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The aim of the study. To develop a mathematical model of changes in corneal refraction during femtosecond laser-assisted lenticule extraction through a small surgical incision and, on this basis, to propose a technology for modified calculation of surgical parameters and to prove its effectiveness. Material and methods. The study included 191 patients with high myopia. They were divided into two groups: group 1 consisted of 55 patients who were had SMILE (SMall Incision Lenticule Extraction) surgery with standard calculations; group 2 included 136 patients who had SMILE surgery with a modified calculation of surgical parameters based on the developed mathematical model of the refractive effect of the surgery. Results. When assessing the refractive effect of patients who were operated using standard technology, it was found that it was possible to achieve a refraction different from emmetropia for ± 0.5 D only in 51 % of cases; in the remaining patients, the planned residual refractive effect was obtained and averaged –1.96 ± 0.29 D. In patients operated using the modified technology, a statistically significantly better refractive result was achieved already on the first day. A refractive error of more than ± 1.0 D was obtained in only 1 % of cases; a deviation from the calculated refraction of ± 0.5 D was achieved in 82 % of cases, with the average values by 1 year –0.24 ± 0.57 D. Conclusions. The developed technology of a modified calculation of the parameters of the SMILE surgery for high myopia correction makes it possible to obtain an optimal refractive effect in compliance with safety rules when the structural and functional parameters of the eye are initially unfavorable for refractive surgery.
The aim of the study. To develop a mathematical model of changes in corneal refraction during femtosecond laser-assisted lenticule extraction through a small surgical incision and, on this basis, to propose a technology for modified calculation of surgical parameters and to prove its effectiveness. Material and methods. The study included 191 patients with high myopia. They were divided into two groups: group 1 consisted of 55 patients who were had SMILE (SMall Incision Lenticule Extraction) surgery with standard calculations; group 2 included 136 patients who had SMILE surgery with a modified calculation of surgical parameters based on the developed mathematical model of the refractive effect of the surgery. Results. When assessing the refractive effect of patients who were operated using standard technology, it was found that it was possible to achieve a refraction different from emmetropia for ± 0.5 D only in 51 % of cases; in the remaining patients, the planned residual refractive effect was obtained and averaged –1.96 ± 0.29 D. In patients operated using the modified technology, a statistically significantly better refractive result was achieved already on the first day. A refractive error of more than ± 1.0 D was obtained in only 1 % of cases; a deviation from the calculated refraction of ± 0.5 D was achieved in 82 % of cases, with the average values by 1 year –0.24 ± 0.57 D. Conclusions. The developed technology of a modified calculation of the parameters of the SMILE surgery for high myopia correction makes it possible to obtain an optimal refractive effect in compliance with safety rules when the structural and functional parameters of the eye are initially unfavorable for refractive surgery.
PURPOSE. To study the epidemiological features of glaucoma prevalence among the population of the Russian Federation and to assess the organization of primary specialized medical care for patients with this pathology.MATERIALS AND METHODS. The subject of this study was the population of the Russian Federation diagnosed with glaucoma. In order to assess the epidemiological features of glaucoma prevalence and to assess the organization of primary specialized medical care for patients with this pathology, according to the federal statistical reporting forms (Forms No. 12, No. 30), the following indicators were calculated: overall and primary incidence of glaucoma in the general population; proportion of patients with glaucoma who are registered with ophthalmologists; availability of ophthalmologists (individuals) per 100 thousand population; proportion of patients with glaucoma diagnosis established during preventive examinations; total number of registered patients with blindness and visual impairment. Statistical processing of the material involved methods of descriptive statistics; calculation of average and relative values with a preliminary assessment of the distribution of indicators for normality. Spearman rank correlation method was used to determine the correlation between quantitative variables.RESULTS. The studied data was used to calculate the following average values: total and primary glaucoma incidence among the population of the Russian Federation — 78.2 (55.8–105.3) cases per 100 thousand population; the proportion of patients with dispensary registered glaucoma — 80% (74.4–85.8%). The performed correlation analysis established a moderate direct statistically significant relationship between the indicators of total and primary glaucoma incidence among the population (rank correlation coefficient: r=0.72 at p<0.05). In its turn, the correlation between the indicators of glaucoma incidence among the population and the availability of ophthalmologists for the population has not been established (r=0.14, p>0.05). It was found that the indicators of dispensary observation of glaucoma patients do not depend on the indicators of total glaucoma incidence (r=0.16) and availability of ophthalmologists for the population (r=0.13). There is a weak inverse correlation between the proportion of glaucoma cases detected during preventive examinations and the indicator of primary glaucoma incidence among the population (r=-0.28; p<0.05). Also, the correlation analysis did not establish a relationship between the indicator of total glaucoma incidence among the population and the total number of registered patients with blindness and low vision (r=-0.008).CONCLUSION. The incidence rate of glaucoma in specific administrative territories should be assessed by comparison with the average values among the whole population, which are represented by the median and quarterly ranges. The incidence rate of glaucoma in the general population is not statistically related to the level of availability of ophthalmologists for the population. The proportion of follow-up observation of glaucoma patients does not depend on the availability of ophthalmologists and the level of glaucoma incidence. The incidence of blindness and low vision does not statistically correlate with the incidence of glaucoma in the population.
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