Medical service management in LACs demands to define groups of priority for VRS between the wounded with WROGI during triage at the first echelon of SOC. Multistage VRS determines unfavorable outcomes of the WROGI. Treatment should be determined by diagnosis, and there is a need to introduce a new category into the OGI classification--eye destruction, because only this damage determines the choice of enucleation/evisceration of the eye.

Introduction. In a number of pathological conditions accompanied by the basement membrane defects, such as chemical or thermal burns, mechanical trauma, Sjögren’s syndrome, neurotrophic keratopathy or some corneal dystrophies, in which conditions are created independent epithelialization is weakened or becomes impossible. This condition was named recurrent corneal erosion (RCE). For the experimental study of the regenerative processes and evaluation of the effectiveness of new treatments, a standardized and reproducible RCE model is needed. Several RCE models are known: chemical, bacterial. The disadvantages of such models are the labour intensity of their implementation and a relatively high cost. The proposed method makes it possible to create the necessary conditions for local inflammation and destruction of adhesive molecules using the energy of ultraviolet (UV) irradiation. In this study, an experimental RCE model in rabbits has been proposed.Purpose. To create a reproducible standardized experimental model of recurrent corneal erosion.Materials and methods. The studies were conducted in 8 chinchilla rabbits (16 eyes). After local instillation (0.5 % alkaine solution) and retrobulbar anesthesia (2 % lidocaine solution), superficial deepithelialization of the cornea was performed by mechanical removal of its epithelium with a blunt scraper; and the quality of deepithelialization was assessed by staining the surface with 2 % fluorescein solution. In the optical zone with a diameter of 4 mm, local UV irradiation of the cornea was performed with exposures of 30 and 45 minutes.Results. In case of 30-minute exposures, the epithelialization of the cornea subjected only to mechanical deepithelialization was observed since Day 3 in the form of concentric epithelial growth. On Day 14, a complete epithelialization of the cornea was observed, along with the formation of superficial newly formed vessels along the limbus. On Day 24, the vascular injection significantly decreased; and no erosion was observed. After 45-minute exposure without treatment, the regeneration occurred much slower; and a complete epithelialization had been achieved by Day 34 of the experiment, by the time the newly formed vessels grew to the epithelial defect zone. It was noted that since Day 86, the turbidity in the irradiation area persisted, as well as the inflammatory infiltrate.Conclusions. The proposed method makes it possible to reproduce RCE, in which there is an alternation of epithelialization and deepithelialization of the irradiated corneal area through 30 days of the experiment and is arrested only after the ingrowth of surface vessels into the affected area. At that, the non-irradiated cornea is epithelialized by Day 7 of the experiment.

AIM: To analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment (RRD) depending on the surgical approach. METHODS: Eighty-one eyes of 81 patients (47 males and 34 females with a mean age of 54.8±14.1y) who demonstrated at least one inferior recurrence of RRD were included in this retrospective study. All patients were categorized as having received either circular scleral buckling (SB), pars plana vitrectomy (PPV), a combination of SB and PPV (SB+PPV), PPV with retinotomy (PPV+RT), or PPV+RT and short-term postoperative perfluorocarbon liquid tamponade (PPV+RT+pPFCL). All cases were followed up until successful retinal reattachment or third recurrence. The primary outcome measures were the achievement of the surgical goal without recurrence of RRD and best-corrected visual acuity (BCVA). RESULTS: After the treatment of the first recurrence, the recurrence rate in the PPV+SB group was statistically significantly lower than that of the PPV (P=0.0012), PPV+RT (P=0.028), or PPV+RT+pPFCL (P=0.047) group. There was no statistically significant difference between PPV+SB, PPV+RT, and PPV+RT+pPFCL groups in the recurrence rate after treatment of the second recurrence (42 eyes). However, there was a statistically significant (P=0.016) trend towards a decrease of recurrence rate after PPV+RT+pPFCL. There was no statistically significant improvement of BCVA in either study group (P>0.05) after both first and second recurrence surgery. The mean time follow-up was 109.0±91.0d before the first recurrence and 210.0±186.6d between previous surgery at second recurrence. CONCLUSION: Patients with first inferior recurrence of RRD may benefit from SB as an adjunct to PPV. RT and short-term pPFCL tamponade in the second recurrence may allow better anatomical outcomes, however, without functional improvement.

Purpose The purpose of this study was to characterize labial mucosa stem cells (LMSCs) and to investigate their potential for corneal epithelial reconstruction in a rabbit model of total limbal stem cell deficiency (LSCD). Methods Rabbit LMSCs (rLMSCs) and human (hLMSCs) LMSCs were derived from labial mucosa and characterized in terms of their proliferation activity by the evaluation of proliferation index (PI) and colony forming efficiency (CFE), cell senescence, and differentiation abilities. The expression of various limbus-specific, stem cell-specific, and epithelial markers was assessed via immunocytochemistry. Flow cytometry was used to evaluate mesenchymal and hematopoietic cell surface markers expression. Chromosomal stability of the derived cells was examined using the conventional GTG-banding technique. To assess the impact of LMSCs on corneal epithelial reconstruction, rLMSCs were seeded onto a decellularized human amniotic membrane (dHAM), thereafter their regeneration potential was examined in the rabbit model of total LSCD. Results Both rLMSCs and hLMSCs showed high proliferation and differentiation abilities, entered senescence at later passages, and expressed different stem cell-specific (ABCB5, ALDH3A1, ABCG2, and p63α), mesenchymal (vimentin), and epithelial (CK3/12, CK15) markers. Cell surface antigen expression was similar to other described mesenchymal stem cells. No clonal structural chromosome abnormalities (CSCAs) and the low percentage of non-clonal structural chromosome abnormalities (NSCAs) were observed. Transplantation of rLMSCs promoted corneal epithelial reconstruction and enhanced corneal transparency. Conclusions LMSCs have significant proliferation and differentiation abilities, display no detrimental chromosome aberrations, and demonstrate considerable potential for corneal repair.

Актуальность. Среди воспалительных заболеваний переднего сегмента глаза особого внимания заслуживают хронические эрозии роговицы (ХЭР).ХЭР трудно поддаются лечению и почти всегда приводят к значительному снижению остроты зрения. Одним из перспективных методов лечения ХЭР является применение обогащенной тромбоцитами плазмы (ОбТП). Цель. Оценить влияние ОбТП на репаративную регенерацию роговицы в условиях экспериментальной хронической эрозии роговицы (ЭХЭР). Материал и методы. На 12 кроликах породы Шиншилла (24 глаза) воспроизводили модель ЭХЭР по разработанному нами способу (патент RU2709834 от 23.12.2019): локальное ультрафиолетовое (УФ) облучение с экспозицией 45 мин. на предварительно деэпителизированную поверхность роговицы. Затем всех животных распределили на три группы. В I (основной) группе проводили инстилляцию ОбТП по 1 капле через 1 мин. в течение 10мин. (10 капель) однократно, во II основной группе проводили лечение по вышеуказанной методике ежедневно в течение 5 суток. В группе контроля(III) лечение ОбТП не применялось, выполнялось закапывание декса-гентамицина 4 раза в сут. (базовая терапия во всех группах исследования). Результаты. УФ-облучение в течение 45 минут вызывает стойкую ХЭР до 30-х суток эксперимента. ЭХЭР самостоятельно купируется только после врастания поверхностных сосудов до пораженного участка. Однократное применение ОбТП оказывает недостаточный терапевтический эффект – отмечается рецидив на 11±2 сут. в 100%. Инстилляция ОбТП в течение 5 дней ускоряет репаративную регенерацию роговицы. На 9-е сутки зарегистрировано отсутствие эпителиального дефекта, новообразованных сосудов и помутнения роговицы. Гистологически на 30-е сутки в роговице обнаружен нормальный многослойный неороговевающий эпителий. Выводы. Однократное применение ОбТП не дает стойкого эффекта – рецидив ЭХЭР в 100%.Применение ОбТП в течение 5 сут. при ЭХЭР восстанавливает роговичный эпителий в 100%.