[Modern aspects of reconstructive surgery for orbital trauma].

The article describes the symptoms of an indirect orbital injury. Special attention is paid to clinical manifestations of muscle entrapment after trapdoor fractures in pediatric patients. Advantages of an original method of functional MSCT for orbital trauma are specified.

[Pre- and postoperative ocular blood flow in transconjunctival orbital surgery].

Objective: to evaluate the pre- and postoperative ocular blood flow in patients with post-traumatic orbital deformities who underwent transconjunctival orbital reconstruction.

Material And Methods: A total of 40 patients with post-traumatic deformities of the inferior and medial orbital walls were examined before and after transconjunctival "Alloplant" implantation to the orbit.

Results: Before the surgery, blood flow deficiency in a.

[Giant cavernous hemangioma of the orbit (case report)].

The following case demonstrates a successful en bloc removal of a massive cavernous hemangioma of the orbit via vertical transpalpebral approach with postoperative improvement of optic nerve condition and optimal cosmetic result.

[Autofluorescent diagnostics of skin and mucosal tumors].

The article discusses the results of a research on fluorescent diagnostics of skin and mucosal tumors carried out by a workgroup of the Research Institute of Eye Diseases of the Russian Academy of Medical Sciences between 2006 and 2012. The main achievement to be mentioned is the development of an easy to perform, noninvasive, safe and economy method of autofluorescent image acquisition and analysis that does not require the use of protoporphyrin IX precusors or exogenous fluorophores. The research workgroup has also devised an original method of tumor probabilistic border estimation which is valuable for assessment of the extent of surgical intervention.

[Conceptual basics of paralytic lagophthalmos correction].

The article discusses complications of paralytic lagophthalmos, such as exposure keratopathy, keratitis, corneal lysis, as well as other exposure-related problems and abnormalities of eyelid position. Thorough analysis of surgical methods of eyelids malposition correction, besides conservative protective measures for the cornea, has been performed. The primary treatment goal in facial nerve paralysis is the prevention of severe corneal complications.

[Silent sinus syndrome (clinical case). New potential for enophthalmos correction].

Silent sinus syndrome (SSS) is a rare condition presenting with spontaneous enophthalmos and hypoglobus caused by volume reduction of maxillary sinus due to centripetal collapse of its walls. A case of SSS manifested during pregnancy in 43 years old patient is presented. In 16 months after manifestation of symptoms endoscopic sinus surgery was performed with no postoperative improvement of ocular symptoms.

[Eyelid reconstruction after full-thickness resections in benign and malignant tumors].

Full-thickness eyelid defect closure requires appropriate reconstruction, function recovery and acceptable cosmetic result. The aim of the study was to study the results of eyelid reconstruction after full-thickness resections in different benign and malignant tumors. 241 patients (63,5% females, 36,5% males) who underwent full-thickness resectioh of the lower or the upper eyelid due to tumor with primary defect closure were enrolled in the study.

[Improving efficacy of fluorescent diagnostics of skin and mucosal tumors in ocular oncology].

Developed in 2006 by our institute, the method of primary detection of skin and mucosal tumors based on non-induced fluorescence of endogenous protoporphyrin IX is used to estimate proliferative activity of tumor and its probable progression. This study was aimed to improve method efficacy by means of additional parameter which would quantitatively describe the interpenetration of tumor and surrounding tissues. The authors analyzed autofluorescent data of 97 patients and determined medico-biological factors which could cause controversal results (all cases were histologically controlled).

[Static correction of lagophthalmos in chronic facial palsy].

Choice of surgical option for lagophthalmos correction (use of encircling allotendinous string or fixation of medial aspect of the lower tarsal plate) in patients with chronic facial palsy is proved. This technique was reinforced with dissection of the tendon or superior tarsal muscle resection and lateral canthopexy. The advantages of surgical methods considering clinical aspects (in particular the degree of medial canthal tendon laxity) are shown.

[Functional multi-detector computed tomography in diagnosis of orbital fractures. The first results].

The first results of use of functional multi-detector computed tomography in diagnosis of orbital fractures with eye movement impairment are obtained. In addition to orbital bone fractures diagnosis this method allows to perform more detailed evaluation of orbital soft tissues particularly extraocular muscles. Proposed method allows differentiating paralytic and restrictive ophthalmoplegia, evaluate the function of extraocular muscles in severe orbital deformities.

[Comparative experimental study of current implant materials used in orbital surgery].

Reconstructive orbital procedures are often associated with the use of different implant materials, that may sometimes cause complications resulting in surgery efficacy impairing and need of reoperation. At the present time in Russia and abroad various orbital implants are used though there are no experimental or clinical studies comparing implant materials used In this study comparative experimental morphological investigation of biointegrative characteristics of 6 current orbital implant materials was performed, tissue reactions in response to implantation is described in details in laboratory animals, recommendations for implant use in clinic are given.

[The first experience of using an implant for upper eyelid loading in paralytic lagophthalmos].

The results of using an implant (weight) for upper eyelid loading to correct paralytic lagophthalmos in patients with chronic facial palsy are presented 7 patients (7 eyes) were included into the study. The weight was implanted into the upper eyelid and fixed to the tarsal plate. No intra- and postoperative complications caused by weight implantation into the upper eyelid were observed during 12 months of follow-up.

[Functional multislice spiral computed tomography of the rectus muscle of the eye in scar changes].

The study deals with the capacities of functional multislice spiral computed tomography (FMSCT) in choosing a treatment policy and planning the tactic and scope of surgery for posttraumatic scar changes in the rectus muscle of the eye. Orbital MSCT and FMSCT were conducted in 15 patients (30 orbits). The findings showed that it was necessary to perform orbital FMSCT in posttaumatic scar changes to evaluate the contractility of the rectus muscles and their involvement in the area where a fracture occurs.

[On conservative management of cicatricial eyelid malpositions].

Methods of conservative and complex rehabilitation of patients with cicatricial eyelid malpositions are proposed. Conservative treatment included developed regimen of antihomotoxic agents, different techniques of graduated extension of scar tissues, special eyelid exercises. In complex management conservative treatment was provided along with surgery, in some cases botulinum toxin A was administered.

[Morphology of conjunctival changes in thyroid eye disease].

The goal of the study was to determine morphological changes of conjunctiva underlying positive vital staining in TED. 46 patients (92 eyes) with TED were included into the study. Besides routine ophthalmologic examination they underwent impression cytology and histology.

[Risk factors of corneal damage in patients with Thyroid Eye Disease].

Risk factors of corneal involvement and association of keratopathy with HBD-2 gene expression were evaluated in patients with Thyroid Eye Disease (TED). 46 patients (92 eyes) were included into the study. Investigation included routine ophthalmological examination, palpebral measurements, Schirmer test I, vital staining, corneal sensitivity evaluation.

[Surgical treatment options for paralytic lagophthalmos].

Facial nerve palsy may result from a broad spectrum of causes, which is largely due to its topographic complexity. Different types of cross plastic surgery and nerve autografting and muscle transplantation and transposition are used to recover nerve function. Lagophthalmos is a most severe sequel of facial nerve palsy.

[Study of the three-dimensional structure and biointegrative characteristics of porous orbital implant materials].

Plastic repair operations in ophthalmic surgery frequently require the use of various biological and artificial implants. The biointegrative properties of implants are provided by the physicochemical characteristics of the material that is used to make them, by the three-dimensional structure of an implant and its immunological characteristics. The authors comparatively studied the three-dimensional structure of a Carbotexim-M carbonic felt, porous polyethylene, polytetrafluoroethylene, demineralized bone alloimplant, and marine coral hydroxyapatite, which are employed in orbital surgery and also examined the adhesion of fibroblasts to their surface.

[Materials used in orbital surgery].

Implant materials for orbital surgery are mainly used during orbital traumatic deformity-eliminating operations, postenucleation stump plasty, evisceration, and anophthalmic syndrome correction. There are currently a lot of biological and artificial implant materials, but there is no universal material to correct all types of defects and this makes surgeons use a great quantity of reparative procedures and techniques and scientists continue to search for more suitable implant materials. This paper reviews the currently available materials used in orbital surgery in Russia and foreign countries.

[The first experience in using the stabilized hyaluronic acid preparation to correct lagophthalmos].

The authors report the results of the first experience in using the stabilized hyaluronic acid preparation in patients with lagopthalmos in the presence of facial nerve palsy and thyroid eye disease and resultant keratopathy of varying degrees. The study included 21 patients, including 15 patients with facial nerve palsy and 6 with endocrine ophthalmopathy. The gel was injected externally to the levator aponeurosis and/or intramuscular, and/or under the pretarsal portion of the orbicularis oculi muscle, and/or subcutaneously.

[Experimental assessment of various external tarsorrhaphy techniques].

The authors first examined morphological differences in interpalpebral fibrous adhesions after "tongue-in-groove" tarsorrhaphy and tarsorrhaphy with additional periosteal fixation. Postsurgical interpalpebral fibrous adhesions indicate the advantages of tarsorrhaphy with periosteal fixation over "tongue-in-groove" tarsorrhaphy and suggest its preference for palpebral fissure narrowing and static correction of lagophthalmos.

[Involvement of lacrimal organs in Wegener's granulomatosis].

Wegener's granulomatosis (WG) is a primary systemic vasculitis characterized by the development of granulomatous inflammation and necrotizing vasculitis of small- and middle-sized vessels. The clinical symptoms of the involvement of lacrimal organs in WG are of no specificity. Lacrimal tract lesion is encountered in prolonged Wegener's granulomatosis.

[Complex treatment for decompensated edematous exophthalmos].

In endocrine ophthalmolopathy, there may be persistent dysfunction of the organ of vision due to corneal lesion or optical neuropathy. As an illustration of severe corneal lesion in edematous exophthalmos decompensation, the authors give their own observation that shows it necessary to use in such cases complex treatment comprising pulse therapy with glucocorticoids, followed by a long-term dosage reduction and switching over to its oral administration, as well radiotherapy and surgery.