PURPOSE. To study the role of the choroid and lens in the development of primary anterior chamber angle closure.MATERIAL AND METHODS. The study included 90 patients aged 47 to 80 years (30 with primary angle closure (PAC), 30 with suspected primary angle closure (PACs), and 30 in the control group) who underwent swept source optical coherence tomography (SS-OCT). The following parameters were analyzed: subfoveolar choroidal thickness (SFCT), intraocular pressure (IOP), axial length (AL), anterior chamber depth (ACD), lens vault (LV), iris curvature (ICurv) and iris thickness (IT750), angle opening distance (AOD500, AOD750), and trabecular-iris space area (TISA500, TISA750).RESULTS. SFCT in PAC (341±59 µm) and PACs (340±51 µm) was higher than in the control group (257.0±37.0 µm, p<0.05). In PAC and PACs, the correlations of SFCT with age, AL, LV, ICurv, IT750 were revealed (p<0.05 for each), as well as correlations of LV with age, IOP, ACD, ICurv, IT750, AOD500, AOD750, TISA500, TISA750 were found (p<0.05 for each). The correlation of SFCT with IOP was determined only in PAC (p=-0.476; p=0.008).CONCLUSION. The increase in the choroidal thickness in macula in both PACs and PAC compared with the controls, as well as the correlations of subfoveolar choroidal thickness with lens vault and iris parameters suggest the involvement of the choroid in the pathogenesis of primary angle closure disease (PACD). The correlations of lens vault with IOP, as well as the parameters of anterior chamber and iris indicate the prevailing role of the lens in the development of PACD and the need for its early replacement.

Purpose: to evaluate the clinical results of trifocal intraocular lenses implantation with different optical characteristics; optimization of preparation stages and intraocular correction of presbyopia. Patients and Methods. Phacoemulsification with binocular implantation of trifocal intraocular lenses (IOL) was performed in 35 patients with cataract and presbyopia. IOL AcrySof® IQ PanOptix® was implanted in 32 eyes, AT LISAtri839MP — 38 eyes. Preoperative evaluation included standard examination with surgeon’s consultation and clarification of patients’ lifestyle and vision motivations at all distances. Postoperative evaluation included measurement of refraction, visual acuity at three distances, quality and visual acuity under mesopic conditions. Proposed to use the test questionnaire, visual acuity testing tables at intermediate distances, nomograms for IOLs power calculation developed by the authors. Results. Postoperative spherical refraction was 0.17 ± 0.23D, which did not exceed 0.5D deviation from the target refraction. Uncorrected distance visual acuity ≤ 0.5 reached in 100 % of patients on the first day after surgery. Visual acuity ≤ 0.5 at intermediate distance was achieved in 34 eyes (89.5 %) of patients with implanted IOL AT LISAtri, and the same results has been recorded for near in 33 eyes (86.8 %). On the next day after surgery in the PanOptix® group, all patients monocular gave ≤ 0.6 for intermediate and near, and 96.9 % of eyes ≤ 0.5 for far. All patients from both groups (PanOptix® or LISAtri) after 6 months binocular showed visual acuity ≤ 0.8 for far, near or intermediate distances, no patient noted a need to use any spectacle correction and did not notice significant visual impairment in mesopic conditions. Conclusion. Implantation of Trifocal IOLs AcrySof® IQ PanOptix® and AT LISAtri 839MP allows patients spectacle independence and high-quality of vision in mesopic conditions. An individual approach to each patient, concomitant ophthalmopathology, general status, life style, primary refraction and precise IOLs power calculation, allows the surgeon widely to apply this technology for presbyopia intraocular correction.

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Purpose. Scientific substantiation, development, evaluation of the safety and clinical efficacy of vitrectomy technology in patients with severe forms of proliferative diabetic retinopathy (PDR) who are on hemodialysis (HD).Methods. We observed 100 patients (69 % women; 31 % men, mean age 63.2 ± 2.4 years) with PDR and chronic renal failure (CRF) requiring regular HD sessions (for at least 3 months). Patients were divided into two equal age, gender and number of patients (50 patients, 50 eyes) groups — the main group (MG), who underwent vitrectomy according to the developed technology, and the control group (CG), who underwent surgical intervention according to the traditional method. A comprehensive examination of the vision’s state was performed before and 14 days after surgery according to clinical and subjective indicators.Results. The data obtained indicate a more pronounced dynamics of the studied parameters in the MG compared to the CG, manifested by a significant (by 3–18 %) decrease in the incidence of intra and postoperative complications, a more pronounced (by 16.6 %, p < 0.01) decrease total score according to two developed specific subjective qualitative criteria for the condition of the fundus, a significantly higher (by 20 %) probability of an increase in BCVA, as well as a more significant increase in the level of the patient’s “quality of life” (by 10.4–14.9 %, p < 0.05 depending on the questionnaire used).Conclusion. The developed technology for performing vitrectomy in patients with PDR and end-stage chronic renal failure requiring continuous hemodialysis provides (compared to traditional) a higher level of safety and clinical efficacy due to an integrated approach to surgical intervention based on improving the stages of the operation (the maximum possible removal of the basal vitreum, performing peripheral endolaser coagulation, bimanual vitrectomy technique, and a number of others), as well as the developed medical and anesthetic support, which is confirmed (compared to the traditional technique) by a decrease in the incidence of intra and postoperative complications, as well as a more pronounced positive dynamics of BCVA, the state of the fundus and patient’s quality of life.

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