The purpose: to determine the features of different stages of active retinopathy prematurely according to fluorescent angiography data.Patients and methods. In 2011–2017, 271 angiographic studies were performed in 207 premature infants born at 25–33 weeks of gestation with 710–1980 grams weight at birth, with different stages of active ROP in age of live 3–12 weeks (30-39 weeks of post-conceptual age). A voluntary informed consent to perform the examination was received from the legal representatives of all patients. FAG was performed using retinal pediatric digital video system “RetCam-3” with built-in angiographic unit under mask anesthesia, in the presence of anesthesiologist-resuscitator, under the monitor control of the respiratory and cardiovascular systems of the child.Results. Unfavorable types of active ROP are characterized by the specific manifestations that are not defined by the standard ophthalmologic methods: early flat neovascularization, the presence of small tortuous peripheral vessels with signs of leakage, reperfusion areas with an apparent lack of capillaries and shunts. This opens up the opportunities for early detection of stages of the disease requiring therapeutic measures. The aggressive posterior ROP is distinguished by a variety of angiographic patterns, the most important feature is the massive loss of the retinal capillary bed in the vascularized retina. FAG data about latent neovascularization and ischemic zones of the retina represent the particular value in the prediction of active ROP course.Conclusion. The obtained results could allow to make the most differentiated approach to the management of children with active ROP, timely and effectively predict the course of the disease and to performed adequate treatment based on objective indications.

Purpose — to perform a comparative analysis of the clinical efficacy of intrastromal keratoplasty (ISKP) in patients with keratoconus during surgery with and without Verion digital marking device.Patients and methods. 37 patients (50 eyes) with corneal astigmatism up to -5.0 diopters were included in the study. These patients were operated with the femtolaser method of ISKP with implantation of corneal segments. The average age of the patients was 27.96 ± 3.40 years. The observation period is from 3 to 12 months. All patients were divided into two groups depending on the surgical technique: Verion-assisted, using a digital marking device and taking into account the angle of cyclotorsia, or standard, without taking into account the angle of cyclotorsia. The first main group included 28 eyes (56 %), the second control group included 22 eyes (44 %) accordingly.Results. The functional results after ISKP in both groups were quite good. Stabilization of functional parameters and keratometric data was noted in the postoperative period, by 3 months. Patients of the main group showed a statistically significant (p < 0.05) increase in average uncorrected visual acuity to 0.50 ± 0.16, and visual acuity with maximum correction to 0.70 ± 0.12 (p < 0.05). The average keratometry of the weak meridian decreased to 44.3 ± 1.4 diopters, the average keratometry of the strong meridian decreased to 50.8 ± 3.2 diopters. Patients in the control group showed a statistically significant (p < 0.05) increase in average uncorrected visual acuity to 0.45 ± 0.12, and visual acuity with maximum correction to 0.60 ± 0.17. The average values of keratometry of the weak meridian decreased to 45.3 ± 1.8 diopters, the average values of keratometry of the strong meridian decreased to 51.8 ± 2.2 diopters. The results of the vector analysis reliably indicate a significantly higher accuracy of the Verion-assisted ISKP. Which is confirmed by the achieved indicators of the “success” index, the calculated astigmatism vector close to the actual postoperative astigmatism vector, the smaller the magnitude of the astigmatism axis difference vector compared to the control.Conclusion. The use of the Verion-assisted intrastromal technique for keratoconus reduces the risk of erroneous positioning of the corneal segments in the tunnel during transferring diagnostic data to the operating room. Taking into account the angle of cyclotorsia during cutting into the intrastromal tunnel increases the effective correction of the cylindrical component of refraction, which is confirmed by the main coefficients of the vector analysis by N. Alpins.

For the treatment of progressive keratoconus in the early stages, corneal collagen crosslinking is currently actively used. This technique is based on the stabilization of the pathological process by increasing the biomechanical properties of the own cornea. The thickness of the cornea less than 400 microns significantly limits the possibility of a standard cross-linking procedure performing.The article analyzes the literature data on the use of various methods of corneal crosslinking with a corneal thickness of less than 400 microns, which signifi cantly limits the possibilities of the standard procedure.It is known, that during crosslinking, at the initial stage, de-epithelialization of the cornea is performed, which, in the postoperative period, leads to a pronounced corneal syndrome. This determined the direction of the fi rst modifi cations of the technique associated with the use of partial de-epithelialization or its complete absence. Later, during cross-linking of “thin” corneas, techniques with the use of additional covering materials were actively used in order to replenish the missing corneal tissue of the patient during the UV irradiation procedure. Among them are the use of a soft contact lens without an ultraviolet fi lter, the use of a corneal lenticule obtained after SMILE surgery, the use of a protective fl ap of the donor cornea obtained using a femtosecond laser from the residual stroma of the corneal disc after descemet membrane transplantation or posterior lamellar keratoplasty. The variety of the proposed modifications and the ongoing search for better options indicate the demand for this technology and the need for further research, taking into account the individual characteristics of the patient’s ectasia.