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Currently a wide range of instruments for surgical procedures on the bony structures of the orbits is offered. Each of them has its advantages and disadvantages. Cutter causes less injury, in comparison with a chisel or an ultrasonic saw [15]. In using a drill during surgery there was an increase in temperature of bone edge of the opening above acceptable values [17]. The use of low frequency ultrasonic tools allows you to create holes in the bones of any desired size and shape with smooth edges [5, 11, 16, 20]. The disadvantages of this method include the heating of tool’s tip up to 140° during prolonged continuous action [6]. Thus, techniques using tools for formation of the bone window require further study and improvement. Aim: to compare surgical equipment for bone window formation in modeling an orbital decompression. Materials and methods. In an experimental study in vivo, 12 surgical interventions on the scapula on both sides were performed in 6 Chinchilla breed rabbits. On the right side, the formation of a bone window was carried out by the ultrasonic bone scalpel MISONIX, on the left side - by a drill. Results. It was found that during first 7-21 days there was more pronounced inflammation of soft tissues on the left side. At the same time, delayed proliferation and maturation of fibrous connective tissue was observed in comparison to the opposite side. Bone tissue inflammation and subsequent regeneration took place without significant differences on both sides. The experiment showed that the use of ultrasonic scalpel in flat bones creates less inflammation of surrounding tissues and the bone itself as compared to a diode laser. A.V. Kravchenko (2006) reports that, after exposure to a diode laser in an acute experiment there was a scalloped edge with an area of photocarbonization (charring) on the 7th and the 21st day; while the use of an ultrasonic scalpel did not create any signs of infiltrative inflammation, later on a nonspecific inflammation developed. Conclusion. Ultrasonic scalpel has a number of advantages when performing osteoperforation, such as time-saving during surgical procedure, control of the osteotomy process, less trauma to surrounding tissues during action and less pronounced inflammatory response of the wound during early postoperative period. (For citation: Konovalov KA, Davydov DV, Roshchin VY. A comparative analysis of the application of piezoelectric surgery and mechanical osteoperforation techniques in modeling an orbital decompression. Ophthalmology Journal. 2018;11(1):10-18. doi: 10.17816/OV11110-18).

BACKGROUND: The most effective method of surgical treatment of lipogenic and mixed forms of edematous exophthalmos is currently the internal orbital decompression. During this surgical procedure, the excessive pathologically altered adipose tissue is removed from the external and the internal surgical spaces of the orbit. Many scientists are developing methods for calculating the volume of orbital fat, but the question on developing a method for predicted exophthalmos after internal orbital decompression, which could be used without attracting additional equipment and software, is easy to learn and does not require a long calculation time, remains actual. This method has to take into account the individual features of the patients orbital structure and be used for calculations in the bilateral proptosis correction. AIM: To develop and evaluate the effectiveness of a new method for calculating the eyeball position after orbital decompression. MATERIALS AND METHODS: 64 patients (126 orbits) with lipogenic and mixed forms of endocrine ophthalmopathy were examined. All patients underwent internal orbital decompression, during which the orbital fat was removed, the volume of which was calculated according to the developed original method. Patients underwent ophthalmological examination and MSCT before surgery and 6 months after it. . RESULTS: As a result of orbital decompression in the examined group, a decrease in proptosis was observed in all patients, and the exophthalmos calculated by the method corresponded to the eyeball position in patients in 6 months after surgery. The level of statistical significance of the planned postoperative eyeball position in relation to the actual postoperative exophthalmos calculated according to the Students t-test was 0.98 (p 0.05), that is, it can be argued that the groups do not differ, and no statistically significant differences were found. CONCLUSIONS: The developed method for calculating the estimated postoperative exophthalmos is effective without using additional software. This technique allows you to achieve a symmetrical eyeball position in the postoperative period and to reduce the risk of complications.

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