Relevance. Modern keratorefractive surgery is a high-tech field of ophthalmology aimed at solving various problems of correcting a wide range of ametropias.Objective: to formulate recommendations for refractive surgeons when planning the correction of hypermetropic refraction using modern keratorefractive surgery.Materials and methods. An analysis of 20 literature sources and a retrospective analysis of outpatient records of 188 patients with hypermetropia who underwent surgery were carried out.Results. The analysis of the literature and our own clinical study allows us to recommend focusing on the final keratometry after keratorefractive surgery, which should not exceed 48 diopters. Among the analyzed charts of patients in compliance with these criteria, the accuracy of hitting the target refraction in the range of ± 1 D was 98.9 %, the regression did not exceed 0.5 D from that obtained 1 month after surgery in 96.8 %, and the loss of 1 line of BCVA was 3.7 % of cases. Among patients with achieved keratometry above 48 diopters, the loss of line 1 BCVA was 13.8 %, line 2 — 2.7 %.Conclusion. Thus, the tactics of correction of hypermetropia by CRC methods require an integrated approach to the assessment of visual functions, drug preparation for surgery, careful implementation of the surgical stages of the intervention, and rational postoperative pharmacological support.

Relevance. Today, keratorefractive surgery is a high-tech branch of ophthalmology and provides a predictable, high-precision, stable and safe refractive result in patients with a wide range of refractive disorders.Purpose. To evaluate the clinical and functional results of myopia correction using the technology of fractional lenticular extraction performed using femtosecond VisuMax and LDV Z8 lasers.Materials and methods. Within the framework of this work, 160 patients (160 eyes) with inpatient myopia of medium and high degree were examined and operated, with average keratometry parameters (43.0–45.0 dptr), aged from 18 to 36 years. The follow-up period was 1 month after the operation. The SMILE group was formed: a group of patients who underwent surgery using refractive lenticular extraction technology using a femtosecond VisuMax 500 laser (80 eyes); and the CLEAR group: a group of patients who underwent surgery using refractive lenticular extraction technology using femtosecond laser Femto LDV Z8 (80 eyes).Results and discussion. Operations with SMILE and CLEAR technology were performed in the Department of refractive laser surgery of the FSAU NMIC MNTC “Eye Microsurgery” named after S.N. Fedorov of the Ministry of Health of Russia (Moscow) according to standard protocols. No intraoperative complications were recorded. The analysis of comparable clinical and functional results of myopia correction using the technology of fractional lenticular extraction performed using femtosecond VisuMax and LDV Z8 lasers was carried out.Conclusion. Thus, the analysis of the clinical and functional results of correction of myopia of medium and high degree by the technology of refractive extraction of the lenticle performed using femtosecond lasers VisuMax and LDV Z8 showed their high comparability in terms of efficiency, safety, predictability and stability. A new technology of fractional lenticular extraction using a comprehensive assessment of the condition of the ocular surface at the preoperative stage, which allows to identify and eliminate the changes that have occurred, can be recommended for widespread clinical implementation.

Purpose. To analyze the clinical and functional results of refractive lenticular extraction using ReLEx SMILE® and CLEAR® technologies in patients with moderate and high myopia.Materials and methods. 160 patients (160 eyes) aged 18 to 36 years diagnosed with moderate or high myopia, who had binocular vision, average keratometry parameters (43.0–45.0 D), and no contraindications to laser vision correction were operated according to the technology of refractive extraction of lenticula followed up 1 and 3 months after surgery. The patients were divided into 2 groups: (1) SMILE, which included 80 eyes of patients operated with the femtosecond laser VisuMax 500; and (2) CLEAR, including 80 eyes of patients operated using the femtosecond laser FEMTO LDV Z8. Both types of surgery were performed according to standard protocols.Results. No intraoperative complications were recorded. The analysis of clinical and functional parameters in the correction of myopia using the technology of refractive lenticular extraction performed with VisuMax and LDV Z8 femtosecond lasers demonstrated high and comparable efficiency, safety, predictability and stability.Conclusion. Both technologies of refractive lenticular extraction can be recommended for wide clinical use in the correction of moderate and high myopia.