[Hybrid phacoemulsification: a new stage in the improvement of cataract surgery (?)].

Purpose: To evaluate the early results of femtosecond laser application in phacoemulsification of cataracts of different density.

Material And Methods: Femtosecond laser-assisted phacoemulsification cataract surgery was performed on 277 patients (390 surgeries) with II-IV degree lens nuclear density.

Results: The use of femtosecond laser for capsulorexis and lens nucleus fragmentation enables forming of a well-shaped, properly sized, and accurately centered aperture in the anterior lens capsule, reduces the equivalent time of ultrasound exposure (by 30% in average) and decreases the total time of nuclear fragments emulsification by a third.

[Modern methods of astigmatism correction in cataract surgery].

Modern methods of astigmatism correction in lens surgery are reviewed in the article. Keratorefractive, including laser-assisted, and intraocular techniques employing different models of toric intraocular lenses (IOL) are described. Current state of the problem is analyzed.

[Hypotensive efficacy of combined pathogenically oriented surgical treatment of cataract and primary open-angle glaucoma].

A new algorithm of combined surgical treatment of cataract and glaucoma was developed. It enables selection of a proper method of pathogenically oriented antiglaucomatous intervention, decreases surgical trauma, facilitates normalization of intraocular pressure and helps stabilizing the course of the disease. Another development is a modification of combined phacoemulsification and trabeculectomy ab interno, aimed at increasing visual and hypotensive results.

[Calculation of intraocular lens power in non-standard clinical situations].

Methods of intraocular lens (IOL) calculation in non-standard clinical situations have been developed and introduced. These include a formula that improves the calculation accuracy in patients with relatively short anterior-posterior axis and another method for eyes after previous radial keratotomy. A comparative clinical evaluation of the proposed methods has been performed.

[Some features of phakoemulsification in lens subluxation].

A study was performed to compare three techniques of phakoemulsification (PE) (use of iris retractors, capsular ring and their combination) in 315 patients (407 eyes) with cataract and lens subluxation of different degree. A PE technique was proposed and studied in clinic using developed method of extracapsular fragmentation of two nuclear halves. Proposed and clinically approved surgical techniques (10 years follow-up) as well as differentiated approach for choosing surgical method in patients with lens subluxation let perform surgery less traumatically with minimal complication rate, get excellent and stable results during long-term follow-up.

[Comparative study of posterior corneal epithelium after different cataract phacoemulsifiication techniques].

Comparative study of posterior corneal epithelium showed that ultrasound torsional phacoemulsification (OZil) at present is the most preserving technique with regard to posterior epithelium damage. Hidromonitoring phacofragmentation has comparable results in grade II nucleus density in terms of posterior epithelial cell loss. Torsional phacoemulsification in patients with grade IV nucleus density is the most effective and preserving low-energy technique of cataract removal.

[Comparison study of new nucleus fragmentation technique in dense cataract phacoemulsification].

Comparison study of new fragmentation technique of dense nucleus in ultrasound phacoemulsification is performed. Proposed method of dense nucleus fragmentation allows to decrease equivalent time of ultrasound exposure using Ozil and NeoSoniX techniques. Minimal loss of corneal posterior epithelial cells was showed in combination of developed nucleus fragmentation technique with torsional phacoemulsification (Ozil).

[Results of combination surgical treatment for open-angle glaucoma and cataract].

The results of 257 combined, pathogenically oriented operations were analyzed in 181 patients with cataract concurrent with open-angle glaucoma (OAG). A system of pathogenically oriented combined surgical interventions was shown to be highly effective in patients with cataract concurrent with OAG. The proposed procedure for intraoperative determination of the retention of intraocular fluid allows a pathogenically oriented antiglaucomatous component of combined surgery to be chosen in patients with cataract and OAG.

[Evaluation of the efficiency of hydromonitoring phacofragmentation versus ultrasound phacoemulsification on the morphometric parameters of the central retinal region].

Morphometric studies using a laser retinal thickness showed great differences in the impact of hydromonitoring phacofragmentation and ultrasound phacoemulsification on the thickness of the central retinal region. Unlike ultrasound phacoemulsification, hydromonitoring phacofragmentation caused no transient increase in the thickness of the central retinal area. The performed studies revealed no correlation between the equivalent time of ultrasound and ultrasound phacoemulsification and the changes in the thickness of the central retinal region and fovea.

[Intraocular and spectacular chromatographic correction in opacities of the posterior lenticular capsule].

Intraocular and spectacular chromatographic correction was comparatively studied by examining blindness and spatial contrast sensitivities in 81 patients (116 eyes) after implantation of achromatic and chromatic hydrophobic acrylic intraocular lenses (IOL). Spectacular chromatic correction with yellow filters was additionally used in patients with achromatic IOL. 1.

[Phacoemulsification of cataract in patients with high myopia].

We conducted a study for the purpose of developing a phacoemulsification technique for patients with high myopia optimized for the specificity of myopic eye. The study involved 124 (165 eyes) patients with high myopia and cataract. The lens density in operated patients was of degrees II-IV according to Buratto.

[A new method of macrofragmentation of dense nuclei by using loop fragmentizer].

The study results showed a principle possibility to fragmentize the most dense lens nuclei by means of a nylon cutting loop. The safety and efficiency of applying a loop fragmentizer in phacoemulsification of high-density cataract were equally demonstrated. The method advantages are conditioned by that a preliminary splitting of the nucleus into fragments without trenches being shaped cuts essentially the total capacity and duration of ultrasound impact, thus, the irrigation time and the needed volume of balance salt solution also decrease intraoperatively: it, naturally, diminishes the generally-known traumatic aftermaths of surgical intervention.

[Original method of extracapsule fragmentation of the lens nucleus during phacoemulsification].

Clinical estimation of different modifications of phacoemulsification revealed the formation of the second tunnel in the nucleus for its division into quadrants in "four-quadrant phaco" increases the required duration of ultrasonography (US) and irrigation, which causes greater endothelial losses associated with the use of nuclear breakdown by means of a chopper tunnel. When the authors used their own methods of "extracapsular half-nuclei" fragmentation, endothelial losses are rather greater than those with the similar method "stop & "chop", which is associated with closer disposition of the US tip to the posterior corneal surface. At the same time nuclear breakdown by means a chapper in the capsular sac by the "stop & chop" method causes dilation of Zinn's ligaments, fraught by their rupture, particularly if latent derangement or defects of the zonular apparatus, and increases the risk of damage to the posterior capsule by the chopper.