Objective (aim): to test the refractive and visual outcomes and the quality of vision after the bilateral implantation of three different multifocal intraocular lenses (MIOLs) in patients with age-related cataract. Methods: In this retrospective, comparative study including 90 eyes of 45 cataract patients, bilateral implantation of either the hydrophilic trifocal Liberty® 677MY capsular bag IOL, the hydrophilic AT LISA® tri 839M lens, or the hydrophobic AcrySof® IQ PanOptix® IOL was performed during routine cataract surgery. Refractive outcomes, visual acuities (VA) for far, intermediate and near distances, as well as visual quality, dysphotopic events and spectacle use were evaluated six months postoperatively. Results: VA curves were similar for the three MIOLs, however the Liberty lens seemed to be superior for far and near, while AT LISA tri provided somewhat better VA in the intermediate range. Refractive correction was the most effective with the Liberty IOL (p=0.0131). Dysphotopic phenomena were usually perceived in low light conditions. Their frequency was lower with the AT LISA tri and Liberty lenses. Symptoms were significantly less disturbing for patients implanted with the Liberty lens, two-thirds of AT LISA tri and Liberty patients, while only 57% of PanOptix patients achieved spectacle independence. Conclusions: All examined MIOLs were found to be safe and efficient in presbyopia-correction of cataract patients, however different models had different advantages. The vision preferences of each patient should always be taken into consideration when choosing a MIOL, and the possible occurrence of dysphotopic events should be also clearly communicated in each case. Abbreviations: ACD = Anterior chamber depth, ANOVA = Analysis of variance, AXL = Axial length, CDVA = Corrected distance visual acuity, CYL = Cylinder; Cylindric refraction, D = Diopter, IOL = Intraocular lens, K1; K2 = Keratometry values, MIOL = Multifocal intraocular lens, n = Number of cases, n.a. = Not applicable, Postop = Postoperative, QoV = Quality of Vision, SD = Standard deviation, SEQ = Spherical equivalent, SPH = Sphere; Spherical refraction, UDVA = Uncorrected distance visual acuity, UIVA = Uncorrected intermediate visual acuity, UNVA = Uncorrected near visual acuity, VA = Visual acuity

The study included 62 children aged 6 to 14 years with mild to moderate myopia, born at 28-34 weeks of gestation with a birth weight of 970 to 2200 g. Selection criteria: corneal refractive power >46.00 D, no keratoconus or macular degeneration. The main group – 32 children (64 eyes), who were assigned orthokeratologic lenses, the control group – 30 children (60 eyes) – glasses users. Differences between the groups were not significant. Observation period was 3 years. There were no complications. Corrected visual acuity in the main group increased from 0.63±0.08 to 0.98±0.06, in the control – from 0.61±0.05 to 0.73±0.05; p<0.005. Stable restoration of binocular vision was observed in all children of the study group and 83% of children in the control one. Reserves of absolute accommodation in the main group during the observation period increased by 6.7±0.38 D, and in the control group – by 2.3±0.42 D (p<0.001), which is explained by the active use of accommodation by children of the main group. After 3 years of observation in the main group, the anteroposterior size of the eyeball, according to echobiometry data, almost did not change (from 22.32±0.9 to 24.02±1.1 mm, p>0.2), and in the control group, the eye elongation was more pronounced: from 22.45±0.8 to 25.94±0.9 mm (p<0.01). Complete stabilization of myopia was observed in 30 children (93.75%) of the study group. Orthokeratological lenses MoonLens can be used in patients with high corneal curvature; their use in prematurely babies with a high refractive power of the cornea (>46.0 D) allowed to obtain better results of the treatment.

The aim: To develop the model for predicting primary open – angle glaucoma (POAG) depending on the presence of the genetic polymorphism in the endothelial NO-synthase (NOS3) gene. Materials and methods: The results of genotyping 153 patients (153 eyes) with POAG are included in this investigation. 47 patients were in the control group. Their age was 65,0±13,1 years, duration of disease – 4,9±5,3 years. The polymerase chain reaction was carried out in the patients’ blood in the real time mode (Gene Amp® PCR System 7500 amplifier; USA) with the help of the TaqMan Mutation Detection Assays Life-Technology test system (USA). The program Statistica 10 (StatSoft, Inc., USA) was used for mathematical testing of the obtained results. Results: The regression analysis confirmed the effect of rs1799983 and rs2070744 polymorphisms of the NOS3 gene on the development of POAG. Calculating their specific gravity based on the degree of the impact on the probability of developing the disease showed that rs2070744 – 72.2% had the greater impact than rs1799983 – 38.5%. The regression model of POAG risk depending on the genotypes of the NOS3 gene rs1799983 and rs2070744 polymorphisms was constructed with the satisfactory quality of mathematical prediction (-2log=202.59; χ2=28.91; P<0.001). The value of probability of developing POAG exceeded the limit value (Cut-off=0.8), respectively, OR 4.39 (95% CI 1.00-19.30; P=0.048) and OR 14.15 (95% CI 1.88-106.28; P<0.001) in carriers of the rs1799983 and rs2070744 GT-CC and TT-CC haplotypes. Conclusions: The results of the study proved the importance of risk genotypes (TT rs1799983 and CC rs 2070744) for the development of POAG in patients from the Ukrainian population. It has been shown that the significant increase in the risk of POAG exists for carriers of the GT-CC and TT-CC haplotypes.

Relevance – it is promising to develop a system for the diagnosis and prevention of primary open-angle glaucoma (POAG), which would be based on the determination of constitutive propensity factors and would be able to predict the onset and progression of the disease. The aim of the study was to develop a model for predicting the rate of progression of primary open-angle glaucoma depending on gender and endothelial NO-synthase (NOS3) gene polymorphism. There were genotyped 153 patients with POAG aged 36-84 years. Genotypes rs1799983 and rs207074 were determined in the blood of patients by real-time polymerase chain reaction (amplifier Gene Amp® PCR System 7500; USA) using the TaqMan Mutation Detection Assays Life-Technology test system (USA). For mathematical processing of the obtained results, the Statistica 10 program (StatSoft, Inc., USA) was used. The rate of progression of POAG was higher in the presence of risk alleles in the haplotype of the NOS3 gene polymorphisms: T rs1799983 and C rs2070744 (haplotypes TT-CC, GT-CC and GT-CT), which, when distributed by gender, was more pronounced in women than in men of each of the possible haplotypes. The maximum difference was noted for carriers of the TT-SS haplotype, in whom the rate of progression of POAG in women exceeded that in men by 1.4 times (p<0.001). A regression model was built with satisfactory prediction indicators (multiple correlation coefficient R=0.963; coefficient of determination R2=0.928; p<0.001). The probable “hereditary” age of patients in which one or another stage of POAG should be expected is calculated. Gender and haplotypes rs1799983 and rs2070744 of the NOS3 gene were shown to be associated with the onset and rate of progression of POAG, which was implemented in the prognostic model of the disease. Separately for men and women, carriers of different haplotypes, the rate of progression and the possible age of POAG development by stages were calculated.

The WHO Global vision detection program and preventing blindness "VISION 2020: the right to Sight" has shown the need to identify the genetic predisposition to glaucoma. It provides new opportunities for diagnosis, early prevention and treatment. The aim of this study was to determine the effect of the rs1799983 polymorphism (G894T, Glu298Asp) of the NOS3 gene on the development of primary open-angle glaucoma (POAG) in patients from the Ukrainian population. The study involved data from 153 patients (153 eyes) with POAG and 47 controls. The age of patients was 65.0±13.1 years. The duration of the disease was 4.9±5.3 years. The real-time polymerase chain reaction (Gene Amp® PCR system 7500 amplifier; USA) was performed in the patients “blood using the TaqMan Mutation Detection Assays Life-Technology test system (USA). The Statistica 10 program (StatSoft, Inc.) was used for statistical processing of the obtained results, USA). The significant increase in the frequency of the minor genotype TA and the T allele was found in POAG compared to the controls. The distribution of genotypes was not associated with the disease (p=0.051). While the effect of alleles was significant: for the T allele, OR=1.806; 95% VI 1.11-2.93 (p=0.016). It was preserved when it was stratified by gender for women (OR=2.00; OR 1.01-3.95; p=0.043). According to the presence of the risk TT genotype rs1799983, POAG developed at the younger age (p<0.001), such patients had significantly higher intra-abdominal pressure, worse perimetry indicators (MD and PSD), lower thickness of nerve fiber layers (RNFL) and ganglion cell complex (GCC), a larger ratio of excavation area to the area of the optic disc (Cup/Disk Area Ratio). The Association of the RS1799983 polymorphism of the NOS3 gene with PVKG was also confirmed in other populations, and the aggravating effect of the minor TT genotype on the phenotype of patients was shown.