Ophthalmic diseases

The VIII Congress of Ophthalmologists took place in Minsk. Forum participants comment

Tatyana Imshenetskaya, head. Department of Ophthalmology BelMAPO, Doctor of Medical Sciences. sciences, professor

Since 2007, qualitative changes have been taking place in Belarus in the provision of ophthalmic surgical care to the population. Thus, for cataract surgery, in most cases, small incisions are used with the implantation of intraocular lenses, including toric and multifocal; the number of operations on the vitreous body and retina has increased 4 times.

Over the past 5 years, significant advances have been made in the treatment of retinopathy of prematurity. In 2010, 239 laser operations were performed, which made it possible to reduce the number of children with advanced stages of the disease by 2 times. Work is underway to introduce remote consultation of children with retinopathy of prematurity into widespread clinical practice under the leadership of the Republican Scientific and Practical Center “Mother and Child”.

Over 6 months of 2011, 130 corneal transplants were performed in the country, amniotic membrane transplantation for diseases of the ocular surface was introduced in the Vitebsk and Mogilev regions. Ophthalmo-oncology has achieved great success - the detection of stage 1–2 choroid melanomas has increased to 70% (previously only 20%). This became possible thanks to the close interaction of practical healthcare with the departments of ophthalmology of medical universities and BelMAPO, 6 instructions on methods of diagnosis, treatment, rehabilitation and prevention of ophthalmological diseases were developed and implemented, 12 patents for inventions were received, more than 50,000 patients were consulted. Over the course of 5 years, 105 ophthalmologists (every 7!) were trained in clinical residency. Ophthalmology is one of the most delicate areas of clinical medicine. The modern approach to the diagnosis and treatment of diseases and injuries of the organ of vision is a combination of highly informative, non-invasive diagnostic methods and filigree microsurgical techniques, which is only possible with the constant updating and improvement of the material and technical base and the education of a young, thinking doctor.

Your successes have a state approach

Galina Drozhzhina, head. Department of Pathology and Corneal Microsurgery, Odessa Institute of Eye Diseases and Tissue Therapy named after. V. P. Filatova, Dr. med. sciences, professor

I really liked the organization of the congress, lectures by leading experts on the most important problems: glaucoma, cataract extraction, vitreoretinal, plastic surgery, eye trauma, neuro-ophthalmology, etc. I would especially note the high scientific level of the reports of Belarusian ophthalmologists, beautifully designed presentations and evidence of the data provided. I am sincerely glad for the high level of this science in Belarus, for the state approach to solving the problems of transplantology in the country and the availability of this type of highly specialized surgical care for patients with pathologies of the eye and other organs and systems.

Pterygium plastic surgery

Galina Sitnik, Associate Professor of the Department of Ophthalmology of BelMAPO, Candidate of Medical Sciences. sciences

Men are 2–3 times more likely to suffer from pterygium (growth of fibrovascular tissue on the cornea). Risk factors are increased levels of ultraviolet or infrared radiation, infection with papillomaviruses, as well as... passion for hunting and fishing.

In the 10th City Clinical Hospital of Minsk from April 2010 to October 2011. 78 people with pterygium aged 32–86 years were treated. Patients complained of redness, inflammation and the presence of formation on the surface of the eye, severe visual fatigue, and a sensation of a foreign body in the eye.

To preserve visual functions and prevent relapses, to achieve a good cosmetic result, you have to resort to plastic surgery; for this, the surgeon primarily uses local tissue. This method is indicated for grades 1–2 of the disease, when only the active part (the head of the pterygium) is excised and the main volume of the conjunctiva is preserved.

For grade 3 and relapse, autoconjunctival graft plastic surgery is widely used in our clinic. The essence is extensive excision of scar tissue and altered outer shell of the eye. An autograft completely corresponding to the size of the defect is cut out from the outer part of the upper conjunctival fornix, then it is fixed to the area of the medial corner of the eye with interrupted sutures.

The combined method of plastic surgery is indicated for repeatedly recurrent forms, when, after excision of the scars, extensive damage to the tissues of the surface of the eye is discovered. Partial layer-by-layer corneal transplantation is performed when it is significantly damaged and thinned. Then the autoconjunctival graft is fixed directly at the limbus, and the remaining area is covered with the amniotic membrane - part of the placenta that has undergone special treatment and cryopreservation.

According to our observations, the combined method can increase the effectiveness of treatment up to 83%.

Pterygium is a complex pathology; to successfully correct it, it is extremely important to choose the correct surgical method and take into account all the individual characteristics of the patient.

Irina Yanushkevich, "MV".

“Today” of refractive surgery

Sergey Poznyak, ophthalmic surgeon, doctor of medicine. Sciences, Minsk

Ophthalmologists are faced with the problem of choosing the optimal correction method for various degrees of refractive error. If, when correcting myopia up to -10.0 D or farsightedness less than +3.0 D, the recommendations are clear, then for patients with myopic refraction more than -10.0 D or hyperopic refraction more than +3.0 D, there are alternatives.

A mandatory requirement for surgical correction of refractive errors is anatomical and functional safety for the eye and ensuring the desired refractive effect.

In modern refractive surgery, two directions have emerged: corneal and lenticular. It is important to choose a method for eliminating ametropia and justify the indications for keratorefractive and intraocular methods of surgical correction of refractive errors.

With excimer laser interventions in patients with farsightedness, despite the good results obtained, the frequency of reoperations is high (43.7%). For farsightedness more than +5.0 D, intraocular methods are still preferable.

Implantation of phakic (without removing the patient's own lens) intraocular lenses has not taken root in Belarus due to the high cost and dissatisfaction of surgeons and patients with the results of treatment.

When installing multifocal and toric intraocular lenses, the predicted refraction is achieved in more than 90% of patients. However, this technique requires a thorough and comprehensive examination of patients, as well as highly qualified surgeons.

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