MEIBOMIAN GLAND DYSFUNCTION WITH INVOLUTIONAL EYELIDS MALPOSITION©

Pseudoexfoliation syndrome (PEX) is a relatively widespread generalized age-related disease of connective tissue. It seems reasonable to evaluate the condition of ocular adnexa in patients with PEX. Purpose. To evaluate the condition of ocular adnexal tissue in PEX. Methods. 132 eyes of 66 patients with PEX syndrome and 128 eyes of 64 patients without it were enrolled in the prospective study. We evaluated function of upper eyelid levator muscle, lower eyelid retractors, horizontal lid laxity (HLL), canthal integrity, degree of retractors disinsertion and tone of orbicularis muscle. Results. HLL, degree of retractors disinsertion, laxity of medial canthal tendon were statistically significantly more expressed in patients with PEX (p < 0,05). The tone of orbicularis muscle and function of lower eyelid retractors were statistically lower in patients with PEX (p < 0,05). The function of eyelids levator muscle, tone of lateral canthal tendon and degree of ptosis were similar in both groups. Conclusion. Signs of atonic changes of ocular adnexa are relatively more common in patients with PEX (p < 0,05).

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 gold standard of cataract surgery. Сataract surgery in eyes with pseudoexfoliative (PEX) syndrome is associated with increased risk of intra- and postoperative complications. Zonular laxity is one of the main causes of surgical complications. Purpose. To assess the degree of zonular weakness in patients with PEX. Materials and methods. 1010 eyes (580 eyes with PEX and 430 eyes without it) that underwent consecutive PHACO at the Ophthalmology Department No 5 of the City Multifunctional Hospital No 2 from May 2016 until October 2017 were enrolled in the study. The zonular laxity was assessed preoperatively and intraoperatively. Results. Zonular weakness was observed more often in patients with PEX, both at preoperative and intraoperative evaluation (p < 0.05). However, in both groups, the percentage of zonular weakness estimated intraoperatively, was several times higher, than that estimated preoperatively. Nevertheless there was no difference in the rate of capsular bag related intraoperative complications between two groups. (For citation: Potemkin VV, Ageeva EV. Zonular instability in patients with pseudoexfoliative syndrome: the analysis of 1000 consecutive phacoemulsifications. Ophthalmology Journal. 2018;11(1):41-46. doi: 10.17816/OV11141-46).

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).