1 СПбГБУЗ «Городская многопрофильная больница № 2», Санкт-Петербург; 2 ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова» Минздрава России, Санкт-Петербург Для цитирования: Офтальмологические ведомости. Конфокальная микроскопия -современный метод исследования, позволяющий в режиме реального времени оценить неинвазивно in vivo структуру роговицы, лимба и конъюнктивы. При различных заболеваниях тканей глазной поверхности метод может быть использован как с диагностической целью, так и с целью мониторинга течения заболевания и оценки эффективности лечения. В рамках данной статьи рассмотрены основные изменения, наблюдаемые при конфокальной микроскопии у пациентов с синдромом сухого глаза (ССГ), и приведён составленный авторами алгоритм исследования тканей глазной поверхности при ССГ. Ключевые слова: конфокальная микроскопия; ткани глазной поверхности; синдром сухого глаза.
Phacoemulsification (PHACO) is the basic procedure of cataract extraction. Purpose. To assess the impact of PHACO on corneal epithelium layers in patients with pseudoexfoliation syndrome (PEX) by confocal in vivo microscopy. Methods. 24 patients with PEX syndrome and 18 patients without it were enrolled in the prospective study. In vivo confocal microscopy was performed with assessment of cellular density in corneal epithelial layers, degree of its desquamation, degree of Bowman membrane stiffening and dendritic cells density. Results. The epithelial cells density didn’t change significantly in groups. Confocal microscopy showed high density of dendritic cells and marked desquamation of the epithelium in patients with PEX (p < 0,05) after PHACO. (For citation: Potemkin VV, Varganova TS, Terekhova IV, Ageeva EV. The influence of phacoemulsification on various corneal layers in patients with pseudoexfoliation syndrome assessed with confocal in vivo microscopy. Ophthalmology Journal. 2017;10(3):29-34. doi: 10.17816/OV10329-34).
Конфокальная микроскопия -современный метод исследования, позволяющий в режиме реального времени оценить неинвазивно in vivo структуру роговицы, лимба и конъюнктивы. Цель -оценить основные морфологические изменения роговицы, наблюдаемые при конфокальной микроскопии у пациентов с псевдоэксфолиативным синдромом (ПЭС). Материалы и методы. Был обследован 21 пациент. Основную группу составили 12 пациентов с ПЭС, группу контроля -9 пациентов без ПЭС. Результаты. У пациентов с ПЭС наблюдалось снижение плотности клеток эпителия и стромы роговицы, большое количество гиперрефлективных межклеточных микровключений и дендритических клеток (p < 0,05). Ключевые слова: конфокальная микроскопия; псевдоэксфолиативный синдром. Confocal microscopy is a modern examination method, which provides in real-time mode a noninvasive in vivo imaging of the cornea, limb, and conjunctiva. Purpose. To evaluate main morphological changes observed by confocal microscopy in patients with pseudoexfoliation (PEX) syndrome. Methods. 21 patients were examined. 12 patients with PEX syndrome were enrolled as the main group, and 9 patients without PEX -as controls. Results. In patients with PEX, there was a decreased cell density in the epithelium and the stroma of the cornea, as well as a lot of hyperreflective intercellular microdeposits and dendritic cells (p < 0.05). THE INFLUENCE OF PSEUDOEXFOLIATIVE SYNDROME ON CORNEAL MORPHOLOGY BASED ON IN VIVO CONFOCAL MICROSCOPY Key words: confocal microscopy; pseudoexfoliation syndrome. ВВЕДЕНИЕПсевдоэксфолиативный синдром (ПЭС) -системное, ассоциированное с возрастом забо-левание, для которого характерна продукция и накопление внеклеточного амилоидподобного материала [3,[5][6][7]. ПЭС поражает множество тканей и органов, но именно офтальмологиче-ские проявления являются основой для поста-новки диагноза [3,4,6]. Это возможно благо-даря тому, что рутинного биомикроскопического исследования достаточно для обнаружения псев-доэксфолиативного материала (ПЭМ). Типичным
Introduction. Surgically induced astigmatism (SIA) is one of the reasons of the patient’s dissatisfaction with the refractive result after phacoemulsification (PHACO). The degree of SIA depends mainly on the type, length, shape and location of the tunnel, the distance to the optical center of the cornea, as well as the biomechanical properties of the cornea. Pseudoexfoliation syndrome (PEX) is associated with a change of the biomechanical properties of the cornea. The issue of the effect of these changes on the degree of SIA remains unexplored.The objectiveis to assess the influence of PEX on the degree of SIA after PHACO.Material and methods. The study included 42 patients (42 eyes) admitted for surgical treatment of cataracts to the V micro-surgical Department of the HMB № 2. The main group consisted of 20 patients (20 eyes) with PEX, the control group consisted of 22 patients (22 eyes) without PEX.The groups were of equal sex and age. The main selection criterion for the main group was the detection of pseudoexfoliative material on the anterior lens capsule, along the pupillary edge edge or in the corner of the anterior chamber. The exclusion criteria were the traumatic and uveal cataracts, glaucoma and laser vision correction in the anamnesis. All patients underwent keratotopography (TMS-3, Tomey, Japan) preoperatively and in 4 to 6 weeks after surgery.Results. There was no significant difference in the degree of SIA (limbal incision, 2.4 mm) among the groups provided the formation of a 2.4 mm limbal tunnel. Moreover, there was no significant difference in the degree of SIA between the nasal and temporal limbal tunnels within the groups.
In this article, using a clinical case as example we report clinical features of keratopathy associated with pseudoexfoliation syndrome, as well as pathological changes found by confocal microscopy.
BACKGROUND: Intraocular lens (IOL) repositioning and IOL exchange are the main methods of surgical treatment of late in-the-bag IOL dislocation. AIM: To evaluate refraction, induced corneal astigmatism and IOL tilt after surgical treatment of late in-the-bag IOL dislocation by transscleral suture fixation and exchange to iris-claw IOL with retropupillary fixation. MATERIALS AND METHODS: 78 of patients with late in-the-bag IOL dislocation were included. Transscleral suture IOL fixation was performed in group I (38 eyes), exchange to iris-claw IOL was performed in group II (40 eyes). Refractometry, keratotopography and optical coherence tomography of anterior segment were performed before surgery, 1 week, 1, 3 and 6 months after surgery. RESULTS: The groups did not differ in subjective and objective refraction. But there was significant variability of data in the group I 3 and 6 months after surgery. There was no difference in corneal astigmatism in both groups during 3 months, but a significant increase was found in group II 6 months after surgery. There was no difference in IOL tilt between groups before surgery. Decrease of IOL tilt in 180 degrees plane was observed after 1 month in group II, while there was no difference in 90 degrees plane between groups. CONCLUSIONS: Both methods of late in-the-bag IOL dislocation treatment allow to receive good refractive result, but refraction is less predictable after trans-scleral suture IOL fixation. Surgically induced astigmatism is higher in IOL exchange group due to large sclerocorneal tunnel incision. Transscleral suture IOL fixation does not cause clinically significant IOL tilt.
Phacoemulsification (PE) is the leading method of cataract surgery. Purpose. To assess the impact of PE on corneal subbasal nerve plexus in patients with pseudoexfoliation syndrome (PEX) using confocal in vivo microscopy. Methods. 42 patients (42 eyes) were enrolled in the study. The main group consisted of 24 patients (24 eyes) with PEX syndrome, and 18 patients (18 eyes) without it composed the control group. Confocal in vivo microscopy was performed before and after PHACO. Results. In patients with PEX after PE, an increase in number of nerve branches and pellet-like structures in them were noticed (p < 0,05).
The vitreous body destruction (VBD) is one of the most common conditions bringing patients to visit an ophthalmologist. The absence of the effective treatment of VBD today worries both doctors themselves and their patients. Since 2014, “Vitrocap” (Ebiga-VISION, Germany) has been registered in the Russian Federation, its components of which prevent the biochemical and anatomical vitreous body structure changes by a natural way. Objective: to evaluate the clinical efficacy of Vitrocap in patients with VBD, as well as to analyze the psychological characteristics of individuals complaining of “floaters”. Material and methods. The study included 32 patients in total, 16 of which (5 men and 11 women aged from 37 to 57 years) comprised the main group of individuals complaining of “floaters”. The patients in this group received active treatment using Vitrocap according to the licensed posology. The control group included patients with the vitreous body floaters confirmed by B-scan, but without active complaints. All patients underwent standard echography (A-, B-scan) using the Tomey UD-8000 device with a 15 MHZ frequency sensor before and after treatment. In addition, voluntary anonymous survey was performed in both groups using “Minnesota Multiphase Personality Test” (MMPI). The results of the study showed that after the Vitrocap course patients reported a reduction or absence of “floaters” complaints in 76% of cases, and according to A-scan characteristics (the number and height of echogenicity peaks) there were quantitative and qualitative improvements in 32% and 80% of cases, correspondingly. According to MMPI test results, the patients in the main group had an increased need for the doctor’s emotional involvement in the process of eliminating visual discomfort. In such cases, the very fact of prescribing therapy caused a beneficial effect on the patient’s emotional state. Thus, we have found Vitrocap treatment to improve both subjective and objective status in patients with VBD.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.