, in which the integration of digital technologies leads to the formation of high-hume communicative space that serves as the locomotive of global changes. The study also identifies four theoretical models of media space and classification of urban screens according to compositional-planning implementation methods. As a result of the research, a hypothesis is suggested that there are some key factors and conditions furthering the implementation of the “smart city” concept, as exemplified by the creation of media spaces in urban environment. In addition, a conclusion is made about the prospects of using media technologies in the city on the example of Samara.
Purpose The study aims to compare the impact of non-mechanical excimer laser-assisted (EXCIMER) and femtosecond laserassisted (FEMTO) trephinations on graft endothelial cell density (ECD) and graft thickness before and after suture removal following penetrating keratoplasty (PK). Methods The inclusion criteria for this prospective, randomized, clinical study were as follows: (1) surgeries performed by one surgeon; (2) primary central PK; (3) keratoconus (KC) or Fuchs' dystrophy (FUCHS); (4) no previous intraocular surgery; (5) graft oversize, 0.1 mm; and (6) 16-bite double-running suture. In 68 eyes of 68 patients (mean age: 53.3 ± 19.8 years), PK was performed using either 193-nm MEL70 excimer laser (BEXCIMER^: 17 KC, 18 FUCHS) or 60-KHz femtosecond laser (BFEMTO^: 17 KC, 16 FUCHS) trephination. Specular microscopy (EM 3000) and pachymetry (EM 3000; Pentacam HR; Casia SS-1000) were performed before removing the first suture (11.4 ± 1.9 months) and after removing the second suture (22.6 ± 3.8 months), but before any additional ophthalmic surgery. Results ECD did not differ significantly (P ≥ 0.436) between EXCIMER and FEMTO either with Ball-sutures-in^(1887 ± 409 vs. 1886 ± 438) or with Ball-sutures-out^(1703 ± 379 vs. 1737 ± 362). Central corneal thickness and corneal thickness at the thinnest point of the cornea did not differ significantly between EXCIMER and FEMTO either with all-sutures-in (P ≥ 0.096 and P ≥ 0.653) or with all-sutures-out (P ≥ 0.636 and P ≥ 0.717). Conclusions EXCIMER and FEMTO trephinations from the epithelial side seem to have no disadvantages regarding endothelial cell loss after PK, and both surgical procedures are safe for the endothelium. A larger sample size and longer follow-up are needed to evaluate the long-term impact of EXCIMER and FEMTO trephinations on ECD.
The article deals with topical issues of town-planning design of the agricultural cluster in a big city as an integral part of the designing methodology for sustainable development of urban areas. The research subject is connected with ecological principles of town-planning, historical features of urban area development, agricultural settlement and specialization of the agricultural sector. The purpose of the study is to develop the town-planning concept of the agricultural cluster in a big city, the functional structure of its elements and to define principles of their organization within the context of methodology of area sustainable development. As a result of the research a number of principles for forming architectural and town-planning structures of the agricultural cluster have been formulated, including: the principle of sectorial townplanning, the principle of urban and rural areas integration, the principle of ecologization of cluster strategies and architectural and town-planning solutions, the principle of integrating landscape, agro-landscape and housing development, the principle of bio-positive design of buildings and complexes.
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